"Work with me": service users' perspectives on shared decision making in mental health. Issue 3 (11th September 2017)

• Record Type: Journal Article
• Authors: Castillo, Heather; Ramon, Shulamit
• Is Part Of: Mental health review. Volume 22:Issue 3(2017)
• Page Start: 166
• Page End: 178
• Publication Date: 2017-09-11
• Subjects: Mental health -- Shared decision making -- Barriers to shared decision making -- Narrative synthesis -- Service users' perspectives; Mental health services -- Great Britain -- Periodicals; Mental health -- Periodicals; Mental Health Services -- Great Britain -- Periodicals; 362.20941
• DOI: 10.1108/MHRJ-01-2017-0005
• Languages: English
• ISSNs: 1361-9322

Abstract

Abstract : Purpose: While shared decision making (SDM) in general health has proven effectiveness, it has received far less attention within mental health practice with a disconnection between policy and ideals. The purpose of this paper to review existing developments, contemporary challenges, and evidence regarding SDM in mental health with a particular focus on the perspectives of service users. Design/methodology/approach: This is a review of international papers analysed using narrative synthesis of relevant data bases. Findings: The review shows significant barriers to the utilisation of SDM including ethical and legal frameworks, accountability and risk. The medical model of psychiatry and diagnostic stigma also contributes to a lack of professional acknowledgement of service user expertise. Service users experience an imbalance of power and feel they lack choices, being "done to" rather than "worked with". Practical implications: The paper also presents perspectives about how barriers can be overcome, and service users enabled to take back power and acknowledge their own expertise. Originality/value: This review is the first with a particular focus on the perspectives of service users and SDM.