Pediatric Palliative Care and Child Psychiatry: A Model for Enhancing Practice and Collaboration

Abstract

As the field of Pediatric Palliative Care continues to develop, it is important to consider the scope of practice and the utility of collaboration with other specialties, including child and adolescent psychiatry. The integration of psychiatry and palliative medicine has been explored in adult practice, but has not yet been elaborated in pediatrics. This article proposes a clinical model of care that highlights the overlapping and unique expertise that each discipline brings, in a continuum of collaboration, and proposes an integrated care model for the most complex patients and families. Case examples are used to define specific professional skills and roles, and to describe shared and distinct clinical approaches used by pediatric palliative care and child psychiatry. Effective collaboration provides opportunities for cross-disciplinary educational exchange and enhanced care of children and families with comorbid mental health issues and serious illness.

Psychotropic medication use trends in a large pediatric and young adult solid organ transplant population

“…Psychiatric involvement in end‐of‐life care is becoming more widely appreciated due to severe symptoms at end of life . This was mirrored in our results by greater lifetime psychotropic usage and consultation in transplant patients that had end‐of‐life disease progression and died.…”

“…Psychiatric involvement in end-of-life care is becoming more widely appreciated due to severe symptoms at end of life. [44][45][46] In addition to the limitations and future studies previously discussed, other notable constraints included the data set being from a single transplant center, which may limit the generalizability of the study, and an analysis of retrospective data. The binary psychopharmacologic variable study design also limits conclusions about the differential indication for psychotropic usage over time and specific inciting events.…”

Characteristics of Child and Adolescent Psychiatry Consultations at a University Hospital and Accuracy Rates of Recognition of Childhood Psychiatric Diseases by Nonpsychiatry Specialists

“…Organization of awareness-raising trainings by CLP teams for non-psychiatric physicians and holding meetings where complex cases are discussed with a multidisciplinary perspective by psychiatrists and non-psychiatric physicians in psychiatry clinics can raise awareness about the issue and contribute to the more effective use of CLP services. As a matter of fact, the results of relevant studies available in the literature indicate that cooperation among physicians and consultations have increased as a result of the development and implementation of new models that provide effective use of CLP (26,27).…”

The 2023-2026 Hospice and Palliative Nurses Association Research Agenda

“…In addition, limited research has examined the intersection of PPHC and mental illness and, in particular, the assessment and treatment of mental illness in pediatric patients who receive or who could benefit from both palliative and psychiatric care. [119][120][121] Further, as pediatric chronic illness management and palliative/hospice care shifts more heavily into the home setting and as treatment options become increasingly sophisticated, research that aims to understand patients', parents', home care nurses', and palliative and hospice providers' experiences of symptom assessment and management in the home is necessary. 79,86,122 Similarly, we must also improve symptom assessment and management for minoritized, historically marginalized communities.…”