Decision making in recovery-oriented mental health care

Area of Science:

• Mental Health Services Research
• Health Communication
• Psychiatry

Background:

• Patient-centered communication positively impacts satisfaction, adherence, and outcomes.
• Shared decision making (SDM) is ethically essential but underutilized in mental health care.
• Recovery-oriented systems emphasize active consumer participation in treatment.

Purpose of the Study:

• To explore decision-making processes in medication management consultations between consumers with severe mental illness and providers.
• To assess the extent of SDM in a recovery-oriented mental health setting.

Main Methods:

• Direct observation of 40 medication management appointments.
• Audio recording and transcription of consultations.
• Emergent thematic analysis of decision-making dynamics.

Main Results:

• Providers initiated most decisions, though consumer participation was often invited.
• Consumer-initiated decisions led to more discussion and disagreement, but often favored patient preferences.
• Consultations demonstrated higher person-centeredness than SDM.

Conclusions:

• SDM was not prevalent despite high person-centeredness in observed mental health consultations.
• Interventions to boost consumer initiative may enhance SDM.
• Further research is needed on SDM in diverse mental health settings and its impact on recovery.