Practicing shared decision making in the outpatient psychiatric care of adults with severe mental illnesses: redesigning care for the future.
Psychiatrist outpatient office visits have the potential to support the recovery of adults with severe mental illnesses by engaging them in a collaborative process of evaluating, selecting, and trying individually-tailored therapeutic options. Evidence-informed shared decision making is difficult for psychiatrists to offer within the framework of care as it is delivered today: it requires time, easy access to relevant scientific information, and extensive communication between patients and psychiatrists. In this paper, we describe the current structural obstacles to collaborative psychiatric care and envision a redesigned office visit process that facilitates active informed patient involvement.
Torrey
William C
WC
Dartmouth Medical School, Hanover, NH, USA. William.C.Torrey@Dartmouth.EDU
Drake
Robert E
RE
D000328:Adult; D000553:Ambulatory Care; D003142:Communication; D003657:Decision Making; D055317:Evidence-Based Practice; D005544:Forecasting; D006801:Humans; D001523:Mental Disorders / Q000523:psychology / Q000628:therapy*; D009819:Office Visits; D010358:Patient Participation / Q000379:methods / Q000523:psychology* / Q000639:trends; D010817:Physician-Patient Relations; D011570:Psychiatry; D012559:Schizophrenia / Q000175:diagnosis / Q000534:rehabilitation*