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Shared decision making and medication management in the recovery process.
Patricia E Deegan1, Robert E Drake
1Pat Deegan, Ph.D., and Associates, LLC, 17 Forest Street, Byfield, MA 01922, USA. patricia.deegan@comcast.net
Psychiatric Services (Washington, D.C.)
|November 7, 2006
Summary
Medication adherence in severe mental illness requires a shift from compliance to shared decision-making. This approach respects patient autonomy and complex decision-making in long-term disorder management.
Area of Science:
- Psychiatry
- Mental Health Care
- Health Psychology
Background:
- Medication management for severe mental illness often focuses on compliance.
- The concept of compliance is criticized for being paternalistic and inadequate for autonomous patients.
- Current approaches fail to capture the complexity of long-term medication use in mental health.
Purpose of the Study:
- To critique the construct of medication compliance in severe mental illness.
- To advocate for a more collaborative approach to medication management.
- To propose shared decision-making as a superior model.
Main Methods:
- Conceptual analysis of medication adherence.
- Critique of the compliance model in psychiatric care.
- Argument for person-centered and evidence-based practices.
Main Results:
- Compliance is an insufficient framework for understanding medication use in severe mental illness.
- Medication use involves complex decision-making and conflict resolution.
- A partnership between client and practitioner is essential.
Conclusions:
- Shared decision-making offers a model for effective medication management.
- This model supports patient autonomy and recovery.
- It facilitates a balanced assessment of treatment benefits and drawbacks.
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