City Research Online

Abstract

Risk Assessment (RA) and Risk Management (RM) are fundamental processes in the delivery of safe and effective mental health care, yet studies have shown that service users are often not directly involved or are unaware that an assessment has taken place. Shared Decision-Making (SDM) in mental health systems is supported by research and advocated in policy. The primary aim of this programme of research was to identify the barriers and enablers to SDM in RA and RM,from the perspective of mental health professionals and service users.

Study 1 synthesised the best available evidence on mental health professionals’ experiences of SDM in RA and RM. The findings of this review indicate that SDM is not a concept commonly used in mental health services when exploring processes of RA and RM. The key barriers identified were ‘power and best interest’ and ‘my professional role and responsibility’. Key enablers were ‘therapeutic relationship’ and ‘value collaboration’. An exploratory sequential mixed-methods design and psychological theory were applied in study 2 (a qualitative interview study) and study 3 (a cross-sectional survey), which explored mental health professionals and service users’ perceived barriers and enablers to SDM in RA and RM. The findings show that stakeholders are motivated to work collaboratively but experience a complex range of social, cultural, and environmental factors that influence theiropportunity and capability to achieve SDM in RA and RM.

The findings of this thesis can be used to develop targeted interventions aiming to increase SDM in RA and RM. However, further empirical work is needed to validate these findings and determine the acceptability and feasibility of an intervention with key stakeholders.

Publication Type:	Thesis (Doctoral)
Subjects:	R Medicine > RC Internal medicine > RC0321 Neuroscience. Biological psychiatry. Neuropsychiatry R Medicine > RT Nursing
Departments:	Bayes Business School > Actuarial Science & Insurance > Statistical Research Reports

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