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Laurie Curtis and Melody Riefer

Laurie Curtis and Melody Riefer

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Published by dwellintheheart
Concerns a process of shared decision making in mental health treatment based on the work of Dr. Pat Deegan.
Concerns a process of shared decision making in mental health treatment based on the work of Dr. Pat Deegan.

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Published by: dwellintheheart on Mar 22, 2010
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 Shared Decision-Makingin Mental Health and Behavioral Healthcare
National Grantee Conferenceon the Mental Health Block Grant and Data
Washington, DCJune 18, 2009
Presenters:Melody Riefer
Pat Deegan & Associates, Inc.Shared Decision-Making ProjectAtlanta Office2392 Cardinal WayTucker, GA 20084
Laurie Curtis
Project DirectorSAMHSA’s Shared Decision-Makingin Mental Health ProjectAdvocates for Human Potential2 E-Comm Square324 BroadwayAlbany, NY 12207lcurtis@ahpnet.com 
Stacey LeskoContract OfficerOffice of Consumer AffairsCenter for Mental Health Services (CMHS)Substance Abuse and Mental Health Services Administration (SAMHSA)1 Choke Cherry road, Room 2-1012Rockville, MD 20857stacey.lesko@samhsa.hhs.gov 
Shared Decision-Making (SDM):Making Recovery Real in Mental Health Care
Substance Abuse and Mental Health Services Administration (SAMHSA)Center for Mental Health Services (CMHS)
 About Shared Decision-Making
Shared decision-making is an interactive and collaborative process between individuals and their health carepractitioners about decisions pertinent to the individual’s treatment, services, and ultimately their personalrecovery. The practitioner brings expertise about disorders, treatment options, risks and benefits. Individualsbring their lived experience, knowledge, values, and preferences.
An optimal decision is one that is informed, consistent with personal values, and acted upon. Participants aresatisfied with the process used to make the decision.
Shared decision-making is particularly relevant when there is uncertainty about a particular decision.Uncertainty may stem from multiple or competing options each with advantages and disadvantages,incomplete or inconclusive scientific outcome evidence, or individual factors such as personal values andbeliefs, a limited knowledge about the options, or lack of support to make a clear choice.
Effective shared decision-making requires both informed and involved consumers, and practitioners who arewilling to enter into meaningful dialogue with the person about the decision to be made.
In general health care, people are increasingly recognized as key decision-makers about their own healthcare.For example, the Institute of Medicine (IOM) Report,
Crossing the Quality Chasm,
calls for health care to bepatient-centered with individual preferences, needs, and values guiding clinical decisions. The IOM’s follow-upreport,
Improving the Quality of Health Care for Mental and Substance Abuse Conditions,
expands theprinciples of informed, patient-centered treatment, and shared decision-making to mental health andsubstance abuse treatment services.
Decision Aids and Decision Support 
Decision aids
are tools that help provide information and provide a structured process for making decisionsabout a particular concern. They may be presented in any number of formats, such as paper-pencil,audio/visual, computer-assisted or web-based interactive technologies. Regardless of format, decision aidscontain four primary elements: (1) Information; (2) Values clarification; (3) Recognition of social pressures ondecision-maker; and (4) Resources required to act on decision.
Decision Support 
: Processes for helping individuals gather information, assess risks/benefits, and use decisionaids and other resources to come to a decision that aligns with personal values and goals. May includepreparation for communicating and implementing a decision.
The Ottawa Health Research Institute maintains the Ottawa Health Decision Centre
which has an inventory of many decision aides for physical health care, many of which are available on line.The Dartmouth-Hitchcock Medical Center Decision Support Center, with funding from the Foundation for Informed Medical Decision Making and Health Dialog, Inc., has established an on-site decision-support center  for patients and also provides limited on-line resources
 About Shared Decision-Making in Mental Health
SAMHSA/CMHS is interested in promoting and supporting SDM in mental health for a number of reasons
SDM is consistent with recovery-based transformation and the foundation values of choice, self-determination, and empowerment.
SDM is a means of enhancing involvement of consumers in mental health care, which has recognizedbenefits for positive treatment outcomes.
Mental health consumers have an active desire to participate in decisions about their care and arecapable of doing so.
To promote these interests and objectives, SAMHS/CMHS has initiated and funded this project.
There is growing understanding and interest in how approaches to shared decision-making emerging in thephysical health arena may be adapted to mental health field. Currently there is very little research and fewdecision-aides or other materials on shared decision-making specific to the mental health context.
Dr. Patricia Deegan has pioneered an innovative approach to helping mental health consumers to participatein shared decision-making about the use of psychiatric medication. This program, “Common Ground” is oneexample of decision support and includes peer-to-peer workshops, an interactive software program availableto patients in a clinical waiting-room setting, and training for practitioners to help clients navigate decisionalconflict related to medication use. Dr. Deegan is a lead member of the SAMHSA/CMHS SDM project.
 About the SAMHSA/CMHS Project: Shared Decision-Making: Making Recovery Real in Mental Health
The project is intended to identify existing proven decision-making technologies from general healthcare orother sources, and then adapt and pilot test them for use by mental health care practitioners and consumers.
SDM is a very new approach for mental health services and it is expected that this project will develop interestand provide a foundation for future development in the field.
The intended audiences for shared decision-making materials developed through this project include mentalhealth consumers, practitioners, and family members.
Products under Development 
Three different kinds of products are being developed under this project.
Introductory materials for specific audiences such as consumers, providers, administrators, prescribers
Decision support materials providing general structure and guidance for making any decisions
An interactive, web-based decision aid focusing a decision relevant to antipsychotic medications
Method for Development 
The SAMHSA/CMHS SDM project is being developed under a contract with Advocates for Human Potential,Inc. (AHP) and Westat, with an experienced team of staff, consultants, and subcontractors to design, developand pilot test SDM products.
SDM project receives regular input and feedback from a Planning Team, an advisory group of researchers,policy-makers, consumers, family members, and practitioners.
All SDM products will undergo pre-development audience testing and field evaluation.
For further information contact:
Laurie Curtis, Project Director Shared Decision-Making: Making Recovery Real in Mental Health Care Advocates for Human Potential, Inc.lcurtis@ahpnet.com 

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