End-of-life care and mental illness: a model for community psychiatry and beyond

UMMS Affiliation

Department of Psychiatry



Document Type


Medical Subject Headings

Bioethics; Chronic Disease; *Community Psychiatry; Decision Making; Health Services Research; Humans; Mental Competency; *Mental Disorders; Models, Theoretical; Risk Assessment; Stereotyping; Suicide; *Terminal Care; United States


Bioethics and Medical Ethics | Mental and Social Health | Psychiatry | Psychiatry and Psychology


End-of-life care is often influenced by the stereotyping of patients by age, diagnosis, or cultural identity. Two common stereotypes arise from the presumed incompetence of many patients to contribute to end-of-life decisions, and the fear that the discussions themselves will be de-stabilizing. We present a model for end-of-life discussions that combines competence assessment with healthcare preferences in a psychiatric population that faces identical stereotypes. The model, which draws on clinical research in competence and suicide risk assessment, has important implications for all patients in the community who are marginalized or stereotyped during discussions of end-of-life treatment.

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Citation: Community Ment Health J. 2004 Feb;40(1):3-16.

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Link to Article in PubMed

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