scholarly journals Medication decision-making by persons with serious mental illness

2004 ◽  
Vol 18 (4) ◽  
pp. 126-134 ◽  
Author(s):  
Irma H Mahone
2021 ◽  
Vol 7 (1) ◽  
Author(s):  
Emily B. H. Treichler ◽  
Borsika A. Rabin ◽  
William D. Spaulding ◽  
Michael L. Thomas ◽  
Michelle P. Salyers ◽  
...  

Abstract Background Collaborative decision-making is an innovative decision-making approach that assigns equal power and responsibility to patients and providers. Most veterans with serious mental illnesses like schizophrenia want a greater role in treatment decisions, but there are no interventions targeted for this population. A skills-based intervention is promising because it is well-aligned with the recovery model, uses similar mechanisms as other evidence-based interventions in this population, and generalizes across decisional contexts while empowering veterans to decide when to initiate collaborative decision-making. Collaborative Decision Skills Training (CDST) was developed in a civilian serious mental illness sample and may fill this gap but needs to undergo a systematic adaptation process to ensure fit for veterans. Methods In aim 1, the IM Adapt systematic process will be used to adapt CDST for veterans with serious mental illness. Veterans and Veteran’s Affairs (VA) staff will join an Adaptation Resource Team and complete qualitative interviews to identify how elements of CDST or service delivery may need to be adapted to optimize its effectiveness or viability for veterans and the VA context. During aim 2, an open trial will be conducted with veterans in a VA Psychosocial Rehabilitation and Recovery Center (PRRC) to assess additional adaptations, feasibility, and initial evidence of effectiveness. Discussion This study will be the first to evaluate a collaborative decision-making intervention among veterans with serious mental illness. It will also contribute to the field’s understanding of perceptions of collaborative decision-making among veterans with serious mental illness and VA clinicians, and result in a service delivery manual that may be used to understand adaptation needs generally in VA PRRCs. Trial registration ClinicalTrials.gov Identifier: NCT04324944


2020 ◽  
Author(s):  
Emily Treichler

Objective: Collaborative decision-making is valued by people with serious mental illnesses and associated with important outcomes like treatment engagement and satisfaction, but levels of collaboration remain low. We developed a skills training manual to increase consumer ability to initiate and engage in collaborative decision-making in the hopes of facilitating higher levels of collaboration. Our study included two aims: 1) to understand stakeholder perception of collaborative decision-making, and 2) to gain feedback from stakeholders regarding the skills training manual to inform manual revisions.Methods: Eleven consumers with serious mental illness and eleven providers of mental health treatment were recruited. Each participant received a copy of the skills training manual and engaged in one of two mixed participatory dialogues with eleven participants each.Results: Stakeholders reported having a positive perception of collaborative decision-making, but also reported concern about a number of barriers that may inhibit collaborative interactions. Participants believed that increases in collaboration would have to come from consumer self-advocacy despite provider resistance. Stakeholders responded positively overall to the skills training manual, but made a number of suggestions to improve it, leading to 10 revisions.Conclusions and Implications for Practice: Stakeholders’ response emphasizes the desirability and importance of improving CDM, and suggests that a consumer-led intervention is a promising method to do so. Participatory dialogues were not only an effective method to gather data for this study, but also provided a structured and supportive space for consumers to speak to and with providers, including responding directly to stigma among providers.


2008 ◽  
Vol 16 (10) ◽  
pp. 826-833 ◽  
Author(s):  
Erica L. O'Neal ◽  
Jared R. Adams ◽  
Gregory J. McHugo ◽  
Aricca D. Van Citters ◽  
Robert E. Drake ◽  
...  

2017 ◽  
Vol 52 (4-6) ◽  
pp. 381-398 ◽  
Author(s):  
Karen L Fortuna ◽  
Matthew C Lohman ◽  
John A Batsis ◽  
Elizabeth A DiNapoli ◽  
Peter R DiMilia ◽  
...  

Objective To compare patient experience with healthcare services and providers among older patients (≥50 years old) with and without serious mental illness. Methods Using secondary data from the Medical Expenditures Panel Survey from 2003 through 2013, we compared adults aged 50 years and older with schizophrenia spectrum disorder ( n = 106), mood disorders (i.e., major depressive disorder and bipolar disorder) ( n = 419), and no serious mental illness ( n = 34,921). Results Older adults with schizophrenia spectrum disorder reported significantly worse provider communication than older adults without serious mental illness. Older adults with mood disorders reported the greatest barriers to shared decision-making and the greatest difficulty accessing services. Conclusions Our results highlight the need to improve the patient experience of older adults with serious mental illness. Addressing provider communication, shared decision-making, and access to care among this vulnerable group of older adults may impact clinical outcomes and costs. Future research examining the extent to which improving the patient experience may improve health outcomes and enhance treatment for this highly vulnerable older group is warranted.


2014 ◽  
Vol 65 (12) ◽  
pp. 1409-1413 ◽  
Author(s):  
Stephanie G. Park ◽  
Marisa Derman ◽  
Lisa B. Dixon ◽  
Clayton H. Brown ◽  
Elizabeth A. Klingaman ◽  
...  

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