Mental health and palliative care patients: the “treatment gap”
Sadness, social withdrawal, depression, loss of hope; if a non-palliative person experiences any of these feelings, the health care system has well established processes and services to treat them. Why then do we accept this as ‘normal’ and ‘to be expected’ for those facing the end of life? Why does the system hesitate to ‘label’ these vulnerable people with a mental illness tag?

Mental illness in the terminally ill is too often underdiagnosed and undertreated. It’s frequently ignored – “well of course you’re having trouble coping, you’re dying,” – or pushed aside in favour of addressing clinical symptoms. While existential and psychological care is acknowledged as being crucial to providing quality end of life care, people continually report that theirs, their families and care givers needs in this domain are not addressed.
 

Who are we?
The Palliative Care Outcomes Collaboration (PCOC) is a nationally funded program that uses standardised clinical assessment tools to benchmark and measure patient outcomes in palliative care.

• PCOC is a collaboration between four universities, each represented by a chief investigator:
• Professor Kathy Eagar, University of Wollongong, New South Wales
• Professor David Currow, Flinders University, South Australia
• Professor Patsy Yates, Queensland University of Technology
• Dr Claire Johnson, University of Western Australia

Children’s palliative care shares many of the principles of palliative care that is provided to adults.  However, there are unique aspects of the care provided in looking after a child with a life limiting illness.  This includes children diagnosed with cancer and non-cancer diagnoses from infancy to young adulthood.  We are also providing this care working with the children’s family (parents, siblings, grandparents) and the broader community (including schools).

The goal of our project is to deliver education in paediatric palliative care in areas outside of the metropolitan centres of Australia, and in all states and territories of Australia.  This reflects the geographic diversity of Australia, with many patients living outside of capital cities, and also large distances between centres.  The anticipated outcome of this education is greater confidence of health professionals to care for dying children, and improved quality of care.
 

The release of the Guidelines for a Palliative Approach in Residential Aged Care (APRAC) and the Guidelines for a Palliative Approach for Aged Care in the Community Setting (COMPAC) were a significant advance in recognising and responding to changing population demography in Australia.  They aimed to support the provision of palliative care for older people living in the community or in residential aged care by identifying and evaluating the evidence for care to promote quality of life for older Australians who have a life-limiting illness or who are becoming progressively frailer during old age. The two sets of guidelines were important landmarks nationally and internationally.