Factors affecting shared decision-making in mental health care: A cross-sectional explorative study in specialist mental health care and addiction services

Presently, the health care service experiences increased expectations of patient involvement in decisions about treatment. Shared decision-making (SDM) is a conceptualization of patient involvement, described as a meeting of two equal parts with different expertise: the professional as expert on the discipline, and the patient as expert on his or her own life. Present descriptions of patient preconditions for SDM are mainly restricted to patient education. However, the concept needs a broader approach, where the contributions from health professionals and service structures, as well as further sides of patient contribution should be included. We performed a cross-sectional study at Division of mental health at Sørlandet hospital in Norway January 2017. We included 992 patients and 312 clinicians. We explored the patients’ experiences of SDM; the concurrence of experienced SDM between patients and their clinicians; how the attitudes of the clinician influenced the patient experiences of SDM, and if patients experienced support with medication issues. The participants reported adequate experiences of SDM. Male patients, patients with diagnoses involving psychotic symptoms, patients with longer treatment durations, and involuntary treated patients experienced less SDM. Patients with longer treatment durations and involuntarily treated patients had a higher probability of reporting less SDM than their clinician. Patients, whose clinicians expressed a patient-centred attitude, experienced more SDM. Older patients and patients with beliefs of stronger needs for medication experienced more medication support. Patients with beliefs of higher concern to medication experienced less support