Shared Decision Making is a collaborative process where a young person works together with their carers and health care provider to make an informed decision about the treatment or care options that are best for them. This is not always straightforward or easy as there are often quite complicated things that need to be talked about together.
Tip 1: Invite participation in the decision-making process
Make sure the young person and their carer understand that there are choices around mental health treatment and support and that they can be involved in making decisions about what is best for them. Sometimes participation can be assumed so it’s really important to be explicit that they are taking an active part in deciding what is going to be most helpful for them with the problems they are experiencing.
It is at this point that you can assess a young person’s and carer’s capacity and willingness to be involved in the decision making process. Not all young people or carers will want to be involved, or their degree of involvement may fluctuate. However, they have a right to understand all the options surrounding their treatment and are encouraged to engage fully in choosing the best treatment option for them.
Tip 2: Present and encourage exploration of the options
There may be multiple treatment options available. Some of these will be provided via your service, others may not. Regardless, the young person and their carers may wish to have access to information about all possible options, including details about the evidence base and potential benefit or harm for each.
Make sure you have a clear picture of what the young person and carer already know and understand about the options. Use plain, simple language as much as possible and allow space for questions, clarification and reflection. Make sure any known risks and benefits associated with a treatment are made clear and explain any limitations of what is known and unknown about the treatment options. You should also explore what can happen with no treatment at all.
If you are trying to communicate complex ideas, numbers or statistics, consider the use of visual aids and evidence-based decision-making tools to help the young person and carer understand the treatment options.
Tip 3: Consider the young person's values and preferences
If they haven’t made it clear, ask the young person and or carer what matters to them in terms of treatment and support. For example, a young person may prefer to speak to a woman or a man. They may prefer to be seen after school or college and they may prefer to bring a friend or advocate.
Utilise open-ended questioning and active listening, acknowledging their values and preferences to encourage discussion to help everyone reach a consensus on what is important.
Remember each young person and carer is different and will have different priorities. Some will be more focused on the nature of the treatment and its outcomes, e.g. strength of evidence base, format of delivery, recovery time, while others may have more practical considerations, e.g. travel, cost and how to fit the treatment around other commitments.
Tip 4: Work together to reach a decision
Following discussions and considerations, you should then work with the young person and or carer to decide on the best treatment decision and arrange a follow-up appointment.
Help the family move to a decision by asking if they are ready to make a decision but try not to rush them. Allow the opportunity for them to express what matters most to them and time and space to carefully consider the options with their wider support network. Ask if additional resources are required or if they wish to delegate the decision to someone else.
Once the young person has reached a decision, make sure you confirm it clearly to ensure understanding and clarify the next steps. You can schedule follow-up appointments as appropriate.
Tip 5: Continue to monitor the chosen treatment
Even if you are not involved in the delivery of treatment, as much as possible, continue to support the young person and ensure the treatment decision remains the right option for them.
If it looks like the treatment decision might not be right for the family, help them to understand the issues by evaluating the extent to which the treatment decision has been implemented and identify any barriers to implementation. If they wish to review the decision and explore other others, facilitate this in the same manner as before and help them consider what else is available.