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Psychiatr Serv 58:1219-1221, September 2007
doi: 10.1176/appi.ps.58.9.1219
© 2007 American Psychiatric Association
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Brief Report

Shared Decision-Making Preferences of People With Severe Mental Illness

Jared R. Adams, B.S., Robert E. Drake, M.D., Ph.D. and George L. Wolford, Ph.D.

OBJECTIVE: Perceived roles and preferences were explored for shared decision making among persons with severe mental illnesses. METHODS: In this pilot study, 30 adult clients with severe mental illness in a community mental health center were surveyed about decision making regarding psychiatric medications, rehabilitation, and general medical care. RESULTS: Clients generally expressed a desire for greater participation in decisions about psychiatric care than they currently experienced. Regarding use of new psychiatric medications, 23 persons (77%) preferred autonomous or shared roles, but only 11 (37%) rated their current roles as more than passive (z=-2.83, p=.005). Clients were less likely to prefer a passive role in medication decisions about psychiatric care than about general medical care (seven persons, or 23%, versus 23 persons, or 77%; z=-3.01, p=.003). CONCLUSIONS: Most clients with severe mental illnesses prefer shared decision making, particularly in relation to their mental health care.


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