Healthcare professionals’ perceptions of managing psychological needs in palliative and end-of-life care: an All-Ireland mixed-methods survey

Background Despite recognition in clinical guidelines and quality standards, integration of psychological care into palliative and end-of-life care settings remains inconsistent across and within health systems. Structural, workforce and training challenges persist as key barriers. This study provides the first investigation of healthcare professionals’ perspectives on the assessment and support of psychological needs within adult palliative and end-of-life care across the island of Ireland. Methods A convergent mixed-methods design, with online survey data from 152 healthcare professionals working in palliative and end-of-life care settings across the island of Ireland. Quantitative data were analysed descriptively and qualitative data using reflexive thematic analysis. Results The findings indicate that although psychological support is perceived as foundational to palliative and end-of-life care, this does not appear to be prioritised in relation to workforce development and service delivery. Healthcare professionals report a lack of training opportunities, issues with accessing specialist psychology resource, and time constraints that hinder their ability to assess and address psychological needs effectively. Conclusions There is an urgent need for investment in psychological care across adult palliative and end-of-life care settings on the island of Ireland. Integration of specialist psychology resource and enhancing training pathways for the broader workforce are essential to implementing effective stepped care models that ensure psychological needs are met.