Pushing the envelope: Shared decision making in mental health.

Abstract

Structured shared decision making in mental health shows promise in supporting service user involvement in critical decision making and provides a process to open all treatment and service decisions to informed and respectful dialogue.

Aspectos conceptuales sobre el proceso de decisión compartida en salud mental

“…Por lo que respecta a los pacientes, la falta de información, capacitación, motivación y autoeficacia necesarias para participar en el PDC, así como determinados sesgos en la toma de decisiones, o las dificultades comunicativas en transmitir incertidumbres, riesgos o probabilidades, parecen los más importantes. Finalmente, existen barreras institucionales, como la falta de infraestructura informática para llevar a cabo una información basada en pruebas y con ayudas adecuadas, la falta de tiempo en los clínicos y en los pacientes para implementar estas estrategias, la inexistencia de un marco asistencial que facilite la recogida de historia de valores y preferencias desde el primer momento y la ausencia de un sistema organizativo que permita fluir el PDC y no haga desistir al paciente que toma parte en él (66,(93)(94).…”

Pursuing concordance: moving away from paternalism

“…People with Schizophrenia show a higher level of interest in care plan participation than other groups but report lower involvement in their care amid less effective rates of medicine taking (Curtis et al, 2010). Furthermore participation by mental health patients has leaned towards treatment at the expense of discussion on social issues such as employment, housing and personal relationships despite the relevance of these issues to recovery (Chan and Mak, 2012).…”

“…But duty of care alone will not lead to a sustainable recovery when mental health is built on being able to have control over one's own life. A balanced therapeutic relationship has been shown to improve health outcomes and prolong recovery (Curtis et al, 2010). Far from being undermined by the severity of psychotic illness shared decision making may be crucial.…”

Interactions between patients' experiences in mental health treatment and lay social network attitudes toward doctors in recovery from mental illness

“…A large literature focuses on the therapeutic alliance and satisfaction with providers (Rogers, 1951;Cruz & Pincus, 2002;McCabe & Priebe, 2004). Findings demonstrate that ongoing positive interaction between patients and their providers corresponds to greater compliance with prescribed medications and continuity of care (Curtis et al, 2010;Adair et al, 2005). Moreover, a positive relationship between mental health providers and their patients in community mental health clinics predicts greater patient readiness to take on the role of managing their wellbeing and treatment (Allen et al, 2015).…”