Palliative psychiatry is an emerging and thought-provoking approach that challenges us to rethink how we care for individuals with severe and persistent mental illness. Unlike standard psychiatric care, which aims for symptom remission and functional recovery, palliative psychiatry acknowledges that in some cases, the relentless pursuit of clinical improvement may do more harm than good (Westmair AL et al, Aust N Z J Psychiatry 2022;56(12):1535–1541). 

We’ve all seen patients for whom the next medication trial, hospitalization, or forced intervention is unlikely to help and may, in fact, make things worse by eroding trust, causing side effects, or deepening hopelessness. Palliative psychiatry asks us to shift the focus from finding a cure at all costs to improving quality of life.

Drawing from palliative medicine, palliative psychiatry emphasizes relief of suffering, even when symptoms persist. It’s not about giving up on care, but about redefining care when a cure is no longer a realistic goal. It prompts a different set of questions: What does this person still find meaningful? How can we reduce their distress and support their sense of dignity, autonomy, and connection, even if the illness remains? This approach is still evolving, and it raises important ethical and practical questions. For a subset of patients, though, it may offer a more realistic and compassionate path forward.