Promoting shared decision-making in mental health: Findings from an evaluation of a decision support workbook and a computer-based decision aid on antipsychotic medications

Shared decision-making is a process in which the expertise of a clinician and the self knowledge, values and priorities of a client are used to collaboratively inform a treatment decision. In the past decade, there has been a growing interest in the promotion of shared decision-making in mental health, consistent with a focus on recovery and person-centered care. However, compared with other areas of health care, there are few decision aids or decision support tools available to people who use mental health services. In order to address this gap, SAMHSA funded a project to develop materials to support and promote shared decision-making in mental health. Two of these products, a decision support workbook and a computer-based decision aid on antipsychotic medications, were field-tested in psychiatric rehabilitation programs in three community mental health agencies, including one serving veterans of the US Armed Forces. More than 100 participants tested each product. Both quantitative and qualitative data were collected from clients and providers to evaluate (1) the usefulness of each tool, (2) appropriate contexts for the use of each tool, (3) whether each tool supported shared decision-making, and (4) opportunities and barriers related to implementation of the different tools as regular practice in mental health agencies. Although, both products were generally well-received, factors such as program type and client age influenced client and provider response. The presentation will include specific findings and discussion in each of the areas above.