A critical narrative analysis of shared decision-making in acute, inpatient mental health care

Article


Stacey, Gemma, Felton, Anne, Morgan, Alastair, Stickley, Theo, Willis, M., Diamond, Bob, Houghton, Philip, Johnson, Beverley and Dumenya, John 2016. A critical narrative analysis of shared decision-making in acute, inpatient mental health care. Journal of Interprofessional Care. 30 (1), pp. 35-41.
AuthorsStacey, Gemma, Felton, Anne, Morgan, Alastair, Stickley, Theo, Willis, M., Diamond, Bob, Houghton, Philip, Johnson, Beverley and Dumenya, John
Abstract

Shared decision-making (SDM) is a high priority in healthcare policy and is complementary to the recovery philosophy in mental health care. This agenda has been operationalised within the Values-Based Practice (VBP) framework, which offers a theoretical and practical model to promote democratic interprofessional approaches to decision-making. However, these are limited by a lack of recognition of the implications of power implicit within the mental health system. This study considers issues of power within the context of decision-making and examines to what extent decisions about patients? care on acute in-patient wards are perceived to be shared. Focus groups were conducted with 46 mental health professionals, service users, and carers. The data were analysed using the framework of critical narrative analysis (CNA). The findings of the study suggested each group constructed different identity positions, which placed them as inside or outside of the decision-making process. This reflected their view of themselves as best placed to influence a decision on behalf of the service user. In conclusion, the discourse of VBP and SDM needs to take account of how differentials of power and the positioning of speakers affect the context in which decisions take place.

KeywordsMental Health Care; Shared Decision Making; Values Based Practice; Power; Interprofessional Collaboration
JournalJournal of Interprofessional Care
Journal citation30 (1), pp. 35-41
ISSN1356-1820
Year2016
PublisherTaylor & Francis
Accepted author manuscript
Web address (URL)http://www.tandfonline.com/doi/full/10.3109/13561820.2015.1064878
Publication dates
Print01 Feb 2016
Publication process dates
Deposited17 Feb 2016
Accepted18 Jun 2015
FunderInstitute of Mental Health
University of Nottingham
Copyright informationThis is an Accepted Manuscript of an article published by Taylor & Francis in Journal of Interprofessional Care on 01.02.16, available online: http://wwww.tandfonline.com/10.3109/13561820.2015.1064878
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