scholarly journals An Ecological Model for High-Risk Professional Decision-Making in Mental Health: International Perspectives

2021 ◽  
Vol 18 (14) ◽  
pp. 7671
Author(s):  
Cheryl Regehr ◽  
Guy Enosh ◽  
Emily Bosk
Keyword(s):  
Mental Health ◽  
Decision Making ◽  
Mental Health Professionals ◽  
Ecological Model ◽  
Assessment Tools ◽  
Policy And Practice ◽  
Professional Experiences ◽  
Collective Work ◽  
International Perspectives ◽  
Client Factors

Mental health professionals are frequently presented with situations in which they must assess the risk that a client will cause harm to themselves or others. Troublingly, however, predictions of risk are remarkably inaccurate even when made by those who are highly skilled and highly trained. Consequently, many jurisdictions have moved to impose standardized decision-making tools aimed at improving outcomes. Using a decision-making ecology framework, this conceptual paper presents research on professional decision-making in situations of risk, using qualitative, survey, and experimental designs conducted in three countries. Results reveal that while risk assessment tools focus on client factors that contribute to the risk of harm to self or others, the nature of professional decision-making is far more complex. That is, the manner in which professionals interpret and describe features of the client and their situation, is influenced by the worker’s own personal and professional experiences, and the organizational and societal context in which they are located. Although part of the rationale of standardized approaches is to reduce complexity, our collective work demonstrates that the power of personal and social processes to shape decision-making often overwhelm the intention to simplify and standardize. Implications for policy and practice are discussed.

scholarly journals Profiling mental health professionals in relation to perceived interprofessional collaboration on teams

2019 ◽  
Vol 7 ◽  
pp. 205031211984146
Author(s):  
Nicolas Ndibu Muntu Keba Kebe ◽  
François Chiocchio ◽  
Jean-Marie Bamvita ◽  
Marie-Josée Fleury
Keyword(s):  
Mental Health ◽  
Decision Making ◽  
Knowledge Sharing ◽  
Mental Health Professionals ◽  
Health Professionals ◽  
Knowledge Integration ◽  
Interprofessional Collaboration ◽  
Professional Role ◽  
Mutual Trust ◽  
Participation In Decision Making

Objectives: This study aims at identifying profiles of mental health professionals based on individual, interactional, structural and professional role characteristics related to interprofessional collaboration. Methods: Mental health professionals ( N = 315) working in primary health care and specialized mental health teams in four Quebec local service networks completed a self-administered questionnaire eliciting information on individual, interactional, structural and professional role characteristics. Results: Cluster analysis identified four profiles of mental health professionals. Those with the highest interprofessional collaboration scores comprised two profiles labeled “highly collaborative female professionals with fewer conflicts and more knowledge sharing and integration” and “highly collaborative male professionals with fewer conflicts, more participation in decision-making and mutual trust.” By contrast, the profile labeled “slightly collaborative professionals with high seniority, many conflicts and less knowledge integration and mutual trust” had the lowest interprofessional collaboration score. Another profile positioned between these groups was identified as “moderately collaborative female psychosocial professionals with less participation in decision-making.” Discussion and conclusion: Organizational support, participation in decision-making, knowledge sharing, knowledge integration, mutual trust, affective commitment toward the team, professional diversity and belief in the benefits of interdisciplinary collaboration were features associated with profiles where perceived interprofessional collaboration was higher. These team qualities should be strongly encouraged by mental health managers for improving interprofessional collaboration. Training is also needed to promote improvement in interprofessional collaboration competencies.

Preventing and responding to errors in US child protection

2020 ◽  
pp. 235-254
Author(s):  
Jill Duerr Berrick ◽  
Jaclyn Chambers
Keyword(s):  
Decision Making ◽  
Child Welfare ◽  
Child Protection ◽  
Predictive Analytics ◽  
Assessment Tools ◽  
Policy And Practice ◽  
Protection Policy ◽  
Risk Assessment Tools ◽  
The Us ◽  
Child Protection Policy

This chapter demonstrates how concerns about avoiding errors and mistakes have been at the centre of child protection policy and practice in the US for many years. In particular the chapter focuses on providing a summary of the state of the art relating to risk assessment tools and predictive analytics as strategies to reduce error in child welfare decision making. It also examines whether our understanding of ‘error’ needs to shift to account for the unknowns. When social workers make decisions based upon fundamental principles, and when they determine that it is in the interests of a child to privilege one principle over another, the result may appear in hindsight as an “error”, but when made as a decision guided by one widely-held principle which was in direct conflict with another. Examining child welfare decision making as a process of selecting and then privileging one principle over another narrows what we might otherwise think of as an ‘error’ and instead recasts some decisions as exceedingly difficult to get ‘right’.

scholarly journals Mental health professionals’ experiences with shared decision-making for patients with psychotic disorders: a qualitative study

