*This recording is repurposed from the 2023 Annual Assembly

Many of the patients whom palliative care clinicians find the most challenging are experiencing mental health problems. These situations generate angst and distress among clinicians and may contribute to feelings of helplessness and burnout. In general, HPM training in communication has been strong, but our training in basic mental health issues falls short of what is necessary for clinical excellence. Most of our teams include social workers, who contribute many essential competencies to our teams, but psychologists, and psychiatrists are much less frequently involved. Yet, we are regularly confronted by complex situations in which understanding of how to create a sense of safety for the patient and family, adjust our approach to the developmental stage of the patient, conduct a focused  psychiatric assessment, identify core psychological issues (including psychological defenses, attachment, responses to loss, ambivalence, identity, dependency) that are affecting the patient’s coping, and appreciating and managing the emotions faced by the team in caring for these patients are essential. These competencies are best taught by mental health clinicians, ideally those with palliative care background, as well.