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End-of-life care for people with severe mental illness: the MENLOC evidence synthesis

Ben Hannigan Orcid Logo, Deborah Edwards Orcid Logo, Sally Anstey Orcid Logo, Michael Coffey Orcid Logo, Paul Gill Orcid Logo, Mala Mann Orcid Logo, Alan Meudell Orcid Logo

Health and Social Care Delivery Research, Volume: 10, Issue: 4, Pages: 1 - 206

Swansea University Author: Michael Coffey Orcid Logo

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    Copyright © 2022 Hannigan et al. This work was produced by Hannigan et al. under the terms of a commissioning contract issued by the Secretary of State for Health and Social Care. This is an Open Access publication distributed under the terms of the Creative Commons Attribution CC BY 4.0 licence

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DOI (Published version): 10.3310/ulti9178

Abstract

Background: People with severe mental illness have significant comorbidities and a reduced life expectancy.This project answered the following question: what evidence is there relating to the organisation, provision and receipt of care for people with severe mental illness who have an additional dia...

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Published in: Health and Social Care Delivery Research
ISSN: 2755-0060 2755-0079
Published: National Institute for Health Research 2022
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URI: https://cronfa.swan.ac.uk/Record/cronfa59566
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fullrecord <?xml version="1.0"?><rfc1807><datestamp>2022-11-21T11:54:12.5207479</datestamp><bib-version>v2</bib-version><id>59566</id><entry>2022-03-09</entry><title>End-of-life care for people with severe mental illness: the MENLOC evidence synthesis</title><swanseaauthors><author><sid>12112bd2ce15561464c98607f3a8eb0b</sid><ORCID>0000-0002-0380-4704</ORCID><firstname>Michael</firstname><surname>Coffey</surname><name>Michael Coffey</name><active>true</active><ethesisStudent>false</ethesisStudent></author></swanseaauthors><date>2022-03-09</date><deptcode>PHAC</deptcode><abstract>Background: People with severe mental illness have significant comorbidities and a reduced life expectancy.This project answered the following question: what evidence is there relating to the organisation, provision and receipt of care for people with severe mental illness who have an additional diagnosis of advanced incurable cancer and/or end-stage lung, heart, renal or liver failure and who are likely to die within the next 12 months?Objectives: The objectives were to locate, appraise and synthesise relevant research; to locate andsynthesise policy, guidance, case reports and other grey and non-research literature; to produceoutputs with clear implications for service commissioning, organisation and provision; and to makerecommendations for future research.Review methods: This systematic review and narrative synthesis followed international standards andwas informed by an advisory group that included people with experience of mental health and end-of-life services. Database searches were supplemented with searches for grey and non-research literature. Relevance and quality were assessed, and data were extracted prior to narrative synthesis. Confidence in synthesised research findings was assessed using the Grading of Recommendations, Assessment, Development and Evaluation and the Confidence in the Evidence from Reviews of Qualitative Research approaches.Results: One hundred and four publications were included in two syntheses: 34 research publications,42 case studies and 28 non-research items. No research was excluded because of poor quality. Research, policy and guidance were synthesised using four themes: structure of the system, professional issues, contexts of care and living with severe mental illness. Case studies were synthesised using five themes: diagnostic delay and overshadowing, decisional capacity and dilemmas, medical futility, individuals and their networks, and care provision.Conclusions: A high degree of confidence applied to 10 of the 52 Grading of Recommendations, Assessment, Development and Evaluation and Confidence in the Evidence from Reviews of QualitativeResearch summary statements. Drawing on these statements, policy, services and practice implicationsare as follows: formal and informal partnership opportunities should be taken across the whole system, and ways need to be found to support people to die where they choose; staff caring for people with severe mental illness at the end of life need education, support and supervision; services for people with severe mental illness at the end of life necessitate a team approach, including advocacy; and the timely provision of palliative care requires proactive physical health care for people with severe mental illness. Research recommendations are as follows: patient- and family-facing studies are needed to establish the factors helping and hindering care in the UK context; and studies are needed that co-produce and evaluate new ways of providing and organising end-of-life care for people with severe mental illness, including people who are structurally disadvantaged.