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Shared decision-making with involuntary hospital patients: a qualitative study of barriers and facilitators

  • Domenico Giacco (a1), Liza Mavromara (a1), Jennifer Gamblen (a1), Maev Conneely (a1) and Stefan Priebe (a1)...
Abstract
Background

Last year, there were more than 63 622 involuntary admissions to psychiatric hospitals in England. One of the core principles stipulated in the code of practice for care under the Mental Health Act is involving involuntary patients in care decisions.

Aims

Identifying barriers and facilitators to shared decision-making with involuntary patients.

Method

Focus groups and individual interviews with patients and clinicians who have experience with involuntary hospital treatment were carried out. Data were subjected to thematic analysis.

Results

Twenty-two patients and 16 clinicians participated. Barriers identified included challenges in communication, and noisy and busy wards making one-to-one meetings difficult. Patient involvement was identified as easier if initiated early after admission and if the whole clinical team was on board. Carers' presence helped decision-making through providing additional information and comfort.

Conclusions

The barriers and facilitators identified can inform changes in the practice of involuntary care to increase patient involvement.

Declaration of interest

None.

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Copyright
This is an Open Access article, distributed under the terms of the Creative Commons Attribution-NonCommercial-NoDerivatives licence (http://creativecommons.org/licenses/by-nc-nd/4.0/), which permits non-commercial re-use, distribution, and reproduction in any medium, provided the original work is unaltered and is properly cited.
Corresponding author
Correspondence: Domenico Giacco, Newham Centre for Mental Health, London E13 8SP, UK. Email: d.giacco@qmul.ac.uk
References
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Shared decision-making with involuntary hospital patients: a qualitative study of barriers and facilitators

  • Domenico Giacco (a1), Liza Mavromara (a1), Jennifer Gamblen (a1), Maev Conneely (a1) and Stefan Priebe (a1)...
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