“I Want To Go Home”: Dissecting the Intersection Between Behavioral Health, Palliative Medicine, and Spiritual Care When Addressing Patient Needs In the Hospital

Abstract: Patients admitted to a general hospital with acute and/or chronic illness can undergo a myriad of emotional experiences including sadness, confusion, and existential concerns related to their illness. Many of these patients will receive one or some combination of behavioral health, palliative, and spiritual consultation, but do clinicians know what features to focus on that will guide them in consulting the appropriate team(s)? Behavioral Health services can help identify, process, and treat conditions such as mood, anxiety, and trauma disorders. Palliative Medicine can address total pain, elicit meaning from broad statements around patient goals, and help patients better understand their medical condition in order to align treatment choices with their goals of care. Chaplain services specialize in understanding, supporting, and interpreting the religious, spiritual and existential experiences of patients and their loved ones along their healthcare journey.

Our general session will be led by professionals representing four different disciplines. We will examine the intersection between these disciplines and highlight where they overlap and where they rely on each other for complementary patient care. We will provide a richer understanding of which patient characteristics are better suited for each type of consultation, thereby raising clinician awareness of when they should call on their colleagues to address their patients’ needs more fully.

We will utilize multiple techniques to engage audience participation including live polling, breakout groups, and large group discussion. Three clinical scenarios will be presented, all with the same chief complaint, and each featuring patients that could benefit from one or more of the three services. We will reflect on the ways to approach the intersecting identities and cultural values of the patients, how these disciplines can join to best serve patients, and potential barriers to goal-concordant care.

● Audience polling: We will utilize live polling to gauge audience understanding of what each of the three services do and do not provide and what resources audience members have available to them at their institutions.

● Presentation: Dr. Novoa (psychiatry) will serve as moderator and Dr. Pickenpaugh (psychology), Dr. Ferraro (palliative medicine), and Rebecca Scull, MA, BCC (chaplain services) will provide a brief overview of how their teams collaborate to meet the biopsychosocial needs of our complex patient population.

● Small group breakout sessions: Participants will be divided into small groups, with a preceptor, to review a case, explore reactions, and share thoughts of how such a case could benefit from communication and collaboration between the services. We will ask one member from each group to volunteer to present how they handled their case to the audience in the large group discussion.

○ Dr. Pickenpaugh will present a young adult with passive suicidal ideation.

○ Dr. Ferraro will present an elderly adult approaching end of life care.

○ Rebecca Scull will present a middle aged adult who has experienced a significant physical trauma

● Large group discussion: Representatives from each small group will share highlights of the discussion from their breakout session case.

● Q&A: Additional audience questions will be addressed.