Clinical decision-making style preferences of European psychiatrists: Results from the Ambassadors survey in 38 countries

Abstract

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Clinician treatment choices for post-traumatic stress disorder: ambassadors survey of psychiatrists in 39 European countries

“…However, these results also appear to be related to a complex interplay of historical, cultural, and socioeconomic aspects that show differences between the four European regions and have subsequently contributed to differences in the training of mental health professionals and the organization of mental health services. For example, the educational and organizational characteristics of mental health services in CEE countries have been largely similar for decades in most of the Commonwealth of Independent States, which includes the largest part of the former Soviet Union’s member states [ 14 ], and may still influence clinicians’ decision-making processes 12 ], regardless of the recent changes in European mental health systems. On the other hand, NE and WE high-income countries have introduced a wide range of multidisciplinary community-based services for people with mental health problems and reorganized mental health care services toward recovery-oriented care models and a move toward human rights, social inclusion, and empowerment in recent decades [ 25 ], which may also have influenced the decreased use of medication in favor of non-pharmacological methods.…”

“…Thus, this survey was conducted within the European Psychiatric Association (EPA) Ambassador Programme [12,18]…”

“…On the European level, there is considerable variability of attitudes, procedures, and strategies in mental health care between clinicians and settings across different regions and countries. For example, we found significant differences in the predominant styles in decision-making, when comparing European regions and individual countries [ 12 ]. When it comes to service delivery, Northern and Western high-income countries have developed a large variety of multidisciplinary community-based services for people with mental health problems, with most patients being treated outside of psychiatric institutions [ 13 ], contrary to many Eastern European countries where psychiatric care is predominantly hospital-based.…”

“…Thus, this survey was conducted within the European Psychiatric Association (EPA) Ambassador Programme [ 12 , 18 ] in order to identify therapeutic choices for treating PTSD among psychiatrists working in different European regions (Central and Eastern [CEE], Northern [NE], Southern [SE], and Western Europe [WE]).…”

How subjective well-being, patient-reported clinical improvement (PROMs) and experience of care (PREMs) relate in an acute psychiatric care setting?

“…Researchers, policy makers, and patient groups have documented numerous benefits of utilizing patient-reported measures across medical specialties [ 6 , 13 – 17 ]. In clinical management, the use of patient-reported metrics has been found to correspond with increases in clinician awareness and consideration of patient needs, values, and preferences [ 4 ], and can be used to support shared decision-making during treatment [ 7 , 18 – 21 ]. Embedding harmonized patient-reported measures in routine care can lead to their more consistent use, increase systematic uptake for measuring care quality, and generate information to inform the implementation of health policies [ 22 ].…”