Supported decision-making interventions in mental healthcare: A systematic review of current evidence and implementation barriers (3 March 2024)

Summary

There is a growing momentum around the world to foster greater opportunities for the involvement of mental health service users in their care and treatment planning. In-principle support for this aim is widespread across mental healthcare professionals. Yet, progress in mental health services towards this objective has lagged in practice.

Francis et al. conducted a systematic review of quantitative, qualitative and mixed-method research on interventions to improve opportunities for the involvement of mental healthcare service users in treatment planning, to understand the current research evidence and the barriers to implementation.

Overarching barriers to shared and supported decision-making in mental health treatment planning were: (1) Organisational (resource limitations, culture barriers, risk management priorities and structure); (2) Process (lack of knowledge, time constraints, health-related concerns, problems completing and using plans); and (3) Relationship barriers (fear and distrust for both service users and clinicians).

On the basis of the barriers identified, recommendations are made to enable the implementation of new policies and programmes, the designing of new tools and for clinicians seeking to practice shared and supported decision-making in the healthcare they offer.