The Promise of Shared Decision Making in Mental Health
ABSTRACT Shared decision making connotes a process, supported by specific information technologies, that reengineer how practitioners and people with diagnoses work together. The articles in this section of the journal provide just a glimpse of the activity underway to promote shared decision making in mental health. Nevertheless, they are important windows into the new world of possibilities regarding care planning, medication management and the use of information technology. Thus, in this paper we discuss the promise of shared decision making for advancing the field. (PsycINFO Database Record (c) 2013 APA, all rights reserved)
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ABSTRACT: Collaborative practice in health care is hailed by Zwarenstein, Goldman, and Reeves (2009), and Hopkin (2010), as an approach that can produce improved health outcomes by preventing fragmentation in Healthcare and strengthening healthcare systems. A great deal of efforts is being extended by international organizations such as WHO and national Health directorates to improve collaboration in healthcare provision. As a key approach to enhance collaborative practice at the service level, a model of collaborative practice focusing on collaborative processes is proposed in this paper. A model of collaborative practice in community mental health care is based on the results of two case studies and supported by relevant literature. The model has four components – (a) the frameworks for practice consisting of person-centered practice and recovery orientation; (b) the structure of collaborative practice that includes intrasystem collaboration and collaboration in service processes; (c) Three principles for collaboration as self-understanding, mutual understanding, and shared decision-making; and (d) the key processes in Collaboration identified as open dialogue and participatory engagement. Collaborative practice in community mental health care depicted in this model puts service users at the center of service provision and processes with the goal of addressing service users' needs from their perspectives. The model provides a framework to develop and test practice guidelines for community mental health care.
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ABSTRACT: Resumen El presente trabajo desarrolla el concepto de recuperación y repasa su relación con los aspectos clínicos o de remisión sintomática, así como con las dimensiones experienciales, físicas, funcionales y sociales. Los factores o condiciones internas y externas para la recupe-ración son revisados poniendo especial énfasis en los problemas del estigma sobre las personas con enfermedad mental como factor externo que dificulta la recuperación. Se argumenta que la perspectiva y participación de los usuarios en este proceso es absolutamente indispensable y se la compara con aquella que tradicionalmente han tenido en los tratamientos farmacológicos y psicológicos. A modo de conclusión se señala que este movimiento de participación de usuarios y el desarrollo de la recuperación como eje central de los servicios de salud mental podrían constituir un punto de inflexión en la asistencia psiquiátrica de las próximas décadas. Palabras clave: Recuperación -Perspectiva de los usuarios -Participación -Estigma -Rehabilitación. Summary The present paper develops the concept of recovery and its relationship with clinical aspects or symptomatic remission, as well as with other dimensions such as the experiential, physical, functional and social ones. Internal and external factors conditioning recovery are reviewed giving special emphasis to stigma, a powerful external factor that deeply affects recovery in mental illness. Users' perspective and participation in this process are considered to be essential and are compared to their place in traditional psychopharmological and psychotherapeutic treatments. As a conclusion, it is mentioned that users' participation movement and the concept of recovery could be central axes of mental health services and a turning point of a service delivery transformation for the next decades.
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ABSTRACT: While assertive community treatment (ACT) is a widely implemented evidence-based practice, the extent of its recovery orientation has been debated. A literature search identified 16 empirical articles studying recovery and ACT. These 16 studies were classified as involving stakeholder perceptions, interventions, or fidelity measurement. Stakeholders generally viewed ACT as being recovery oriented; research on both interventions and fidelity measurement showed promising approaches. Overall the literature yielded encouraging findings regarding ACT and recovery, though there remains a dearth of research on the topic. We discuss future directions for research and practice to ensure that ACT programs skillfully support recovery.