</abstract><type>Journal Article</type><journal>Health and Social Care Delivery Research</journal><volume>10</volume><journalNumber>4</journalNumber><paginationStart>1</paginationStart><paginationEnd>206</paginationEnd><publisher>National Institute for Health Research</publisher><placeOfPublication/><isbnPrint/><isbnElectronic/><issnPrint>2755-0060</issnPrint><issnElectronic>2755-0079</issnElectronic><keywords/><publishedDay>1</publishedDay><publishedMonth>3</publishedMonth><publishedYear>2022</publishedYear><publishedDate>2022-03-01</publishedDate><doi>10.3310/ulti9178</doi><url/><notes/><college>COLLEGE NANME</college><department>Public Health</department><CollegeCode>COLLEGE CODE</CollegeCode><DepartmentCode>PHAC</DepartmentCode><institution>Swansea University</institution><apcterm>Not Required</apcterm><funders>This project was funded by the National Institute for Health Research (NIHR) Health and Social Care Delivery Research programme</funders><projectreference>17/100/15</projectreference><lastEdited>2022-11-21T11:54:12.5207479</lastEdited><Created>2022-03-09T15:03:26.4372555</Created><path><level id="1">Faculty of Medicine, Health and Life Sciences</level><level id="2">School of Health and Social Care - Public Health</level></path><authors><author><firstname>Ben</firstname><surname>Hannigan</surname><orcid>0000-0002-2512-6721</orcid><order>1</order></author><author><firstname>Deborah</firstname><surname>Edwards</surname><orcid>0000-0003-1885-9297</orcid><order>2</order></author><author><firstname>Sally</firstname><surname>Anstey</surname><orcid>0000-0003-2295-3761</orcid><order>3</order></author><author><firstname>Michael</firstname><surname>Coffey</surname><orcid>0000-0002-0380-4704</orcid><order>4</order></author><author><firstname>Paul</firstname><surname>Gill</surname><orcid>0000-0003-4056-3230</orcid><order>5</order></author><author><firstname>Mala</firstname><surname>Mann</surname><orcid>0000-0002-2554-9265</orcid><order>6</order></author><author><firstname>Alan</firstname><surname>Meudell</surname><orcid>0000-0001-8138-4744</orcid><order>7</order></author></authors><documents><document><filename>59566__22560__aeb0129736094231ba80f5752143ac5b.pdf</filename><originalFilename>Menloc Final Report as Published.pdf</originalFilename><uploaded>2022-03-09T15:07:05.5432436</uploaded><type>Output</type><contentLength>7910643</contentLength><contentType>application/pdf</contentType><version>Version of Record</version><cronfaStatus>true</cronfaStatus><documentNotes>Copyright &#xA9; 2022 Hannigan et al. This work was produced by Hannigan et al. under the terms of a commissioning contract issued by the Secretary of State for Health and Social Care. This is an Open Access publication distributed under the terms of the Creative Commons Attribution CC BY 4.0 licence</documentNotes><copyrightCorrect>true</copyrightCorrect><language>eng</language><licence>https://creativecommons.org/licenses/by/4.0/</licence></document></documents><OutputDurs/></rfc1807>
spelling 2022-11-21T11:54:12.5207479 v2 59566 2022-03-09 End-of-life care for people with severe mental illness: the MENLOC evidence synthesis 12112bd2ce15561464c98607f3a8eb0b 0000-0002-0380-4704 Michael Coffey Michael Coffey true false 2022-03-09 PHAC Background: People with severe mental illness have significant comorbidities and a reduced life expectancy.This project answered the following question: what evidence is there relating to the organisation, provision and receipt of care for people with severe mental illness who have an additional diagnosis of advanced incurable cancer and/or end-stage lung, heart, renal or liver failure and who are likely to die within the next 12 months?Objectives: The objectives were to locate, appraise and synthesise relevant research; to locate andsynthesise policy, guidance, case reports and other grey and non-research literature; to produceoutputs with clear implications for service commissioning, organisation and provision; and to makerecommendations for future research.Review methods: This systematic review and narrative synthesis followed international standards andwas informed by an advisory group that included people with experience of mental health and end-of-life services. Database searches were supplemented with searches for grey and non-research literature. Relevance and quality were assessed, and data were extracted prior to narrative synthesis. Confidence in synthesised research findings was assessed using the Grading of Recommendations, Assessment, Development and Evaluation and the Confidence in the Evidence from Reviews of Qualitative Research approaches.Results: One hundred and four publications were included in two syntheses: 34 research publications,42 case studies and 28 non-research items. No research was excluded because of poor quality. Research, policy and guidance were synthesised using four themes: structure of the system, professional issues, contexts of care and living with severe mental illness. Case studies were synthesised using five themes: diagnostic delay and overshadowing, decisional capacity and dilemmas, medical futility, individuals and their networks, and care provision.Conclusions: A high degree of confidence applied to 10 of the 52 Grading of Recommendations, Assessment, Development and Evaluation and Confidence in the Evidence from Reviews of QualitativeResearch summary statements. Drawing on these statements, policy, services and practice implicationsare as follows: formal and informal partnership opportunities should be taken across the whole system, and ways need to be found to support people to die where they choose; staff caring for people with severe mental illness at the end of life need education, support and supervision; services for people with severe mental illness at the end of life necessitate a team approach, including advocacy; and the timely provision of palliative care requires proactive physical health care for people with severe mental illness. Research recommendations are as follows: patient- and family-facing studies are needed to establish the factors helping and hindering care in the UK context; and studies are needed that co-produce and evaluate new ways of providing and organising end-of-life care for people with severe mental illness, including people who are structurally disadvantaged. Journal Article Health and Social Care Delivery Research 10 4 1 206 National Institute for Health Research 2755-0060 2755-0079 1 3 2022 2022-03-01 10.3310/ulti9178 COLLEGE NANME Public Health COLLEGE CODE PHAC Swansea University Not Required This project was funded by the National Institute for Health Research (NIHR) Health and Social Care Delivery Research programme 