Shared decision-making preferences of people with severe mental illness

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.