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Shared Decision Making and Risk in Adult Mental Health Services.

Record Type:	Language materials, manuscript : Monograph/item
Title/Author:	Shared Decision Making and Risk in Adult Mental Health Services./
Author:	Cartwright, Claire.
Description:	1 online resource (134 pages)
Notes:	Source: Dissertations Abstracts International, Volume: 85-11, Section: A.
Contained By:	Dissertations Abstracts International85-11A.
Subject:	Ethnography. -
Online resource:	click for full text (PQDT)
ISBN:	9798382622378

Shared Decision Making and Risk in Adult Mental Health Services.
Cartwright, Claire.

Shared Decision Making and Risk in Adult Mental Health Services. - 1 online resource (134 pages)

Source: Dissertations Abstracts International, Volume: 85-11, Section: A.

Thesis (D.Clin.Psy.)--The University of Liverpool (United Kingdom), 2023.

Includes bibliographical references

Risk assessment and risk management are considered a fundamental part of safe and effective mental health care for adults (Ahmed et al., 2021). Research and policy both advocate for a shared decision-making approach to risk assessment in mental health settings (Draft Mental Health Bill, 2022). For a decision to be 'shared' it must involve at least two participants, the sharing of information, and a decision that is made and agreed upon by all parties (Stacey et al., 2015). However, studies suggest that service users are often not involved in decisions about risk (or any aspect of their care) and often remain unaware that a risk assessment has taken place for them (Slade, 2017). This thesis aims, firstly, to explore within the existing literature, the attitudes towards and experiences of 'shared decision making' in mental health care from the perspective of staff and service users. Secondly, to look specifically at the discourses service users use to talk about their experiences of 'risk' and 'safety' whilst they have been detained under the Mental Health Act (1983).The systematic review (chapter 1) aims to provide an up-to-date literature review of the experiences of and attitudes towards shared decision making in mental health services from the perspectives of staff and service users. The review uses a meta-ethnographic approach to synthesise qualitative themes from primary studies to produce higher order concepts. These are the role of service user ownership, the influence of fluctuating capacity, the importance of therapeutic alliance and changing clinician's behaviours and attitudes.The empirical paper (chapter 2) recruited people with experience of detention under the Mental Health Act (1983) and uses a Foucauldian discourse analysis approach to explore how service users use language to construct their accounts of risk and safety whilst detained. The findings suggest that participants tended to understand risk and safety in terms of power and control (held by themselves and the mental health system), the role of the 'good' or 'bad' patient, coercion with an additional discourse around their perceptions of service user involvement. One of the key implications emerging from this study was that service users emphasised the risk they experienced from others on the wards and the risks experienced from the system itself.The two papers are aimed for publication in British Medical Council (BMC) Health Services Research journal. Author guidelines for the papers are contained in appendix d. The chapters conform to author guidelines however, tables, figures and further contextual information are provided in accordance with thesis guidelines.

Electronic reproduction.
Ann Arbor, Mich. :
ProQuest,
2024

Mode of access: World Wide Web

ISBN: 9798382622378Subjects--Topical Terms:

1112077
Ethnography.
Index Terms--Genre/Form:

554714
Electronic books.

Shared Decision Making and Risk in Adult Mental Health Services.
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500 $a Source: Dissertations Abstracts International, Volume: 85-11, Section: A.
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502 $a Thesis (D.Clin.Psy.)--The University of Liverpool (United Kingdom), 2023.
504 $a Includes bibliographical references
520 $a Risk assessment and risk management are considered a fundamental part of safe and effective mental health care for adults (Ahmed et al., 2021). Research and policy both advocate for a shared decision-making approach to risk assessment in mental health settings (Draft Mental Health Bill, 2022). For a decision to be 'shared' it must involve at least two participants, the sharing of information, and a decision that is made and agreed upon by all parties (Stacey et al., 2015). However, studies suggest that service users are often not involved in decisions about risk (or any aspect of their care) and often remain unaware that a risk assessment has taken place for them (Slade, 2017). This thesis aims, firstly, to explore within the existing literature, the attitudes towards and experiences of 'shared decision making' in mental health care from the perspective of staff and service users. Secondly, to look specifically at the discourses service users use to talk about their experiences of 'risk' and 'safety' whilst they have been detained under the Mental Health Act (1983).The systematic review (chapter 1) aims to provide an up-to-date literature review of the experiences of and attitudes towards shared decision making in mental health services from the perspectives of staff and service users. The review uses a meta-ethnographic approach to synthesise qualitative themes from primary studies to produce higher order concepts. These are the role of service user ownership, the influence of fluctuating capacity, the importance of therapeutic alliance and changing clinician's behaviours and attitudes.The empirical paper (chapter 2) recruited people with experience of detention under the Mental Health Act (1983) and uses a Foucauldian discourse analysis approach to explore how service users use language to construct their accounts of risk and safety whilst detained. The findings suggest that participants tended to understand risk and safety in terms of power and control (held by themselves and the mental health system), the role of the 'good' or 'bad' patient, coercion with an additional discourse around their perceptions of service user involvement. One of the key implications emerging from this study was that service users emphasised the risk they experienced from others on the wards and the risks experienced from the system itself.The two papers are aimed for publication in British Medical Council (BMC) Health Services Research journal. Author guidelines for the papers are contained in appendix d. The chapters conform to author guidelines however, tables, figures and further contextual information are provided in accordance with thesis guidelines.
533 $a Electronic reproduction. $b Ann Arbor, Mich. : $c ProQuest, $d 2024
538 $a Mode of access: World Wide Web
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650 4 $a Attitudes. $3 935153
650 4 $a Mental health care. $3 1468792
650 4 $a Decision making. $3 528319
650 4 $a Mental disorders. $3 647312
650 4 $a Clinical psychology. $3 649607
650 4 $a Cultural anthropology. $3 1179959
650 4 $a Mental health. $3 564038
655 7 $a Electronic books. $2 local $3 554714
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710 2 $a ProQuest Information and Learning Co. $3 1178819
710 2 $a The University of Liverpool (United Kingdom). $3 1335391
773 0 $t Dissertations Abstracts International $g 85-11A.
856 4 0 $u http://pqdd.sinica.edu.tw/twdaoapp/servlet/advanced?query=30983939 $z click for full text (PQDT)