Dr Alana Fisher

The Matilda Centre for Research in Mental Health and Substance Use, University of Sydney 

Title: Advancing shared decision-making in mental health and alcohol/other drug use conditions

Abstract: Shared decision-making is widely-endorsed as the ‘gold standard’ approach to making healthcare decisions. Shared decision-making involves clinicians, patients (and others, e.g., family) partnering together to discuss the available healthcare options and make a decision that is both evidence-based and consistent with the patient’s values and preferences. Most of the research has focussed on medical conditions such as cancer, however, recent years have seen a shift towards better understanding and applying shared decision-making for people with mental health conditions, such as depression, schizophrenia, and bipolar disorder. The recent literature demonstrates that shared decision-making is preferred by most people with mental health conditions, and delivers similar benefits to patients including satisfaction with care, and better adherence to chosen treatments. Given that mental health conditions often co-occur with at-risk alcohol and other drug (AOD) use (up to 3 in 4 people presenting to AOD treatment services), we need to advance our knowledge of shared decision-making in this comorbid population who often present with more complex and severe needs, and face potentially more complex decisions about their treatment and management. With reference to my PhD and early postdoctoral research work, I will present an overview of i) shared decision-making within the context of mental health conditions, ii) novel directions in shared decision-making through the development and evaluation of patient decision-support interventions for people with co-occurring mental health and AOD conditions.