Exploring the Experiences of Client Involvement in Medication Decisions Using a Shared Decision Making Model: Results of a Qualitative Study

Abstract

This qualitative study explored a newly introduced model of shared decision making (CommonGround) and how psychiatric medications were experienced by clients, prescribers, case managers and peer support staff. Of the twelve client subjects, six were highly engaged in shared decision-making and six were not. Five notable differences were found between the two groups including the presence of a goal, use of personal medicine, and the behavior of case managers and prescribers. Implications for a shared decision making model in psychiatry are discussed.

The Legitimacy of User Knowledge in Decision-Making Processes in Mental Health Care: An Analysis of Epistemic Injustice

“…Shared decision making (SDM) has been promoted as a practice to ensure that people receive care and support corresponding to individual circumstances and choices [1]. In SDM information is shared mutually and joint decisions are made in a process by which service users and providers are conceptualized as equally valuable carriers of knowledge [2]. However, research on SDM within a mental health context shows how the value placed on personal knowledge of service users often remains low [3] and that service users perceive that the extent to which their knowledge is considered in decision making is comparatively limited [2][3][4].…”

“…In SDM information is shared mutually and joint decisions are made in a process by which service users and providers are conceptualized as equally valuable carriers of knowledge [2]. However, research on SDM within a mental health context shows how the value placed on personal knowledge of service users often remains low [3] and that service users perceive that the extent to which their knowledge is considered in decision making is comparatively limited [2][3][4]. Individuals with mental health problems frequently express having negative experiences from meetings with service providers, which may conceived to be of an epistemic nature.…”

Predictors of Shared Decision Making and Level of Agreement Between Consumers and Providers in Psychiatric Care

“…Further, the more thoroughly the core elements of the decision are discussed, the more likely consumers and providers are to reach full agreement about the consumer’s treatment. Some of prior work has examined qualitative descriptions of how decisions are made in psychiatric consultations (Bhugra, Easter, Mallaris et al, 2011; Goscha, 2009; Matthias, Salyers, Rollins et al, 2012). Recently, we have adapted a tool to measure shared decision making (Salyers, Matthias, Fukui et al, 2012) and were interested in better understanding what factors were associated with higher scores and level of agreement as rated on this scale.…”

Supporting shared decision making beyond consumer-prescriber interactions: Initial development of the CommonGround fidelity scale

“…Early evaluations of CommonGround have shown promising results (American Psychiatric Association, 2013; Campbell, Holter, Manthey, & Rapp, 2014; Deegan et al, 2008; Drake, Deegan, Woltmann et al, 2010; Goscha & Rapp, 2014; MacDonald-Willson, Deegan, Hutchison, Parrotta, & Schuster, 2013; Stein et al, 2013). However, the organizational components necessary to facilitate CommonGround integration into psychiatric treatment have yet to be detailed.…”