Integrating Decision Making and Mental Health Interventions Research: Research Directions

Abstract

The importance of incorporating patient and provider decision-making processes is in the forefront of the National Institute of Mental Health (NIMH) agenda for improving mental health interventions and services. Key concepts in patient decision making are highlighted within a simplified model of patient decision making that links patient-level/"micro" variables to services-level/"macro" variables via the decision-making process that is a target for interventions. The prospective agenda for incorporating decision-making concepts in mental health research includes (a) improved measures for characterizing decision-making processes that are matched to study populations, complexity, and types of decision making; (b) testing decision aids in effectiveness research for diverse populations and clinical settings; and (c) improving the understanding and incorporation of preference concepts in enhanced intervention designs.

Figures

Figure 1

A simplified model of decision making, adapted from Rothert et al., (1997), which illustrates key concepts of relevance to patient decision making. In a given context, values and information interact to produce preferences, which in turn shape decisions, behavior, and subsequent outcomes. The double arrows between the concepts reflect the dynamic interactions among the concepts over time.