Promoting client empowerment in mental health service and treatment is linked with positive outcomes and is considered an indicator of quality recovery-oriented services. However, most public mental health services do not yet fully implement this goal.

Recognizing that shared decision-making (SDM) technologies have the potential to encourage more effective communication and collaboration, SAMHSA and Advocates for Human Potential are developing SDM resources for public mental health services and the people they serve.

We report on field tests of one resource, a decision aid (DA) for consumers considering use of antipsychotic medication.

After conducting a literature review and analysis of decision support materials, we performed consumer and provider needs assessments to guide DA development. We constructed a 7-module Webbased consumer-centered DA that follows IPDAS standards. We tested the prototype with groups of consumers and providers available to the team.

Responses to the DA have been mixed. Some providers are concerned about “sharing” treatment decisions with clients and feel there is too much information in the DA. Some consumers want more information yet feel the DA is too long. Both groups express enthusiasm about the use of a DA for antipsychotic medication.

Adapting SDM concepts and tools to public mental health settings has unique challenges. Traditional assumptions about competency of people with mental health diagnoses have resulted in a history of provider-dominated decision-making. While DAs are designed to help balance power in the clinical encounter, we recognize that there are more obstacles to overcome.