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Employing a co\u2010design 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\u2010of\u2010life care for this population. Findings highlighted the suboptimal state of end\u2010of\u2010life care for people with SMI and the underlying challenges at individual, organisational and community levels, including limited knowledge of end\u2010of\u2010life care, low help\u2010seeking motivation, communication difficulties, limited support networks, insufficient on\u2010site medical support for end\u2010of\u2010life care, unclear guidelines for dying\u2010in\u2010place, inadequate collaboration between medical and social sectors, mental health stigma, insufficient legal support and cultural taboo surrounding death. Recommendations were co\u2010developed with participants to inform the design of person\u2010centred, contextually responsive models that promote equitable and dignified end\u2010of\u2010life care for people with SMI.<\/jats:p>","DOI":"10.1111\/inm.70226","type":"journal-article","created":{"date-parts":[[2026,1,28]],"date-time":"2026-01-28T11:45:06Z","timestamp":1769600706000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Co\u2010Designing End\u2010of\u2010Life Care for People With Pre\u2010Existing Severe Mental Illness: Insights From Multiple Stakeholder Consultations"],"prefix":"10.1111","volume":"35","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-8708-1947","authenticated-orcid":false,"given":"Jialiang","family":"Cui","sequence":"first","affiliation":[{"name":"Department of Social Work The Chinese University of Hong Kong  Hong Kong SAR China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0009-0006-6645-7486","authenticated-orcid":false,"given":"Cong","family":"Zheng","sequence":"additional","affiliation":[{"name":"Department of Social Work The Chinese University of Hong Kong  Hong Kong SAR China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7392-9441","authenticated-orcid":false,"given":"Cheryl Chi\u2010Yan","family":"Yeung","sequence":"additional","affiliation":[{"name":"The Nethersole School of Nursing, Faculty of Medicine The Chinese University of Hong Kong  Hong Kong SAR China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4038-4654","authenticated-orcid":false,"given":"Helen Yue\u2010lai","family":"Chan","sequence":"additional","affiliation":[{"name":"The Nethersole School of Nursing, Faculty of Medicine The Chinese University of Hong Kong  Hong Kong SAR China"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2026,1,28]]},"reference":[{"key":"e_1_2_10_2_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMcp074045"},{"key":"e_1_2_10_3_1","doi-asserted-by":"publisher","DOI":"10.1002\/pon.6138"},{"key":"e_1_2_10_4_1","doi-asserted-by":"publisher","DOI":"10.1177\/0004867411432072"},{"key":"e_1_2_10_5_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijnurstu.2017.01.002"},{"key":"e_1_2_10_6_1","doi-asserted-by":"publisher","DOI":"10.1111\/inm.13498"},{"key":"e_1_2_10_7_1","volume-title":"Successful Qualitative Research: A Practical Guide for Beginners","author":"Braun V.","year":"2013"},{"key":"e_1_2_10_8_1","doi-asserted-by":"publisher","DOI":"10.1023\/B:COMH.0000015214.24404.cc"},{"key":"e_1_2_10_9_1","doi-asserted-by":"publisher","DOI":"10.1080\/09638237.2025.2512306"},{"key":"e_1_2_10_10_1","doi-asserted-by":"publisher","DOI":"10.1093\/bjsw\/bcaa232"},{"key":"e_1_2_10_11_1","doi-asserted-by":"publisher","DOI":"10.1111\/jpm.12320"},{"key":"e_1_2_10_12_1","doi-asserted-by":"publisher","DOI":"10.1016\/S2215-0366(19)30132-4"},{"issue":"4","key":"e_1_2_10_13_1","first-page":"1","article-title":"End\u2010of\u2010Life Care for People With Severe Mental Illness: The MENLOC Evidence Synthesis","volume":"10","author":"Hannigan B.","year":"2022","journal-title":"Health Services and Delivery Research"},{"key":"e_1_2_10_14_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ssmmh.2024.100309"},{"key":"e_1_2_10_15_1","doi-asserted-by":"publisher","DOI":"10.1177\/10499091211010722"},{"key":"e_1_2_10_16_1","unstructured":"JCECC.2016.\u201cBackground and Objectives Jockey Club End\u2010of\u2010Life Community Care Project: Hong Kong.\u201dhttps:\/\/foss.hku.hk\/jcecc\/en\/about\u2010us\/background\u2010and\u2010objectives\/."},{"key":"e_1_2_10_17_1","unstructured":"Jerwood J. 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