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Tijdschrift voor Psychiatrie 61 (2019) 7, 487 - 497


Shared decision making in mental health care; evaluation of the added value for patients and clinicians

M.J. Metz, M.A. Veerbeek, I. Elfeddali, E. de Beurs, C.M. van der Feltz-Cornelis, A.T.F. Beekman

background Although the evidence is expanding, in mental health care shared decision making (sdm) is not widely applied. Moreover, little is known about the use of routine outcome monitoring (rom) and eHealth in sdm.
aim PhD research on the added value of sdm using rom and eHealth for patients and clinicians in mental health care.
method Three studies: 1. a literature research and a cross-sectional study on decisional conflict; 2. rom implementation research and a cluster randomised trial on shared decision making using rom (Breakthrough program); 3. a cluster randomised trial on shared decision making during the intake (regional).
results The interventions did not lead to reduced decisional conflict for all patient groups. Decisional conflict gives insight into the patient’s perspective on the quality of the decision making process and decisions being made. Only patients with depression, who participated in the national trial, reported less decisional conflict. This trial did not show a higher level of sdm, but did show increased usage of rom in clinical practice. Although the regional trial showed no results on decisional conflict, the application of sdm and treatment outcomes improved.
conclusion sdm in mental health care needs further improvement. We recommend investigating how to support patients better, taking into account the role that suits them.

keywords eHealth, routine outcome monitoring, shared decision making