A primary goal of recovery-oriented mental health services is to increase client voice and empowerment. Shared decision-making (SDM) technologies can help achieve this goal. We report on two projects that aim to increase engagement around antipsychotic medications by people with serious mental illness (SMI).

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Project 1: Using a participatory-action research (PAR) orientation, a partnership between a university and a public MH clinic developed around a shared goal of finding an acceptable SDM intervention targeting medication use by persons with SMI. We solicited input about SDM from national experts and via focus groups of local stakeholders and analyzed the qualitative data.

Project 2: The US Substance Abuse and Mental Health Service Administration (SAMHSA) contracted with Advocates for Human Potential (AHP) to develop a decision aid (DA) for consumers considering use of antipsychotic medication. Based on the results of literature reviews and stakeholder needs assessments, we constructed a multi-module consumer-centered DA that follows the International Patient Decision Aid Standards (IPDAS) for DAs. The DA is still under construction; however, we have completed entering the format and content of several of the modules.

Audience responses to the concept of SDM have been mixed. The PAR group identified multiple barriers to implementing SDM in practice, including consumer factors, information exchange, skill requirement, and outcomes expected from using SDM.

Adapting shared decision-making technologies to mental health settings has unique challenges. We are using the barriers identified by the PAR group to guide creation of the SAMHSA DA.