Patient engagement is a critical component of modern health care—and that’s especially true for mental health care. A growing body of research supports the concept and practice of shared decision making (SDM), in which clinicians and patients work together to reach mutually agreed upon treatment decisions. This helps patients become more engaged in their treatment, and centers treatment around their values, desires and circumstances.
Until now, there’s been little comprehensive examination of SDM in mental health. But Dr. Yaara Zisman-Ilani, assistant professor of rehabilitation sciences at Temple University College of Public Health, recently co-edited a special issue of Mental Health Review Journal which sought to do just that.
“We created this special issue with the purpose of it being a comprehensive reference tool,” said Dr. Zisman-Ilani, who edited the edition with Dr. Shulamit Ramon of the University of Hertfordshire and Dr. Emma Kaminskiy of Anglia Ruskin University, both in the United Kingdom. “We felt SDM research in mental health has reached a point at which there is enough data that needed to be systematically reviewed and divided to key categories.”
The special issue explores topics such as SDM interventions, implementation efforts and measurements—that is, when and how to use SDM in mental health settings, and how to measure its effectiveness.
Inside the special edition, Dr. Zisman-Ilani and other researchers also contributed a systematic review of previous studies of SDM interventions in mental health. Dr. Zisman-Ilani collaborated with Drs. Erin Barnett, assistant professor of psychiatry and Juliette Harik, assistant professor of psychiatry and assistant professor of medicine of Dartmouth College and Drs. Anthony Pavlo associate research scientist and Maria O’Connell associate professor of psychiatry of Yale University on the review, which found that decision aids — resources that present information about the benefits and risks of treatment options — were central components in these studies. But, Dr. Zisman-Ilani and her colleagues argue, decision aids alone aren’t enough for effective SDM in mental health. They suggest that discussions about patient values, preferences and goal setting should be an inherent part of SDM in mental health care, in addition to the use of decision aids.
“In mental health, presenting information using decision support tools is good but not enough,” said Dr. Zisman-Ilani. “Ideally, there should be a certain level of partnership and trust between the clinician and the patient before one can discuss treatment options.”