Factors influencing patients' preferences and perceived involvement in shared decision-making in mental health care

Johanne Eliacin, Michelle P. Salyers, Marina Kukla, Marianne S. Matthias

Research output: Contribution to journalArticle

31 Scopus citations


Background: Although research has suggested that patients desire to participate in shared decision-making, recent studies show that most patients take a passive role in their treatment decisions. The discrepancy between patients' expressed desire and actual behaviors underscores the need to better understand how patients perceive shared decision-making and what factors influence their participation. Aims: To investigate patients' preferences and appraisals of their involvement in treatment decisions. Methods: Fifty-four qualitative interviews were conducted with veterans receiving outpatient mental health care at a U.S. Veterans Affairs Medical Center. Interviews were analyzed using thematic analysis. Results: Participants outlined several factors that influence their preferences and involvement in treatment decisions. These include the patient-provider relationship, fear of being judged, perceived inadequacy, and a history of substance abuse. Conclusion: Patients' preferences and willingness to engage in shared decision-making fluctuate over time and are context dependent. A better understanding of these factors and a strong patient-provider relationship will facilitate better measurement and implementation of shared decision-making.

Original languageEnglish (US)
Pages (from-to)24-28
Number of pages5
JournalJournal of Mental Health
Issue number1
StatePublished - Feb 1 2015



  • Mental health
  • Patient's preferences and participation
  • Shared decision-making
  • Veterans

ASJC Scopus subject areas

  • Psychiatry and Mental health

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