# Co‐Designing End‐of‐Life Care for People With Pre‐Existing Severe Mental Illness: Insights From Multiple Stakeholder Consultations

## TL;DR

This study explores how to improve end-of-life care for people with severe mental illness by involving multiple stakeholders in Hong Kong.

## Contribution

The paper introduces a co-design approach involving diverse stakeholders to address end-of-life care gaps for people with severe mental illness.

## Key findings

- End-of-life care for people with severe mental illness is suboptimal due to challenges at individual, organizational, and community levels.
- Stakeholders identified issues like limited knowledge, communication difficulties, and cultural taboos surrounding death.
- Recommendations include person-centered models to promote equitable and dignified care for this population.

## Abstract

People with severe mental illness (SMI) experience significant health disparities, and their end‐of‐life care remains underdeveloped. Employing a co‐design approach, this study engaged a range of stakeholders in Hong Kong, including people with SMI, their family members and professionals in mental health and palliative care, to identify service gaps, challenges and opportunities for improving end‐of‐life care for this population. Findings highlighted the suboptimal state of end‐of‐life care for people with SMI and the underlying challenges at individual, organisational and community levels, including limited knowledge of end‐of‐life care, low help‐seeking motivation, communication difficulties, limited support networks, insufficient on‐site medical support for end‐of‐life care, unclear guidelines for dying‐in‐place, inadequate collaboration between medical and social sectors, mental health stigma, insufficient legal support and cultural taboo surrounding death. Recommendations were co‐developed with participants to inform the design of person‐centred, contextually responsive models that promote equitable and dignified end‐of‐life care for people with SMI.