Introduction

Psychiatric concerns with unique features arise in the setting of life-limiting illness. There is currently however little formal teaching on these issues in psychiatry training.

Aims

To explore psychiatry trainees’ views and educational needs regarding the care of patients with life-limiting illnesses. The extent to which psychiatry trainees are given formal teaching on psychiatric issues at the end of life was explored, in addition to their level of confidence in the provision of psychiatric assessment and management of patients with life-limiting illnesses.

Methods

Semi-structured interviews were conducted with 17 psychiatry registrars with experience in consultation-liaison psychiatry. Participants were recruited through the psychiatry training networks in Northern Sydney and Hunter New England Local Health Districts. Registrars were asked about views on the role of psychiatrists looking after patients with life-limiting illness, challenges faced within the role, and educational needs in providing care for these patients. Interviews were audio recorded and fully transcribed and then subjected to thematic analysis.

Results

There were contrasting views on the role of psychiatry in life-limiting illness. Some registrars felt that a humanistic, supportive approach including elements of psychotherapy was helpful, even in the absence of a diagnosable mental disorder. Those who tended to report a more biological and clinical stance (with a reliance on pharmacotherapy), tended to have a nihilistic view of psychiatric intervention in this setting. Registrars generally felt ill-prepared to talk to dying patients and that there is an educational ‘famine’ in this area of psychiatry. They expressed a desire for more training and felt that increased mentorship and case based learning, with input from palliative care clinicians, would be most helpful.

Conclusions

Psychiatry registrars feel ill-prepared to assess and manage patients with life-limiting illness and have contrasting views on the role of psychiatry in this setting. Targeted education is required.