Why More Psychiatrists Should Be Involved in Palliative Care

Palliative care is often associated with physical symptom management at the end of life—but it's much more than that. It is a holistic approach to care that addresses not only pain and physical discomfort, but also the emotional, psychological, social, and spiritual distress that people and their families face when living with serious illness.

And yet, despite the deeply emotional and psychological needs of palliative care patients, psychiatrists remain underrepresented in this vital field. Here’s why that needs to change.

1. Psychological distress is common—and treatable

People facing serious or life-limiting illness often experience depression, anxiety, existential distress, and even suicidal thoughts. These symptoms are not simply “understandable” responses to illness—they are diagnosable, treatable mental health conditions that can significantly reduce a person's quality of life. Psychiatrists bring expertise in identifying and managing these symptoms, using both medication and therapy when appropriate.

2. Psychiatrists offer a unique lens on suffering

Palliative care recognizes that suffering is not only physical. Psychiatrists are trained to explore the internal world of the patient—their fears, regrets, identity, values, and sources of meaning. This makes them uniquely equipped to support patients in processing grief, loss, and complex family dynamics.

3. Managing medications is a shared domain

Psychiatrists are medical doctors. This means they are well-placed to work alongside palliative care teams in adjusting medications—especially when it comes to balancing psychiatric medications with pain treatments like opioids or managing side effects. They can also help distinguish between delirium, depression, and cognitive changes due to illness or medications.

4. The whole-person approach is at the heart of both disciplines

Modern psychiatry emphasizes patient-centered, biopsychosocial care—much like palliative care. When psychiatrists are involved in palliative teams, patients benefit from a truly integrated approach that honours the mind–body connection and considers what matters most to the patient.

5. Families and caregivers need mental health support too

The emotional toll on caregivers and family members is often overlooked. Psychiatrists can offer support not only to the patient but also to those around them, helping families navigate anticipatory grief, burnout, and difficult decisions.

Bridging the Gap

The overlap between psychiatry and palliative care is natural—but the systems that train and deploy psychiatrists often don’t make space for it. It’s time we change that. Integrating psychiatric expertise into palliative care teams can dramatically improve the quality of life for patients and families alike.

By Dr Michelle Beukes-King