Grant: CIHR Fellowship

Schizophrenia is a serious chronic mental illness that affects 1% of the Canadian population. Individuals with schizophrenia often face challenges in accessing and receiving healthcare. As a result, they often have poorer health and die years earlier than individuals without schizophrenia. The differences in health and healthcare experienced by individuals with schizophrenia may extend to the end-of-life period when healthcare needs may be at their highest. However, we have little information on the healthcare that is delivered to individuals with schizophrenia who are at the end of life; for instance, whether they receive palliative care, the role of psychiatry in end-of-life care, and where end-of-life care is delivered, such as in the hospital or home. We are also lacking information on what the end-of-life outcomes look like for this population, such as whether they die in or out of hospital. This knowledge gap is limiting our ability to develop strategies to improve the delivery of end-of-life care for individuals with schizophrenia. In this project, we will examine healthcare use in the last year of life and end-of-life outcomes among individuals with schizophrenia who died in Ontario. We will identify differences in healthcare use and end-of-life outcomes between individuals who died with and without schizophrenia. Further, we will evaluate patterns of healthcare use and outcomes in the last year of life among individuals who died with schizophrenia to understand what optimal versus sub-optimal care looks like. We will also look at predictors of end-of-life healthcare and outcomes to understand who among this vulnerable population is most at risk of poor quality care at the end of life. This study will contribute important information on how best to meet the healthcare needs of individuals with schizophrenia who are nearing death, with findings that will help inform health system planning and policy to support this vulnerable population.