Shared decision making for psychiatric medication management: a summary of its uptake, barriers and facilitators

Abstract

The model of shared decision making with mental health patients and clinicians (doctors and pharmacists) harnesses the benefits of patients becoming partners in their own recovery through improved communication and greater self-advocacy. Shared decision making in mental health services is an emerging model of care which has not been well investigated, however it is seen as the way forward to achieving improved health outcomes for non-pharmacological and pharmacological therapy. Successful implementation of this model requires supporting the process through provision of information and training, use of decision aids, coaching in communication skills and inclusion of family and carers in the decision making process. This summary examines the application of the shared decision making model for psychiatric medication management, including barriers and facilitators.

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Acknowledgements

The authors acknowledge NGO group, Consumers of Mental Health WA, for their ongoing support in raising awareness of SDM and encouraging the development of this document.

Funding

This work was carried out independently with no external funding.

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Correspondence to Deena M. Ashoorian.

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Appendix

Appendix

Key points to consider with implementing SDM model for mental health patients.

Benefits include:

  • Improved symptoms and decreased hospitalisation rates

  • Improved treatment adherence

  • Improved satisfaction with medical care

  • Improved self-esteem

Barriers include:

  • Lack of confidence and assertiveness

  • Limited access to information

  • Patient lack of trust and awareness of rights

  • Poor communication by all or either party

  • Misperceptions about patient’s decisional ability

  • Lack of positive experiences with medications and illness symptoms

Facilitators include:

  • Use of Decision Aids

  • Specific clinician training

  • Specific patient/carer training

  • Involvement of family and carers

  • Development of an implementation strategy

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Ashoorian, D.M., Davidson, R.M. Shared decision making for psychiatric medication management: a summary of its uptake, barriers and facilitators. Int J Clin Pharm (2021). https://doi.org/10.1007/s11096-021-01240-3

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Keywords

  • Clinicians
  • Medications
  • Mental health patients
  • Recovery
  • Shared decision making
  • Treatment