Category Mental Health Reform

Shared Decision Making – with Families – Yields Better Treatment Outcomes

Alison M. Heru, M.D.
Professor of Psychiatry, University of Colorado Denver

In the NES Program at University of Colorado Health, a six-month program combining neurology and psychiatry treatment for non-epileptic or non-electrical seizures, psychiatrist Dr. Alison Heru makes shared decision making an integral part of practice.

In my experience, shared decision making yields the best results in treatment. When patients feel like they have participated in choosing the treatment and are able to ask questions and weigh alternatives, they are more likely to feel they have selected the treatment that is the best for them and have a stronger stake in the outcome.

At the NES program (addressing non-electrical seizures), there’s not clear evidence for which treatment approach will be best for each patient. It’s my role, then, to make sure we make the correct diagnosis, provide information about the treatment modalities available, and decide together with the patient (and the patient’s family, unless not available) on the treatment plan. I won’t tell the patient what to do or to force a choice on them, but I will offer my opinion.

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How Can Parents Help in Shared Decision Making?

Families for Depression Awareness for Care for Your Mind

Your teenager has been diagnosed with a mood disorder and the clinician is talking with her or him about treatment. What is your role as a parent in the shared decision making model? How can you participate?

At Families for Depression Awareness, we believe that parents can play an essential role in recognizing and addressing mood disorders in their children. When you’re worried about a teen in your life, you might need to take crucial actions in a crisis situation, convince a reluctant teen to go to a mental health provider, or be supportive in finding and accessing mental health care.

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How Peer Specialists Enhance Shared Decision Making

Tom Lane, Certified Recovery Support Specialist

Much has been written about patient-centered care. Proof that this model is gaining acceptance is the evolution to shared decision making (SDM). The National Learning Consortium defines SDM as a “process in which clinicians and patients work together to make decisions and select tests, treatments and care plans based on clinical evidence that balances risks and expected outcomes with patient preferences and values.”

In a recent CFYM post John Williams, M.D., writes that there are several tools that clinicians can use to step through the shared decision making process. Dr. Williams opines that when there are many different treatment options, SDM takes on added importance. As a result, a major step in the SDM process must be for clinicians to understand the desired outcomes of their patients.

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Use Shared Decision Making to Maximize Health Insurance Benefits

Depression and Bipolar Support Alliance for Care for Your Mind

It’s no secret that out-of-pocket healthcare costs—the amount you pay—have risen significantly. These expenses have been trending upward for over a decade and there is no indication that this trend will end anytime soon. In 2013, according to the HealthAffairs Blog, nearly one-third of participants in an employer-sponsored plan had a high deductible. Plans purchased through the federal marketplace have similar out-of-pocket costs, especially at the Bronze level.

The rationale behind Health Savings Accounts (tax-free accounts where money is set aside for medical expenses) is that, when people have a financial investment in their healthcare, they are more likely to make better decisions about how they consume or use this commodity. It’s fair to say that this idea can also support the trend towards higher copays or co-insurance.

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Why You Deserve Shared Decision Making

Editor’s note: Care for Your Mind—in partnership with the National Network of Depression Centers and other organizations—has been seeking answers to the question: what’s keeping people from getting the mental health care they need? Shared decision making (SDM) is one piece of the puzzle, through which healthcare providers work with patients to understand their individual needs, preferences, and values. Then, patients and providers discuss different options and make care decisions together. It’s a common sense, personalized approach to care. Dr. John Williams introduces our series on SDM. Join the conversation!

John W. Williams Jr., MD Professor of Medicine and Psychiatry at Duke University

As a patient, would you want your physician making healthcare decisions on your behalf without any regard for your personal preferences, values, or needs? If you’re like most people, you’d prefer to be involved in choosing the care that’s right for you. After all, it’s your body, your mind, your financial resources, and your life.

Shared decision making, or SDM, is a process through which you and your doctor make decisions together, as partners. It’s a common sense concept: you discuss the things that matter to you, your doctor provides information, and then works with you to choose the best treatment for you.

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What Role Do Patients Play in Improving Quality of Care? A Big One.

Editor’s note: Please enjoy this article from the CFYM archive, first published March 24, 2014. Look for the upcoming series which will focus on the collaboration between the patient and the clinical team around shared-decision making.

David Katzelnick, M.D.
Chair, Division of Integrated Behavioral Health, Mayo Clinic
We acknowledge the collaboration of 
National Network of Depression Centers in developing this series.

With a world of health information literally at our fingertips, patients are more informed and engaged than ever. Research indicates that patients who are actively involved in their own healthcare receive higher quality care and achieve better health outcomes.

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Is the “Helping Families in Mental Health Crisis Act” Ready for Prime Time?

Things can move very quickly in DC when the right people are motivated. Case in point: Speaker of the House Paul Ryan (R-WI) signaled that he wanted mental health legislation to reach a floor vote this year. So while H.R. 2646, sometimes known as the Murphy bill, seemed to be languishing, the leadership of the Energy and Commerce Committee worked to bring the bill to mark-up last Wednesday, June 15.

Some people opine that our democracy intends for citizens to advocate hard for their principles while accepting that competing points of views must also be acknowledged when moving legislation. Others believe that people should hold tight to their principles, never relenting.

Depending on your own philosophy, last week’s committee mark-up outcome is cause for celebration, acceptance of the inevitable, or reason to keep up the fight. Following is an overview of the bill that was voted out of committee. Insiders are saying that Speaker Ryan wants a full chamber vote later this summer.

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BCBS North Carolina Isn’t Paying Claims. People Are Suffering. What to Do?

Rhonda Karg, Ph.D.
New Leaf Psychotherapy, Asheville, NC

Imagine being a small business owner. You’re passionate about what you do, you serve your community, and your main purpose is to help people in need. But suddenly your biggest client withholds payment for six months or more. Would you find this unacceptable, illegal, infuriating? How would you keep your doors open or pay your car insurance, phone bill, or mortgage?

For many behavioral health providers who’ve contracted with Blue Cross Blue Shield of North Carolina (BCBSNC), that’s the situation they’ve faced since January.

Citing a software problem, the insurance giant is now months behind on paying 9-15% of its claims from providers. In addition to the outrageous financial toll this is taking on clinicians—some of whom rely on BCBSNC for 90% of their income— thousands of patients statewide have lost their access to care.

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