Shared Decision-Making in Mental Health Care - SAMHSA Store ...

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8Outcomes of SDMThere is limited research on SDM in mental health care, but evidence does exist thatcomponents of SDM result in positive outcomes for health care consumers. Schaueret al. (2007) summarized the evidence of the value of SDM in general health care.• The use of client-centered communication reduces consumer stress andimproves functional status.• Consumers who report fully expressing themselves and receiving all therequested information had better functional outcomes than those who did not.• The provider’s ability to “display concern, warmth, and interest” was the mostpowerful predictor of consumer satisfaction (Adams & Drake, 2006, p. 94).• “Clients who believe they are actively involved in treatment decisions generallyhave better outcomes, whereas having a low sense of control over decisions isassociated with less behavioral involvement in care, poorer self-rated health,and increased illness burden” (Adams & Drake, 2006, p. 94).• The use of decision aids appears to increase the utilization of underused services,and decrease the utilization of overused services (O’Connor et al., 2007).Shared Decision-Making in Mental Health Care:Practice, Research, and Future Directions
9Section 2The Practice of SharedDecision-MakingThe process of SDM, as identified by Simon et al. (2006), includes several steps:• Recognition that a decision needs to be made;• Identification of partners in the process as equals;• Statement of the options as equal;• Exploration of understanding and expectations;• Identifying preferences;• Negotiating options/concordance;• Sharing the decision; and• Arranging followup to evaluate decision-making outcomes.These steps do not all have to be taken at one time, and may not all be conductedin the presence of both parties. Decision aids (DAs), for example, can be utilized byconsumers on their own or with the assistance of peers. These tools can help a consumeridentify the treatment options and explore their preferences prior to meetingwith their provider.Decision AidsDAs are tools used to help consumers understand and clarify their choices and preferencesin regard to a discrete decision within SDM. DAs are offered in a variety offorms, from printed brochures to interactive electronic tools. Some are designed tobe completed by a health care consumer in advance of a professional consultation;others are designed for completion during the clinical encounter. DAs are often utilizedin the context of SDM.“When people have the opportunity to carefully consider their care, theytend to have less decisional conflict.” —Patricia Deegan, Ph.D.DAs have been shown to improve consumer knowledge of treatment options, supportmore realistic expectations of treatment outcomes, increase consumer comfortwith choices, decrease the number of consumers with decisional uncertainty, increaseconsumer participation in decision-making without increasing consumer anxiety,Shared Decision-Making in Mental Health Care:Practice, Research, and Future Directions
Page 4: iiContentsIntroduction ............
Page 11 and 12: 5outpatient commitment (Holmes-Rovn
Page 13: 7Advantages• Practitioners can be
Page 22 and 23: 16Section 3SDM ResearchCurrent rese
Page 24: 18Mental health care providers are
Page 27 and 28: 21want mental health treatment or d
Page 29: 23Some participants raised concerns
Page 37 and 38: 31Section 6ConclusionsShared decisi
Page 39 and 40: 33Fellowes, D., Wilkinson, S., & Mo
Page 41 and 42: 35Power, A. Kathryn. (July 10, 2007
Page 43 and 44: 37Appendix AResourcesThis list is p
Page 45 and 46: 39Appendix BShared Decision-MakingM
Page 47 and 48: 41Annelle Primm, M.D., M.P.H.Direct
Page 49 and 50: 43Supplement 1Shared Decision-Makin
Page 51 and 52: 45IntroductionThe consumer-driven r
Page 53 and 54: 47Background: Definitions of SDM an
Page 55 and 56: 49• Freedom to live in the commun
Page 57 and 58: 51providers only (Wills & Homes-Rov
Page 59: 53SDM for Schizophrenia TreatmentBu
Page 63 and 64: 57I interact with my consumers; I f
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59ReferencesAdams, J. R., & Drake,
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61Elwyn, G., Edwards, A., Kinnersle
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63Murray, E., Pollack, L., White, M
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65Thistlethwaite, J., Evans, R., Ti
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67AbstractShared decision-making is
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69Confronting Critical Challenges:
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71into treatment should still be in
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73these approaches, people are more
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75consumers to engage with their pr
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77that were produced in the U.S., w
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79a healing partnership and develop
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81Shared Decision-Making in Mental
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83However, peer support requires st
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85ConclusionsImplementation of SDM
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87Fellowes, D., Wilkinson, S., & Mo
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89President’s Commission for the
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91Supplement 3Aids to Assist Shared
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93IntroductionSignificance of Share
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95In recent years, a variety of tec
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97• Provide balanced information,
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99Form of Access or AdministrationC
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101ences). Some of these Web-based
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103video about shared decision-maki
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105clarify one’s own values and p
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107potential results, than on quant
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109Once again, however, it is worth
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111who belong to minority groups or
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113Hamann, J., Langer, B., Winkler,
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U.S. DEPARTMENT OF HEALTH AND HUMAN
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