Quality statement 2: Decision making

Quality statement

People using mental health services are supported in shared decision making. [2011, updated 2019]

Rationale

People using mental health services should have overall responsibility for managing their health. This needs to be recognised when providing services, and in the ways healthcare professionals interact with them. Health and social care professionals and service providers need to recognise that many people want to be active in their own care, although not everyone wants an active role. People should be able to work with services to actively manage their health, rather than passively receive care. Supporting people to be at the centre of decisions about their own treatment and care, including people detained under the Mental Health Act, results in better quality decisions that are more appropriate to the person. Feeling supported to make decisions also helps foster an atmosphere of hope and optimism.

Quality measures

Structure

a) Evidence of local arrangements to ensure that people being assessed by mental health services are given information and have their care explained so they understand the assessment process, their diagnosis and treatment options.

Data source: Local data collection.

b) Evidence of local arrangements to ensure that people using mental health services, including people formally detained under the Mental Health Act, are supported in shared decision making.

Data source: Local data collection.

Outcome

a) Evidence from experience surveys and feedback that people being assessed by mental health services understand the assessment process, their diagnosis and treatment options.

Data source: Local data collection.

b) Evidence from experience surveys and feedback that people using mental health services, including people formally detained under the Mental Health Act, feel supported in shared decision making.

Data source: Local data collection. Questions on involvement in making decisions are contained within the Care Quality Commission (CQC) Community mental health survey.

c) Evidence from experience surveys and feedback that people using mental health services feel optimistic that their care will be effective.

Data source: Local data collection. Questions on feelings of optimism are contained within the CQC Community mental health survey.

What the quality statement means for different audiences

Service providers (such as mental health trusts and community services) ensure that systems are in place to provide information for people using mental health services and support shared decision making.

Health and social care professionals (such as psychiatrists, mental health nurses and social workers) give people using mental health services information and support to enable shared decision making.

Commissioners (such as clinical commissioning groups and NHS England) ensure that the mental health services they commission support shared decision making.

People using mental health services are given information and support to help them understand the choices available and make decisions about their care and treatment. Being at the centre of decisions about their own care can help people feel optimistic about the future.

Source guidance

Service user experience in adult mental health services (2011) NICE guideline CG136, recommendations 1.1.1, 1.1.2, 1.3.3 and 1.6.3

Definitions

Shared decision making

This is when health professionals and patients work together. It puts people at the centre of decisions about their own treatment and care. During shared decision making, it's important that:

  • care or treatment options are fully explored, along with their risks and benefits

  • different choices available to the patient are discussed

  • a decision is reached together with a health and social care professional.

[NICE's information on shared decision making]