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Shared decision making for psychiatric medication management: beyond the micro-social
Nicola Morant1, Emma Kaminskiy2, Shulamit Ramon3
1Division of Psychiatry, UCL, London. n.morant@ucl.ac.uk.
Summary
Shared decision making (SDM) in mental health care, particularly for psychiatric medication, needs a broader approach beyond consultations. Recognizing contextual factors is key to improving patient involvement and treatment tailoring.
Area of Science:
- Mental Health Research
- Clinical Psychology
- Psychiatric Practice
Background:
- Shared decision making (SDM) adoption lags in mental health care despite alignment with recovery-oriented practices.
- Patients often feel excluded from psychiatric medication decisions and worry about side effects.
- SDM could enhance personalized psychiatric medication management.
Purpose of the Study:
- To review the conceptualization of SDM in mental health care.
- To explore factors unique to mental health care that impact SDM implementation.
- To propose a broader framework for understanding decision-making in psychiatric medication.
Main Methods:
- Conceptual review of existing literature and theories.
- Analysis of factors influencing SDM in mental health settings.
- Development of a broader conceptualization of decision-making.
Main Results:
- Standard SDM models from other health domains may not be directly applicable to mental health care.
- Unique aspects like coercion, insight, and disempowerment influence SDM processes.
- A broader view, encompassing long-term relationships and service systems, is necessary.
Conclusions:
- A broader conceptualization of decision-making is essential for understanding the rarity of SDM in psychiatric medication.
- This approach offers utility for research evaluation and identifying implementation strategies.
- Tailoring SDM to the specific context of mental health care is crucial for its successful adoption.
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