End of life care for people with severe mental illness: an evidence synthesis

Background People with severe mental illness have significant co-morbidities and reduced life expectancy. This project answered the question, ‘what evidence is there relating to the organisation, provision and receipt of care for people with severe mental illness who have an additional diagnosis of advanced, incurable, cancer and/or end-stage lung, heart, renal or liver failure and who are likely to die within the next 12 months?’ Objectives Objectives were to: 1.locate, appraise and synthesise relevant research; 2.locate and synthesise policy, guidance, case reports and other grey and non-research literature; 3.produce outputs with clear implications for service commissioning, organisation and provision; 4.make recommendations for future research. Methods This systematic review and narrative synthesis followed international standards, and was informed by an advisory group including people with experience of mental health and end of life services. Database searches were supplemented by searches for grey and non-research literature. Relevance and quality were assessed, and data extracted prior to narrative synthesis. Confidence in synthesised research findings was assessed using the Grading of Recommendations, Assessment, Development and Evaluation (GRADE) and the Confidence in the Evidence from Reviews of Qualitative Research (CERQual) approaches.