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Expanding the concept of shared decision making for mental health: systematic search and scoping review of interventions

Yaara Zisman-Ilani (Department of Rehabilitation Sciences, College of Public Health, Temple University, Philadelphia, Pennsylvania, USA)
Erin Barnett (Dartmouth Trauma Interventions Research Center, Dartmouth-Hitchcock Medical Center, Geisel School of Medicine, Lebanon, New Hampshire, USA)
Juliette Harik (National Center for PTSD, White River Junction, Vermont, USA) (Geisel School of Medicine, Lebanon, New Hampshire, USA)
Anthony Pavlo (Program for Recovery and Community Health, Yale University, New Haven, Connecticut, USA)
Maria O’Connell (the Yale University, New Haven, Connecticut, USA)

Mental Health Review Journal

ISSN: 1361-9322

Article publication date: 11 September 2017




Much of the existing literature on shared decision making (SDM) in mental health has focused on the use of decision aids (DAs). However, DAs tend to focus on information exchange and neglect other essential elements to SDM in mental health. The purpose of this paper is to expand the review of SDM interventions in mental health by identifying important components, in addition to information exchange, that may contribute to the SDM process in mental health.


The authors conducted a systematic literature search using the Ovid-Medline database with supplementary scoping search of the literature on SDM in mental health treatment. To be eligible for inclusion, studies needed to describe (in a conceptual work or development paper) or evaluate (in any type of research design) a SDM intervention in mental health. The authors included studies of participants with a mental illness facing a mental health care decision, their caregivers, and providers.


A final sample of 31 records was systematically selected. Most interventions were developed and/or piloted in the USA for adults in community psychiatric settings. Although information exchange was a central component of the identified studies, important additional elements were: eliciting patient preferences and values, providing patient communication skills training, eliciting shared care planning, facilitating patient motivation, and eliciting patient participation in goal setting.


The review indicates that additional elements, other than information exchange such as sufficient rapport and trusting relationships, are important and needed as part of SDM in mental health. Future SDM interventions in mental health could consider including techniques that aim to increase patient involvement in activities such as goal settings, values, and preference clarification, or facilitating patient motivation, before and after presenting treatment options.



The authors of this manuscript would like to thank Tom Mead from Dartmouth College Biomedical Libraries for his time, effort and help in conducting the search.


Zisman-Ilani, Y., Barnett, E., Harik, J., Pavlo, A. and O’Connell, M. (2017), "Expanding the concept of shared decision making for mental health: systematic search and scoping review of interventions", Mental Health Review Journal, Vol. 22 No. 3, pp. 191-213.



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Copyright © 2017, Emerald Publishing Limited

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