A critical narrative analysis of shared decision-making in acute inpatient mental health care

Stacey, Gemma; Felton, Anne; Morgan, Alastair; Stickley, Theodore; Willis, Martin E.H.; Diamond, Bob; Houghton, Philip Stephen; Johnson, B.; Dumenya, John

doi:10.3109/13561820.2015.1064878

Cited by 66 publications

(48 citation statements)

References 19 publications

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“…In Mahone et al's (2011) study, previous experiences of coercive practice and the trauma associated with this, led to future mistrust and a lack of willingness to engage in open and meaningful dialogue with practitioners. On the other hand, previous experiences of involuntary treatment has also been found to be associated with a greater desire for autonomy (Hamann et al, 2005) as well as a greater desire for information (Puschner et al, 2016).In a critical narrative analysis of focus groups with service users in an inpatient setting, Stacey et al (2016) report particular challenges associated with inpatient care. One respondent in this study comments about the particular problems associated with SDM in ward rounds (a format involving a group of practitioners as a panel and service user invited to attFend):…”

Section: Factors Related To the Wider Contextmentioning

confidence: 99%

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Attitudes towards shared decision making in mental health: a qualitative synthesis

Kaminskiy

Senner

Hamann

2017

MHRJ

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PurposeShared Decision Making (SDM) prioritises joint deliberation between practitioner and service user, and a respect for service-users' experiential knowledge, values and preferences.. This article reviews the existing literature pertaining to key stakeholders' attitudes towards SDM in mental health. It examines whether perceived barriers and facilitators differ by group (e.g. service user, psychiatrist, nurse, social worker) and includes views of what facilitates and hinders the process for service users and practitioners. MethodologyThis review adopts the principles of a qualitative research synthesis. A key word search of research published between 1990 and 2016 was undertaken. Qualitative, quantitative and mixed methods studies were included. Findings43 papers were included and several themes identified for service user and practitioner perspectives. Both practitioners and service users see SDM as an ethical imperative, and both groups highlight the need to be flexible in implementing shared decision making, suggesting it is context dependent. A range of challenges and barriers are presented by both practitioners and service users reflecting complex contextual and cultural features within which interactions in mental health take place. There were qualitative differences in what service users and practitioners describe as preventing or enabling SDM. The differences highlighted point towards different challenges and priorities in SDM for service users and practitioners. Originality / ValueThe presentation of nuanced views and attitudes that practitioners and service users hold represent an important and under reported area and offer insight into the reasons for the gap between idealised policy and actual practice of SDM in mental health settings.

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Section: Factors Related To the Wider Contextmentioning

confidence: 99%

“…For practitioners, SDM is not seen as viable for emergency situations and hospital admission, and for service users, ward round meetings are highlighted as a particularly difficult setting (e.g. Hamann et al, 2006;Stacey et al 2016;Mahone et al, 2015).…”

Section: Similarities and Differences Between Professionals And Servimentioning

confidence: 99%

Attitudes towards shared decision making in mental health: a qualitative synthesis

Kaminskiy

Senner

Hamann

2017

MHRJ

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“…In review, five out of seven studies recruiting various MHPs involved mental health nurses. Except for psychiatrists, other MHPs regarded themselves as outsiders to the decision‐making systems (Stacey et al, ). In fact, all the stakeholders thought that involvement of various MHPs could enhance the consumer's voice in the decision‐making, which facilitates SDM (Chong et al, ; Fisher et al, , ; Giacco, Mavromara, Gamblen, Conneely, & Priebe, ).…”

Section: Resultsmentioning

confidence: 99%

“…Four studies found that more than 60% of participants reported that they had experienced a shared or active approach to decision‐making (Cosh et al, ; De las Cuevas, De Rivera et al, ; Liebherz et al, ; Nott et al, ). However, most studies indicated that SDM was not common (Dahlqvist Jönsson et al, , De las Cuevas & Peñate, , Ehrlich & Dannapfel, , Fukui et al, , Grim et al, , Liebherz, Tlach, Härter, & Dirmaier, , Matthias, Salyers, Rollins, & Frankel, , Salyers et al , Stacey et al, , Souraya et al, , Velligan et al, , Younas et al, ). An observational study showed that consumers felt more involved in the consultation than was observed (Verwijmeren & Grootens, ).…”

