Integration of palliative care approach into community mental health service may further reduce emergency admissions

We read the article by Ma CF et al. with great interest.1Ma C.F. Luo H. Leung S.F. al.Impact of community mental health services on adult psychiatric admission through emergency unit: a 20-year population-based study.Lancet Reg Health West Pac. 2023; 100814https://doi.org/10.1016/j.lanwpc.2023.100814Summary Full Text PDF Scopus (0) Google Scholar In this study, patients severe disorders (SPD) benefited less from in Hong Kong terms reduction. believe that palliative care could provide better support for SPD their later stages life, potentially resulting fewer unnecessary admissions. Palliative is "an approach improves quality life (QOL) and families facing problem associated life-threatening illness." Patients should have access to because they more comorbidities shorter lifespan than general population.2Edwards D. Anstey S. Coffey M. al.End people illness: mixed methods systematic review thematic synthesis (the MENLOC study).Palliat Med. 2021; 35: 1747-1760Crossref PubMed (3) They are likely utilize healthcare resources like room visits or hospitalizations. According cohort study Canada, mean total 3-year costs department chronic illnesses (CA$1820) were much higher those without (CA$850).3Sporinova B. Manns Tonelli al.Association utilization among adults disease.JAMA Netw Open. 2019; 2e199910Crossref (61) However, SPD, challenges integration evident multiple levels.2Edwards fact, coordinated who terminally ill history repeated acute admissions lacking.2Edwards Some special features help reduce include early assessment, holistic care. The home nurse usually case manager available during even after office hours. team helps prevent unforeseen hospitalizations predicting clinical problems making necessary arrangements, such as elective unit outpatient clinic symptom management. effectively manage, continuously monitor, rapidly handle patient's condition. addition, direct advocate greater when it required assist patient avoid caregiver burnout. Previous literature showed insufficient control inability cope leading causes end-of-life, other factors.2Edwards One revealed service was introduced disease trajectory, there improved satisfaction frequent hospitalizations.4Saunders Killackey T. Kurahashi A. al.Palliative transitions community-based care-a systemic review.J Pain Symptom Manage. 58: 721-734Summary certain studies, may be outcomes individuals critical illnesses.5Kutney-Lee Khazanov G.K. Carpenter J.G. documented suicide: association veterans high mortality risk.J 2022; 64: e63-e69Summary Thus, incorporating reasonable. must prioritize needs although cost related A connection based dignity, optimism, non-abandonment foundation approach.2Edwards Continuity care, staff training, communication different disciplines integration. Cross-training highly recommended. Policies guidelines revised meet its demands. KY Chan ML contributed conceptualization, project administration, investigation, writing original draft & editing. KW Tsang CY Wong authors declare no conflict interest. Funding: No funding received manuscript. Impact studyICCMW reduced admission, but further reduction following full implementation. Community dynamically tailored populations socioeconomic variations over time. Full-Text Open Access