The Promise of Shared Decision Making in Mental Health

Psychiatric Rehabilitation Journal (Impact Factor: 1.16). 06/2010; 34(1):7-13. DOI: 10.2975/34.1.2010.7.13
Source: PubMed


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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    • "GAM has in common with other approaches that address the issue of medication like shared decision making, the partnership philosophy, the sharing of expertise, and of point of views (Deegan and Drake, 2006; Drake et al., 2010; Duncan et al., 2010). In GAM terms, the " safe space of open dialogue " about the issue of mental health medication extends beyond the patient-doctor relationship and encompasses the different stakeholders: other providers and carers. "
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    ABSTRACT: Purpose – Formal recognition of the human rights of people living with mental health problems has greatly progressed. We must ask ourselves, however, to what extent the formal recognition of these rights has transformed the culture of psychiatric care and improved their quality of life. Gaining Autonomy & Medication Management (GAM) is an approach that strives to empower service users and providers and promotes the exercise of users’ rights by transforming their relationship with the central component of psychiatric treatment in community services: psychopharmacology. The purpose of this paper is to show how GAM highlights the issues surrounding the establishment of a culture of rights. Design/methodology/approach – For this analysis qualitative data were collected in Brazil and in Quebec, Canada, through over 100 interviews done with people living with mental health issues and practitioners who participated in the different GAM implementation projects. Findings – Issues, challenges and obstacles facing the instauration of a human rights culture in mental health services are presented. The profound changes that the understanding and exercise of users’ rights bring to the lives of individuals are supported by excerpts illustrating recurring issues, situations and common experiences that appear in the various contexts of the two different countries. Research limitations/implications – This is not a parallel study taking place into two countries. The methodologies used were different, and as a consequence the comparative power can be limited. However, the results reveal striking similarities. Originality/value – There is scant research on human rights in mental health services in the community, and the issues surrounding the prescribing and follow-up of pharmacological treatment. The joint analysis of the researches in Brazil and in Canada, identified common challenges which are intertwined with the dominant approach of biomedical psychiatry.
    Journal of public mental health 12/2014; VOL. 13(NO. 4):pp. 179-188. DOI:10.1108/JPMH-06-2013-0039
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    • "This study found that a decision support center and a computer program designed ''to amplify the consumer's voice'' and enhance shared decision making in medication visits (Drake et al. 2010) had no impact on adherence rates for antipsychotic, antidepressant, and mood stabilizing medications. Other studies of the impact of shared decision making on medication adherence have had mixed findings (Ludman et al. 2003; Mahone 2004; Mann et al. 2009; Von Korff et al. 2003; Wilson et al. 2010), and our study accords with others that have found no impact. "
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    ABSTRACT: Healthcare reform emphasizes patient-centered care and shared decision-making. This study examined the impact on psychotropic adherence of a decision support center and computerized tool designed to empower and activate consumers prior to an outpatient medication management visit. Administrative data were used to identify 1,122 Medicaid-enrolled adults receiving psychotropic medication from community mental health centers over a two-year period from community mental health centers. Multivariate linear regression models were used to examine if tool users had higher rates of 180-day medication adherence than non-users. Older clients, Caucasian clients, those without recent hospitalizations, and those who were Medicaid-eligible due to disability had higher rates of 180-day medication adherence. After controlling for sociodemographics, clinical characteristics, baseline adherence, and secular changes over time, using the computerized tool did not affect adherence to psychotropic medications. The computerized decision tool did not affect medication adherence among clients in outpatient mental health clinics. Additional research should clarify the impact of decision-making tools on other important outcomes such as engagement, patient-prescriber communication, quality of care, self-management, and long-term clinical and functional outcomes.
    Community Mental Health Journal 07/2012; 49(2). DOI:10.1007/s10597-012-9528-8 · 1.03 Impact Factor
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    ABSTRACT: 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.
    Vertex (Buenos Aires, Argentina) 22(95):56-64.
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