Integrating Shared Decision-Making Into Treatment Planning for Clinicians Who Treat Individuals With Serious Mental Illness.

Abstract

Background: Shared decision-making (SDM) has the potential to significantly improve patient outcomes by enabling clinicians and patients to make health care decisions as partners. However, its implementation in mental health care has been a slow process. Objective: The objective of the study was to implement SDM during outpatient mental health treatment planning. Methods: In an integrated health care clinic, mental health clinicians (n = 4) participated in SDM training to increase their use of SDM. The 9-item Shared Decision-Making Questionnaire Physician Version (SDM-Q9-DOC) tool was used in a pre-post design to evaluate the training's effectiveness in increasing the implementation of SDM during treatment planning. Results: SDM-Q9-DOC scores improved from a median of 49-54, suggesting a clinically significant improvement in SDM implementation. Project limitations included short duration and lack of feedback from clinicians and patients about their SDM experience. Conclusions: While guided SDM training can increase the use of SDM in outpatient mental health care, we acknowledge the existing barriers to its implementation. These barriers, including clinician pessimism, time constraints, lack of appropriate decision aids, and workplace expectations, should be further studied and addressed to enhance the implementation of SDM in the mental health setting. Implications for Nursing: Psychiatric nurse practitioners and registered nurses can assist with implementing SDM by encouraging effective communication between clinicians and behavioral health clients.