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

72identifies a number of critical components in the community and in the healthcare system that support and promote that shared decisional process. These includeself-management, decision support, clinical information systems, and deliverysystem design.Figure 1California’ s Behavioral Health Care ModelResourcesand PoliciesCommunitySocialInclusionandOpportunityIOM Aims and RulesSelf-ManagementSupportMental Health SystemHealth Care OrganizationDeliverySystemDesignURAC standardsDecisionSupportClinicalInformationSystemsEmpoweredHopefulConsumerProductiveInteractionsReceptiveCapableTeamRecovery/Wellness OutcomesUnpacking Shared Decision Barriers to Identify SolutionsProviders and ConsumersThe primary approach to changing providers’ and consumers’ behaviors focuseson the decision support element of the framework. Clinical information systemsare also critical in delivering decision support in forms and at times that serve tofacilitate productive interactions. We include information tools in our definition ofdecision support, as well as training in communication skills to teach providers andconsumers how to exchange information, use the information tools, and negotiate atreatment plan.Patient-centered care, in the context of clinician training, has largely focused oninterviewing skills (Lewin, Skea, Entwistle, Zwarenstein, & Dick, 2001). Rigorousresearch studies have shown that doctors, nurses, and pharmacists can learn newskills of agenda setting, reflective listening, presenting pros and cons of treatment,and collaborative decision-making and planning. When health professionals adoptShared Decision-Making in Mental Health Care:Practice, Research, and Future Directions