2020 ◽  
Vol 20 (1) ◽  
Author(s):  
Espen W. Haugom ◽  
Bjørn Stensrud ◽  
Gro Beston ◽  
Torleif Ruud ◽  
Anne S. Landheim
Keyword(s):  
Mental Health ◽  
Decision Making ◽  
Shared Decision Making ◽  
Mental Health Professionals ◽  
Health Professionals ◽  
Psychotic Disorders ◽  
Successful Implementation ◽  
Practical Training ◽  
Shared Decision ◽  
Antipsychotic Medications

Abstract Background Shared decision-making (SDM) is a process whereby clinicians and patients work together to select treatments based on both the patient’s preferences and clinical evidence. Although patients with psychotic disorders want to participate more in decisions regarding their care, they have limited opportunities to do so because of various barriers. Knowing about health professionals’ experiences with SDM is important toward achieving successful implementation. The study aim was to describe and explore health professionals’ SDM experiences with patients with psychotic disorders. Methods Three focus group interviews were conducted, with a total of 18 health professionals who work at one of three Norwegian community mental health centres where patients with psychotic disorders are treated. We applied a descriptive and exploratory approach using qualitative content analysis. Results Health professionals primarily understand the SDM concept to mean giving patients information and presenting them with a choice between different antipsychotic medications. Among the barriers to SDM, they emphasized that patients with psychosis have a limited understanding of their health situation and that time is needed to build trust and alliances. Health professionals mainly understand patients with psychotic disorders as a group with limited abilities to make their own decisions. They also described the concept of SDM with little consideration of presenting different treatment options. Psychological or social interventions were often presented as complementary to antipsychotic medications, rather than as an alternative to them. Conclusion Health professionals’ understanding of SDM is inconsistent with the definition commonly used in the literature. They consider patients with psychotic disorders to have limited abilities to participate in decisions regarding their own treatment. These findings suggest that health professionals need more theoretical and practical training in SDM.

scholarly journals The Santa Barbara Wellness Project: Development and Implementation

2012 ◽  
Vol 4 (1) ◽  
pp. 69-82
Author(s):  
Melissa L. Morgan Consoli ◽  
J. Manuel Casas ◽  
A. Patricia Cabrera ◽  
Gustavo Prado
Keyword(s):  
Mental Health ◽  
Decision Making ◽  
Mental Health Professionals ◽  
Health Professionals ◽  
Basic Program ◽  
Lessons Learned ◽  
Management Problem ◽  
Community Members ◽  
Santa Barbara ◽  
Relaxation Stress

This article discusses the creation, implementation and maintenance of the Santa Barbara Wellness Project. This initiative was developed in response to an increase in Latino teen suicides in Santa Barbara County in recent years. Community members including mental health professionals, university faculty and students, concerned citizens, youth and parents came together to help form a prevention program in the wake of this adversity. A basic program including components of relaxation, stress management, problem-solving, and decision-making was developed through consultation among these groups and modifications continue as needed. The program is rooted in the empowerment philosophy of Freire (1973, 2004). Thus far, over 500 individuals have been trained and we are in the process of conducting program evaluation. Challenges, “lessons learned,” and successes are discussed.

Networking, Leadership, Empowerment

2009 ◽  
Vol 06 (02) ◽  
pp. 69-74
Author(s):  
I. T. Calliess ◽  
K. Treichel ◽  
J. Nikitopoulos ◽  
A. Malik ◽  
M. Rojnic Kuzman
Keyword(s):  
Mental Health ◽  
Decision Making ◽  
Mental Health Professionals ◽  
Health Professionals ◽  
Educational Programs ◽  
Educational Policies ◽  
Decision Making Processes ◽  
Fit For Purpose

SummaryAs society’s expectations of mental health professional change radically, educational programs and policies need to keep pace with this change. Trainees and young psychiatrists have established their distinct identity and assured that educational policies are reformed to create competent mental health professionals who are fit for purpose in tomorrow’s world. In order for this to happen, it has taken over a decade of dedication, hard work and motivation from past and present psychiatric trainees and young psychiatrists to travel the journey from having a vision of an international network to develop the existing highly structured network. Networking and empowerment facilitated by national and international young psychiatrists’ organizations has allowed young psychiatrists to participate in decision-making processes and create frameworks for their own professional development. This paper outlines the principles and objectives that underpin the existing networks of national and international young psychiatrists’ organizations. It also describes the various educational and networking activities undertaken by these organizations and uses the case study from Croatia to describe the role of these networks in the formation of national associations of young psychiatrists and trainees.

scholarly journals Negotiating styles adopted by consultant psychiatrists when prescribing antipsychotics

