Shared decision-making interventions for people with mental health conditions

Area of Science:

• Mental Health Research
• Healthcare Policy
• Evidence-Based Practice

Background:

• Mental health conditions affect one in four individuals, significantly impacting lives and society.
• International policy increasingly supports partnership models in mental health care.
• Shared decision-making (SDM) is a partnership approach where patients and providers collaborate.

Purpose of the Study:

• To assess the effects of SDM interventions on various outcomes for individuals with mental health conditions.
• To evaluate impacts on clinical outcomes, participation, recovery, satisfaction, and adverse events.
• This is an updated Cochrane Review, first published in 2010.

Main Methods:

• Systematic review of randomized controlled trials (RCTs) including cluster-RCTs.
• Searches conducted across multiple databases (CENTRAL, MEDLINE, Embase, PsycINFO) updated to February 2022.
• Standard Cochrane methodological procedures, including risk of bias assessment and GRADE certainty of evidence.

Main Results:

• SDM interventions may improve immediate user-reported outcomes related to decision-making (low-certainty evidence).
• Evidence is uncertain regarding improvements in clinical outcomes, sustained participation, recovery, and overall satisfaction (very low-certainty evidence).
• SDM interventions likely have little or no effect on consultation length (moderate-certainty evidence) and no reported adverse effects.

Conclusions:

• SDM interventions may enhance immediate perceived involvement in mental health care decision-making.
• The overall certainty of evidence for SDM interventions is low to very low, indicating a need for more high-quality research.
• Further research is essential to clarify the definitive impact of SDM on mental health care outcomes.