ABSTRACT
Shared decision-making has become a central tenet of recovery-oriented, person-centered mental health care, yet the practice is not always transferred to the routine psychiatric visit. Supporting the practice at the system level, beyond the interactions of consumers and medication prescribers, is needed for successful adoption of shared decision-making. CommonGround is a systemic approach, intended to be part of a larger integration of shared decision-making tools and practices at the system level. We discuss the organizational components that CommonGround uses to facilitate shared decision-making, and we present a fidelity scale to assess how well the system is being implemented.
ABSTRACT
OBJECTIVE: The study examined the relationship between fidelity of strengths model case management (SMCM) and client outcomes of psychiatric hospitalization, competitive employment, postsecondary education, and independent living. METHODS: Data were collected over an 18-month period during regularly scheduled fidelity reviews for 14 case management teams representing ten agencies serving an average of 953 clients diagnosed as having a serious mental illness. Time-varying covariate linear growth modeling examined the relationship between fidelity scores and client outcomes. RESULTS: A statistically significant association was found between fidelity scores and psychiatric hospitalization, competitive employment, and postsecondary education. CONCLUSIONS: The study results offer promising evidence that higher SMCM fidelity has a positive effect on clients over an 18-month period, thereby providing an effective complement to current mental health treatment.