2007 ◽  
Vol 13 (1) ◽  
pp. 43-50 ◽  
Author(s):  
Robert Chaplin ◽  
Paul Lelliott ◽  
Alan Quirk ◽  
Clive Seale
Keyword(s):  
Mental Health ◽  
Decision Making ◽  
Therapeutic Alliance ◽  
Mental Health Professionals ◽  
Health Professionals ◽  
Qualitative Interview ◽  
Shared Decision ◽  
Adherence To Medication ◽  
Qualitative Interview Study ◽  
Improve Clinical Outcome

A good therapeutic alliance between mental health professionals and patients with psychosis can enhance adherence to medication regimens and improve clinical outcome. This article explores how the therapeutic alliance might be developed with respect to decisions to prescribe antipsychotic medication. It does this by presenting the implications for practice that arise from a recent qualitative interview study with consultant psychiatrists. We consider strategies for strengthening the therapeutic alliance, occasions when it might be appropriate to suspend shared decision-making temporarily, techniques used to enable discussion of symptoms and side-effects, and how issues of adherence are uncovered and addressed. Psychiatrists already possess considerable skills in these areas. The dissemination of these to colleagues forms an important opportunity for CPD.

scholarly journals Carers' experiences of involuntary admission under mental health legislation: systematic review and qualitative meta-synthesis

BJPsych Open ◽  
2020 ◽  
Vol 6 (2) ◽  
Author(s):  
Ruth Stuart ◽  
Syeda Ferhana Akther ◽  
Karen Machin ◽  
Karen Persaud ◽  
Alan Simpson ◽  
...  
Keyword(s):  
Mental Health ◽  
Mental Health Professionals ◽  
Bibliographic Databases ◽  
Emotional Impact ◽  
Involuntary Admission ◽  
Policy And Practice ◽  
Accessible Information ◽  
Care And Support ◽  
Mental Health Legislation ◽  
Health Legislation

Background Carers are key providers of care and support to mental health patients and mental health policies consistently mandate carer involvement. Understanding carers' experiences of and views about assessment for involuntary admission and subsequent detention is crucial to efforts to improve policy and practice. Aims We aimed to synthesise qualitative evidence of carers' experiences of the assessment and detention of their family and friends under mental health legislation. Method We searched five bibliographic databases, reference lists and citations. Studies were included if they collected data using qualitative methods and the patients were aged 18 or older; reported on carer experiences of assessment or detention under mental health legislation anywhere in the world; and were published in peer-reviewed journals. We used meta-synthesis. Results The review included 23 papers. Themes were consistent across time and setting and related to the emotional impact of detention; the availability of support for carers; the extent to which carers felt involved in decision-making; relationships with patients and staff during detention; and the quality of care provided to patients. Carers often described conflicting feelings of relief coupled with distress and anxiety about how the patient might cope and respond. Carers also spoke about the need for timely and accessible information, supportive and trusting relationships with mental health professionals, and of involvement as partners in care. Conclusions Research is needed to explore whether and how health service and other interventions can improve the involvement and support of carers prior to, during and after the detention of family members and friends.

Ethical Decision-Making in School Mental Health

2021 ◽  
Author(s):  
James C. Raines ◽  
Nic T. Dibble
Keyword(s):  
Mental Health ◽  
Decision Making ◽  
School Psychologists ◽  
Mental Health Professionals ◽  
Health Professionals ◽  
Ethical Decision ◽  
Ethical Decision Making ◽  
School Mental Health ◽  
Codes Of Ethics ◽  
National Association

Ethical decision making in school mental health provides mental health professionals with a seven-step approach to managing ethical predicaments. It combines guidance from four major codes of ethics, including the American School Counseling Association, National Association of School Nurses, National Association of School Psychologists, and National Association of Social Workers. Ethical issues are endemic for mental health professionals working with minors in a host setting like schools. New interventions, evolving technologies, and a patchwork of ethical and legal guidelines create a constant stream of new ethical dilemmas. Longstanding and complex questions rarely give way to quick and easy answers. The seven-step model presented here enables readers to apply a practical process that minimizes their liability and protects their students. Beginning with an introduction of the moral, legal, and clinical foundations that undergird ethical practice, the authors present an ethical decision-making model with seven steps: know yourself and your responsibilities, analyze the dilemma, seek consultation, identify courses of action, manage clinical concerns, enact the decision, and reflect on the process. The second edition includes meticulously updated chapters based on recent changes to all of the codes of ethics over the past 10 years. It also has a new chapter on the universal issue of ethical recordkeeping. This handy guide is written for multidisciplinary teams of mental health professionals, including school social workers, school psychologists, school nurses, and school counselors. It provides a trusty resource with the following elements: Clearly organized chapters that introduce a process approach to ethical decision-making; Interprofessional and collaborative approach to working with other stakeholders; Case examples and practice exercises illustrate real work application of ethical guidelines; and Glossary, web resources, and U.S. Supreme Court decisions on students’ civil rights.

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