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Final Project: 6-2 Final Project Milestone three: Rough Draft of Final Proposal

Department of Psychology

PSY-540-X5265 Cognitive Processes

Gregory Privitera

August 13, 2023

Problem Statement

There are several contemporary problems associated with decision making in mental health. A few key issues.

Lack of access to care: Many individuals face barriers in accessing mental health services, including long wait times, limited availability of specialist, and financial constraints. This can delay decision making and access to timely treatment .

Stigma and discrimination is also a contemporary problem when it comes to decision making in mental health. Mental health conditions carry significant stigma, leading to reluctance to seek help and decision making about treatment. Lastly, I would like to mention that cultural and diversity considerations impact decision making in mental health as well . Decision making in mental health must take into account the cultural and diversity factors. Different cultural beliefs, values, and practices can impact treatment choices.

Addressing these contemporary problems require concerted efforts to improve access to mental health services, prioritize informed consent and promote shared decision-making. Decision making is a complex and dynamic social interaction 1 . The balance of involvement between clinician and patient can be conceptualized as lying on a continuum from clinician-led/passive/paternalistic, through shared, to patient-led/informed/active 2 . Clinician-led decision making occurs when the clinician makes the decision for the patient, possibly after consulting with him/her. 

Contemporary Relevance

Decision making in mental health remains highly relevant in contemporary times. As our understanding of mental health continues to evolve, making informed decisions about treatment options, therapy approaches, medication, and lifestyle changes becomes crucial. With the growing emphasis on patient-centered care, involving individuals in decisions about their own mental health empowers them to take an active role in their recovery journey. Additionally, ethical considerations surrounding consent, privacy, and autonomy highlight the ongoing importance of thoughtful decision making in the field of mental health. Contemporary relevance in decision making in mental health also  refers to the application of current knowledge, research, and practices to guide choices related to mental health treatment, interventions, and policies. It emphasizes using up-to-date information and insights from fields such as psychology, psychiatry, neuroscience, and social work to make informed decisions that promote the well-being of individuals dealing with mental health challenges. This approach ensures that decisions are aligned with the latest understanding of mental health conditions and their management, leading to more effective and evidence-based outcomes.

Interpretation of Research Findings

This article Shared decision making in mental health: prospects for personalized medicine

Focuses on the shared decision-making model, reviews its current status in the mental health field, and discusses its potential impact on personalized medicine. Shared decision making denotes a structured process that encourages full participation by patient and provider. Current research shows that shared decision making can improve the participation of mental health patients and the quality of decisions in terms of knowledge and values. The impact of shared decision making on adherence, illness self-management, and health outcomes remains to be studied. Implementing shared decision making broadly will require re-engineering the flow of clinical care in routine practice settings and much greater use of information technology Similar changes will be needed to combine genomic and other biological data with patients' values and preferences and with clinicians' expertise. The future of personalized medicine is dearly linked with our ability to create the infrastructure and cultural receptivity to these changes.” Patients' decisions impact behaviors, such as treatment initiation and continuance, which in turn can influence individual and aggregate level clinical health status and health system outcomes.”

This article Integrating Decision Making and Mental Health Interventions Research: Research Directions discusses the importance of incorporating patient and provider decision-making processes is in the forefront of the National Institute of Mental Health (NIMH) agenda for improving mental health interventions and services. Key concepts in patient decision making are highlighted within a simplified model of patient decision making that links patient-level/“micro” variables to services-level/“macro” variables via the decision-making process that is a target for interventions. The prospective agenda for incorporating decision-making concepts in mental health research includes improved measures for characterizing decision-making processes that are matched to study populations, complexity, and types of decision making; (b) testing decision aids in effectiveness research for diverse populations and clinical settings; and (c) improving the understanding and incorporation of preference concepts in enhanced intervention designs. “The importance of incorporating patient and provider decision-making processes in interventions research has come to the forefront of the National Institute of Mental Health ( NIMH, 1999) agenda for improving mental health interventions and services and is currently identified as a key research direction for the NIMH Primary Care Research program. Patients/healthcare users 1 are increasingly recognized as key decision makers in shared treatment decision making with healthcare providers, but relatively little research has been done in mental health regarding patient/provider treatment preferences and decision-making processes. 

Methodological Principles

Methodological principles of decision making in mental health involve systematic approaches to assessing, diagnosing, and treating individuals with mental health issues. These principles often include evidence-based practices, cultural sensitivity, collaboration among professionals, patient-centered care, and ethical considerations. It's essential to consider each individual's unique needs and preferences while adhering to established guidelines and staying informed about the latest research in the field. here are a few examples of methodological principles of decision making in mental health:         1.      Evidence-Based Practices: Clinicians use treatments and interventions that have been proven effective through rigorous scientific research. For example, Cognitive Behavioral Therapy (CBT) is widely used for treating conditions like depression and anxiety due to its strong evidence base.         2.      Cultural Sensitivity: Mental health professionals should consider cultural, ethnic, and social factors that might influence a person’s experience of mental health. Tailoring treatment plans to an individual’s cultural background is crucial for effective care.         3.      Collaborative Approach: Decision making often involves collaboration between mental health professionals, patients, and sometimes their families. Open communication and shared decision-making empower the individual to play an active role in their treatment.         4.      Patient-Centered Care: The focus is on the patient’s goals, preferences, and values. For example, a treatment plan might be adjusted to align with a patient’s personal life circumstances and aspirations.         5.      Ethical Considerations: Mental health professionals adhere to ethical guidelines, ensuring confidentiality, informed consent, and respect for autonomy. This is especially important when making decisions about treatment options and sharing information.         6.      Holistic Assessment: Decision making takes into account not only the individual’s mental health symptoms but also their physical health, social environment, and any coexisting conditions.

Conclusion

The conclusion about decision making in mental health is that it's a complex process influenced by various factors such as cognitive abilities, emotional state, social context, and personal values. It's important for individuals and healthcare professionals to collaborate, consider available information, and prioritize the well-being of the person when making decisions related to mental health treatments and interventions.

References

1. Ackermann R, Williams J. Rational treatment choices for non-major depressions in primary care.  Journal of General Internal Medicine. 2002;17:293–301. [ PMC free article] [ PubMed] [ Google Scholar]

2. Barrett B, Kiefer D, Rabago D. Assessing the risks and benefits of herbal medicine: An overview of scientific evidence.  Alternative Therapies. 1999;5(4):40–49. [ PubMed] [ Google Scholar]