PERSON-CENTERED CARE PLANNING AND SHARED DECISION MAKING FOR MENTAL AND COMORBID CONDITIONS

Abstract

Developments in person-centered coordinated care are essential given the challenges of the growing epidemic of physical comorbidity in the mentally ill population. Excessive deaths due to comorbidity, especially cardiovascular disease, continue to contribute to the significant reduction in life expectancy in people with mental health problems. Contemporary and proposed models are now available to provide evidence for a way forward in this field. Practical guidance on implementation using person-centered care planning has now been developed to promote a more collaborative and integrated approach as a solution to the current single disease focused model of care, which is failing this patient group. The WHO perspective supports this strategy with the recent global objectives outlining proactive and preventative strategies and interventions to tackle comorbidity. The emphasis is on a transformation of current systems using evidence-based approaches for more integration to support the delivery of more effective and efficient care for those with mental disorders and other comorbid chronic diseases. Coordinated, collaborative, system-wide strategies encompass transparent shared decision making in prevention, early intervention, treatment options, lifestyle management and pharmacological rationalization. Hence urgent action is required to help create the conditions to enable the delivery of person-centered coordinated care in health care systems by involving commissioning bodies, clinicians, patient groups along with voluntary and other community providers. Contemporary models of care for comorbidity emphasize the importance of coordination in the management of physical well-being from the onset of treatment of people with mental health problems in order to ensure better outcomes, improved overall well-being, and a longer life expectancy. Illustratively, no further funds are available to implement this shift in the model of care in the United Kingdom, so redesign and redistribution of current resources will be key to promote this more seamless coordinated system of care to improve the quality of life and life expectancy for this population.