Section: Resultsmentioning

confidence: 99%

“…Generally, both consumers and MHPs expressed positive attitudes towards family involvement in SDM, and families preferred to be involved (Bradley & Green, 2018;Cohen et al, 2013;Eliacin et al, 2015a;Fisher et al, 2017aFisher et al, , 2017bGrim, Rosenberg, Svedberg, & Schön, 2016;Small et al, 2017;Souraya, Hanlon, & Asher, 2018;Stacey et al, 2016;Velligan et al, 2016). Families were essential to treatment decisions by facilitating communication between consumers and MHPs during consultations and implementation of treatment plans outside consultations (Cohen et al, 2013;Fisher et al, 2017aFisher et al, , 2017bGrim et al, 2016;Velligan et al, 2016).…”

Section: Involvement Of Families In Sdmmentioning

confidence: 99%

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Perceptions of shared decision‐making in severe mental illness: An integrative review

Huang¹,

Plummer

Lam

et al. 2019

Psychiatric Ment Health Nurs

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Accessible Summary What is known about shared decision‐making? There is increasing evidence of the positive impact of shared decision‐making on health outcomes. There has been little exploration of shared decision‐making regarding people diagnosed with serious mental illness from the perspectives of key stakeholders including consumers, families and mental health professionals. What this paper adds to existing knowledge? Consumers show variability in the preference for their involvement. Most stakeholders acknowledge the importance of family involvement. MHPs should share the responsibility and right to facilitate consumer involvement. There is bidirectional association between shared decision‐making and therapeutic relationships. The practice of shared decision‐making is related to multiple factors, and one main perceived barrier is time. The majority of studies are from Western countries. What are the implications for practice? Elicit consumer preferences and establish a collaborative therapeutic relationship. Encourage and engage families in treatment decision‐making. Inter‐professional collaboration should be integrated into shared decision‐making. It might require lengthier consultation time. Studies in non‐Western countries are needed to fully understand the impact of culture on shared decision‐making. AbstractIntroductionShared decision‐making (SDM) has been broadly advocated in health services and constitutes an important component of patient‐centred care and relationship‐based care.AimTo review available literature related to perceptions of key stakeholders about shared decision‐making in serious mental illness.MethodAn integrative review was conducted through a search of four online databases from January 2012 to June 2019.ResultsForty‐six articles were included. Six themes were generated from the data analysis: (a) dynamic preferences for SDM, (b) various stakeholders are rarely involved, (c) SDM is not routinely implemented, (d) multiple facilitators and barriers to SDM, (e) SDM and therapeutic relationships interact, (f) SDM has a promising impact on health outcomes.DiscussionOverall, most stakeholders have recognized the importance and flexibility of SDM in serious mental illness, although it is not routine in mental health service. Consumer preferences show variability in their involvement. Most stakeholders acknowledged the importance of family involvement to treatment decision‐making. There are several significant challenges to practice SDM. It may require extended consultation times and increasing empirical evidence regarding the SDM outcomes, as well as integrating inter‐professional collaboration into SDM. Most studies were conducted in Western culture.Implications for practiceMental health nurses should elicit consumer preferences and establish a collaborative therapeutic relationship. Encourage and engage families in treatment decision‐making when consumers prefer their families to be involved. Inter‐professional collaboration should be integrated into shared decision‐making. The...

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Implementing shared decision making in routine mental health care

2017

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Shared decision making (SDM) in mental health care involves clinicians and patients working together to make decisions. The key elements of SDM have been identified, decision support tools have been developed, and SDM has been recommended in mental health at policy level. Yet implementation remains limited. Two justifications are typically advanced in support of SDM. The clinical justification is that SDM leads to improved outcome, yet the available empirical evidence base is inconclusive. The ethical justification is that SDM is a right, but clinicians need to balance the biomedical ethical principles of autonomy and justice with beneficence and non‐maleficence. It is argued that SDM is “polyvalent”, a sociological concept which describes an idea commanding superficial but not deep agreement between disparate stakeholders. Implementing SDM in routine mental health services is as much a cultural as a technical problem. Three challenges are identified: creating widespread access to high‐quality decision support tools; integrating SDM with other recovery‐supporting interventions; and responding to cultural changes as patients develop the normal expectations of citizenship. Two approaches which may inform responses in the mental health system to these cultural changes – social marketing and the hospitality industry – are identified.

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A critical narrative analysis of shared decision-making in acute inpatient mental health care

Cited by 66 publications

References 19 publications

Attitudes towards shared decision making in mental health: a qualitative synthesis

Attitudes towards shared decision making in mental health: a qualitative synthesis

Perceptions of shared decision‐making in severe mental illness: An integrative review

Implementing shared decision making in routine mental health care

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