Clinical Decision Making and Mental Health Service Use Among Persons With Severe Mental Illness Across Europe

Abstract

A preference for shared decision making may reduce health care costs by reducing inpatient admissions. Patient satisfaction with decisions was a predictor of costs, and clinicians should maximize patient satisfaction with CDM.

Perceptions of shared decision‐making in severe mental illness: An integrative review

“…the diagnosis of illness) (De las Cuevas & Peñate, ; De las Cuevas, Peñate, et al, ; Park et al, ). In studies reporting SDM as a single dimensional concept, most consumers preferred SDM, and a minority of them preferred passive involvement (Cosh et al, ; De las Cuevas & Peñate, ; De las Cuevas, Peñate, et al, ; Ehrlich & Dannapfel, ; Liebherz et al, ; Nott, Mcintosh, Taube, & Taylor, ). Specifically, three articles reported that consumers also preferred shared involvement in physical health (Ehrlich & Dannapfel, ; Small et al, ; Wright‐Berryman & Kim, ; Wright‐Berryman & Cremering ).…”

“…Mental health professionals across various professions and settings were unanimously favourable towards SDM (Ali, Smith, Mican, & Brown, ; Chong et al, , ; Cosh et al, ; De las Cuevas, Rivero‐Santana, Perestelo‐Pérez, Pérez‐Ramos, & Serrano‐Aguilar, ; Fisher, Manicavasagar, Sharpe, Laidsaar‐Powell, & Juraskova, ; Lukens, Solomon, & Sorenson, ; Shepherd, Shorthouse, & Gask, ; Younas, Eleanor, Nikki, Dolly, & Maidment, ). Some MHPs particularly stressed that SDM should be flexible and determined by them, as the consumers’ insight might fluctuate (Chong et al, ; Shepherd et al, ; Younas et al, ).…”

“…This inconsistency may be because different instruments were used to assess SDM. Four studies found that more than 60% of participants reported that they had experienced a shared or active approach to decision‐making (Cosh et al, ; De las Cuevas, De Rivera et al, ; Liebherz et al, ; Nott et al, ). However, most studies indicated that SDM was not common (Dahlqvist Jönsson et al, , De las Cuevas & Peñate, , Ehrlich & Dannapfel, , Fukui et al, , Grim et al, , Liebherz, Tlach, Härter, & Dirmaier, , Matthias, Salyers, Rollins, & Frankel, , Salyers et al , Stacey et al, , Souraya et al, , Velligan et al, , Younas et al, ).…”

“…SDM is associated with a positive impact on health outcomes (e.g. treatment adherence, decision satisfaction, recovery and medical cost) (Clarke et al, ; Cosh et al, ; De las Cuevas & Peñate, ; De las Cuevas, Peñate, et al, ; Freidl et al, ; Klingaman et al, ; Younas et al, ), although causal relationships between SDM and outcomes cannot be established due to limited studies. MHPs’ preference for greater consumer involvement was associated with fewer unmet needs of consumers (Loos et al, ; Puschner et al, ).…”

“…Compared with either passive or shared involvement, consumers experiencing active involvement were more likely to have better recovery (Loos et al, ). Furthermore, a prospective study indicated that the preference for SDM could save medical costs by reducing admissions and inpatient stays (Cosh et al, ).…”