Shared decision making interventions for people with mental health conditions
Open accessAbstract
BACKGROUND: One person in every four will suffer from a diagnosable mental health condition during their life course. Such conditions can have a devastating impact on the lives of the individual, their family and society. Increasingly partnership models of mental health care have been advocated and enshrined in international healthcare policy. Shared decision making is one such partnership approach. Shared decision making is a form of patient-provider communication where both parties are acknowledged to bring expertise to the process and work in partnership to make a decision. This is advocated on the basis that patients have a right to self-determination and also in the expectation that it will increase treatment adherence. OBJECTIVES: To assess the effects of provider-, consumer- or carer-directed shared decision making interventions for people of all ages with mental health conditions, on a range of outcomes including: patient satisfaction, clinical outcomes, and health service outcomes. SEARCH STRATEGY: We searched: the Cochrane Central Register of Controlled Trials (CENTRAL, The Cochrane Library 2008, Issue 4), MEDLINE (1950 to November 2008), EMBASE (1980 to November 2008), PsycINFO (1967 to November 2008), CINAHL (1982 to November 2008), British Nursing Index and Archive (1985 to November 2008) and SIGLE (1890 to September 2005 (database end date)). We also searched online trial registers and the bibliographies of relevant papers, and contacted authors of included studies. SELECTION CRITERIA: Randomised controlled trials (RCTs), quasi-randomised controlled trials (q-RCTs), controlled before-and-after studies (CBAs); and interrupted time series (ITS) studies of interventions to increase shared decision making in people with mental health conditions (by DSM or ICD-10 criteria). DATA COLLECTION AND ANALYSIS: Data on recruitment methods, eligibility criteria, sample characteristics, interventions, outcome measures, participant flow and outcome data from each study were extracted by one author and checked by another. Data are presented in a narrative synthesis. MAIN RESULTS: We included two separate German studies involving a total of 518 participants. One study was undertaken in the inpatient treatment of schizophrenia and the other in the treatment of people newly diagnosed with depression in primary care. Regarding the primary outcomes, one study reported statistically significant increases in patient satisfaction, the other study did not. There was no evidence of effect on clinical outcomes or hospital readmission rates in either study. Regarding secondary outcomes, there was an indication that interventions to increase shared decision making increased doctor facilitation of patient involvement in decision making, and did not increase consultation times. Nor did the interventions increase patient compliance with treatment plans. Neither study reported any harms of the intervention. Definite conclusions cannot be drawn, however, on the basis of these two studies. AUTHORS' CONCLUSIONS: No firm conclusions can be drawn at present about the effects of shared decision making interventions for people with mental health conditions. There is no evidence of harm, but there is an urgent need for further research in this area.
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The review considered papers published between 2009 and 2019, limited to English and peer-reviewed journals.
“The search considered recent papers published between 2009 and 2019, as publications from previous years had already been covered by Duncan et al. [37]. The search was limited to papers in English and published in peer-reviewed journals.”
From The role of shared decision-making in improving adherence to pharmacological treatments in patients with schizophrenia: A clinical review (2020) · cites this paper as [37]
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- Authors
- Duncan, E., Best, C., & Hagen, S.
- Affiliations
- University of Stirling (GB)
- Glasgow Caledonian University (GB)
- Venue
- Cochrane Database of Systematic Reviews
- Publisher
- Wiley
- Published
- 2010-01-20
- Issue
- 1
- Pages
- CD007297-CD007297
- ISSN
- 1361-6137 (ISSN-L)
- 1465-1858
- PMC
- PMC7209977
- OpenAlex
- W2104315782
- Cited by
- 256
- References
- 121
- Citations by year
- 2026: 1 · 2025: 3 · 2024: 12 · 2023: 9 · 2022: 11 · 2021: 15 · 2020: 20 · 2019: 16 · 2018: 21 · 2017: 21 · 2016: 22 · 2015: 20 · 2014: 28 · 2013: 23 · 2012: 18
- FWCI
- 3.38
- Type
- journal article
- Language
- en
- Update notices
- new_version (2022-11-11)
- Open access
- bronze
- doi.org
- Locations
- Cochrane Database of Systematic Reviews (publishedVersion)
- PubMed Central (publishedVersion)
- PubMed (publishedVersion)
- ResearchOnline (acceptedVersion)
- Stirling Online Research Repository (University of Stirling) (submittedVersion, public-domain)
- Topics
- Health Sciences › Health Professions › General Health Professions › Patient-Provider Communication in Healthcare
- Health Sciences › Health Professions › General Health Professions › Mental Health and Patient Involvement
- Social Sciences › Psychology › Clinical Psychology › Psychiatric care and mental health services
- Keywords
- making, mental illness, patient-provider communication, patient satisfaction, medication adherence, schizophrenia, depression, newly diagnosed depression, primary care, hospital readmission, caregiver involvement, self-determination, community mental health services
- MeSH terms
- Decision Making, Depression, Humans, Patient Participation, Schizophrenia, Randomized Controlled Trials as Topic, Patient Satisfaction
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
Statistics and arithmetic are recomputed, not judged.
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