17/100/15 2022-11-21T11:54:12.5207479 2022-03-09T15:03:26.4372555 Faculty of Medicine, Health and Life Sciences School of Health and Social Care - Public Health Ben Hannigan 0000-0002-2512-6721 1 Deborah Edwards 0000-0003-1885-9297 2 Sally Anstey 0000-0003-2295-3761 3 Michael Coffey 0000-0002-0380-4704 4 Paul Gill 0000-0003-4056-3230 5 Mala Mann 0000-0002-2554-9265 6 Alan Meudell 0000-0001-8138-4744 7 59566__22560__aeb0129736094231ba80f5752143ac5b.pdf Menloc Final Report as Published.pdf 2022-03-09T15:07:05.5432436 Output 7910643 application/pdf Version of Record true Copyright © 2022 Hannigan et al. This work was produced by Hannigan et al. under the terms of a commissioning contract issued by the Secretary of State for Health and Social Care. This is an Open Access publication distributed under the terms of the Creative Commons Attribution CC BY 4.0 licence true eng https://creativecommons.org/licenses/by/4.0/
title End-of-life care for people with severe mental illness: the MENLOC evidence synthesis
spellingShingle End-of-life care for people with severe mental illness: the MENLOC evidence synthesis
Michael Coffey
title_short End-of-life care for people with severe mental illness: the MENLOC evidence synthesis
title_full End-of-life care for people with severe mental illness: the MENLOC evidence synthesis
title_fullStr End-of-life care for people with severe mental illness: the MENLOC evidence synthesis
title_full_unstemmed End-of-life care for people with severe mental illness: the MENLOC evidence synthesis
title_sort End-of-life care for people with severe mental illness: the MENLOC evidence synthesis
author_id_str_mv 12112bd2ce15561464c98607f3a8eb0b
author_id_fullname_str_mv 12112bd2ce15561464c98607f3a8eb0b_***_Michael Coffey
author Michael Coffey
author2 Ben Hannigan
Deborah Edwards
Sally Anstey
Michael Coffey
Paul Gill
Mala Mann
Alan Meudell
format Journal article
container_title Health and Social Care Delivery Research
container_volume 10
container_issue 4
container_start_page 1
publishDate 2022
institution Swansea University
issn 2755-0060
2755-0079
doi_str_mv 10.3310/ulti9178
publisher National Institute for Health Research
college_str Faculty of Medicine, Health and Life Sciences
hierarchytype
hierarchy_top_id facultyofmedicinehealthandlifesciences
hierarchy_top_title Faculty of Medicine, Health and Life Sciences
hierarchy_parent_id facultyofmedicinehealthandlifesciences
hierarchy_parent_title Faculty of Medicine, Health and Life Sciences
department_str School of Health and Social Care - Public Health{{{_:::_}}}Faculty of Medicine, Health and Life Sciences{{{_:::_}}}School of Health and Social Care - Public Health
document_store_str 1
active_str 0
description Background: People with severe mental illness have significant comorbidities and a reduced life expectancy.This project answered the following question: what evidence is there relating to the organisation, provision and receipt of care for people with severe mental illness who have an additional diagnosis of advanced incurable cancer and/or end-stage lung, heart, renal or liver failure and who are likely to die within the next 12 months?Objectives: The objectives were to locate, appraise and synthesise relevant research; to locate andsynthesise policy, guidance, case reports and other grey and non-research literature; to produceoutputs with clear implications for service commissioning, organisation and provision; and to makerecommendations for future research.Review methods: This systematic review and narrative synthesis followed international standards andwas informed by an advisory group that included people with experience of mental health and end-of-life services. Database searches were supplemented with searches for grey and non-research literature. Relevance and quality were assessed, and data were extracted prior to narrative synthesis. Confidence in synthesised research findings was assessed using the Grading of Recommendations, Assessment, Development and Evaluation and the Confidence in the Evidence from Reviews of Qualitative Research approaches.Results: One hundred and four publications were included in two syntheses: 34 research publications,42 case studies and 28 non-research items. No research was excluded because of poor quality. Research, policy and guidance were synthesised using four themes: structure of the system, professional issues, contexts of care and living with severe mental illness. Case studies were synthesised using five themes: diagnostic delay and overshadowing, decisional capacity and dilemmas, medical futility, individuals and their networks, and care provision.Conclusions: A high degree of confidence applied to 10 of the 52 Grading of Recommendations, Assessment, Development and Evaluation and Confidence in the Evidence from Reviews of QualitativeResearch summary statements. Drawing on these statements, policy, services and practice implicationsare as follows: formal and informal partnership opportunities should be taken across the whole system, and ways need to be found to support people to die where they choose; staff caring for people with severe mental illness at the end of life need education, support and supervision; services for people with severe mental illness at the end of life necessitate a team approach, including advocacy; and the timely provision of palliative care requires proactive physical health care for people with severe mental illness. Research recommendations are as follows: patient- and family-facing studies are needed to establish the factors helping and hindering care in the UK context; and studies are needed that co-produce and evaluate new ways of providing and organising end-of-life care for people with severe mental illness, including people who are structurally disadvantaged.
published_date 2022-03-01T04:16:59Z
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score 11.012678

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