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Monday, 12 July 2010: 3:05 PM
Learning Objective 1: 1. identify three advantages of usinga cademic-community partnerships to conduct research.
Learning Objective 2: 2. identify five challenges to implementing shared decision making in public mental health.
Purpose: Shared decision making (SDM) holds promise as an emerging best-practice strategy to better engage persons with serious mental illness (SMI) in all aspects of their recovery including decisions about their medications, the need for adherence and collaboration with their provider. SDM may also lead to a better understanding about the effectiveness of antipsychotic medicines in real-world settings.
Methods: An academic-community partnership between a School of Nursing (SON) at a public university and a public MH clinic developed around a shared goal of finding an acceptable SDM intervention targeting medication use by persons with SMI. The planning meetings of the partnership were recorded and analyzed, and seven stakeholder focus groups were conducted to gather relevant information on SDM in public MH.
Results: Themes were identified under the partnership process category (agency values/priorities, research agenda, ground rules, communication) and under the SDM content (barriers, information exchange, positive aspects of SDM, technology). Findings from seven stakeholder focus groups: Barriers to SDM ( history of the medical model, MH crises, lack of system support, time); Consumer-related factors (consumer competency, fears, insight, literacy, trauma from past experiences); Information-exchange issues (consumer passivity, whether consumers could be viewed as experts, adequate history information); New skills needed (provider knowledge about alternative treatments, mastery of person-first language, listening skills, consumer ability to articulate their expert information, computer skills); Outcomes (power-sharing, greater follow-through, greater self-management, improved therapeutic alliances.)
Conclusion: Using the academic-community partnership allowed the community agency to raise questions and concerns throughout the process, be actively involved in research activities, participate in the reflective activities of the impact of SDM on practice and policy, and to feel ownership of the project. Conducting focus groups with stakeholders yielded valuable information in planning for implementing SDM in public MH.
Methods: An academic-community partnership between a School of Nursing (SON) at a public university and a public MH clinic developed around a shared goal of finding an acceptable SDM intervention targeting medication use by persons with SMI. The planning meetings of the partnership were recorded and analyzed, and seven stakeholder focus groups were conducted to gather relevant information on SDM in public MH.
Results: Themes were identified under the partnership process category (agency values/priorities, research agenda, ground rules, communication) and under the SDM content (barriers, information exchange, positive aspects of SDM, technology). Findings from seven stakeholder focus groups: Barriers to SDM ( history of the medical model, MH crises, lack of system support, time); Consumer-related factors (consumer competency, fears, insight, literacy, trauma from past experiences); Information-exchange issues (consumer passivity, whether consumers could be viewed as experts, adequate history information); New skills needed (provider knowledge about alternative treatments, mastery of person-first language, listening skills, consumer ability to articulate their expert information, computer skills); Outcomes (power-sharing, greater follow-through, greater self-management, improved therapeutic alliances.)
Conclusion: Using the academic-community partnership allowed the community agency to raise questions and concerns throughout the process, be actively involved in research activities, participate in the reflective activities of the impact of SDM on practice and policy, and to feel ownership of the project. Conducting focus groups with stakeholders yielded valuable information in planning for implementing SDM in public MH.