Health professionals’ perspectives on shared decision-making in secondary mental healthcare: a qualitative study

Abstract

Background Shared decision-making is widely recommended but has not been widely implemented in mental healthcare. There is a lack of direct evidence about health professionals’ perspectives on shared decision-making in Asian cultures, particularly Taiwan. Such knowledge is of key importance to facilitate shared decision-making. Therefore, further studies are needed to clarify this issue. Aim To explore health professionals’ perspectives of shared decision-making in secondary mental healthcare in Taiwan. Method Qualitative semi-structured interviews were used. Purposive sampling was applied to recruit health professionals. Data were analysed using thematic analysis. Results Twenty-four health professionals were recruited. This study found the absence of shared decision-making was acceptable to them. Barriers included: powerful status of health professionals and families, patients with impaired decisional ability due to mental illness, health professionals’ lack of understanding of shared decision-making, and insufficient time. Facilitators included: awareness of patients’ right to autonomy and understanding of potential benefits of shared decision-making. Conclusions The study found that the absence of patient involvement in decision-making was widely reported. A discussion of barriers and facilitators is provided. Barriers and facilitators are highlighted to build a foundation for implementing shared decision-making in the future.