shared decision making tagged posts

Depression and Bipolar Support Alliance for Care for Your Mind

It’s no secret that out-of-pocket healthcare costs—the amount you pay—have risen significantly. These expenses have been trending upward for over a decade and there is no indication that this trend will end anytime soon. In 2013, according to the HealthAffairs Blog, nearly one-third of participants in an employer-sponsored plan had a high deductible. Plans purchased through the federal marketplace have similar out-of-pocket costs, especially at the Bronze level.

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Editors’ Note: With Congress in recess for the 4^th of July holiday, we get a brief reprieve from the Senate’s consideration of the “Better Care Reconciliation Act.” From where we sit, this legislation severely undermines gains that we have made in access to and quality of mental health care.

In the spirit of citizen engagement, we offer an encore post from former Member of Congress Tony Coelho on the need for patients – and we would add families, too – to be involved in policy-making. We hope it will inspire you to share your concerns about the proposed changes to the healthcare system and to tell your elected officials how this bill would impact you and your family’s health and wellbeing.

Have a safe and happy Independence Day!

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Doug Williamson, M.D.
Chief Medical Officer & Vice President for Lundbeck U.S. Drug Development

Care for Your Mind acknowledges and appreciates the collaboration of the American Brain Coalition in developing this series.

An epidemic
The world’s quietest healthcare crisis is one that starts between the ears.

When it comes to mental illness, the statistics are nearly too staggering to process.

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Care For Your Mind acknowledges and appreciates the collaboration of the National Network of Depression Centers in developing this post.

Juan P. Brito Campana, M.D, MSc.
Annie LeBlanc, Ph.D.
Mayo Clinic Knowledge and Evaluation Research Unit (KER)

As recent CFYM posts have indicated, shared decision making (SDM) is good for patients, doctors, and the system itself. But if we want SDM to become the norm in exam rooms nationwide, we have to support clinicians by giving them the means to make it happen.

We can do this by providing tools that allow physicians to communicate effectively and engage in meaningful conversations about their patients’ preferences, needs, and values.

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Tony Coelho, former Member of Congress, author of the Americans with Disabilities Act, and lifetime disability advocate

Since the age of 16, I’ve suffered from seizures. I’m now 74 and six decades of experience as a patient has taught me a lot about the healthcare system. I’ve seen firsthand how it’s evolved to suit the financial interests of the most powerful players and often ignore the needs of patients.

Unfortunately, many of the decisions that affect patient care are made at the policy level, often by bureaucrats with little or no clinical experience. When decision-makers ignore the patient perspective — including individual exam room experiences — care can become sterile, mechanized, and ineffective.

In order to create a system that better treats patients, we need legislators and decision-makers to create laws and regulations that value and support patient input. By bringing patients to the policymaking table, we can create a stronger healthcare system that addresses the needs of the individual and ensures more effective care for everyone as we move forward.

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Based on an interview with Erica S. Spatz, MD, MHS,
Assistant Professor of Medicine, Yale School of Medicine

Imagine that you’re about to be wheeled into surgery. You’ve fasted for 24 hours, you’re in a hospital gown, and you’re awaiting the doctor’s arrival. Then the nurse brings in some paperwork, and you’re asked to sign a form acknowledging the risks of the procedure. You see some potential side effects or consequences that concern you—but at that point, how likely are you to refuse the procedure?

For many patients, that last-minute signature is the only experience they have with informed consent. Legally, however, informed consent is defined as the process in which a patient learns about and understands the purpose, benefits, and potential risks of a medical or surgical intervention.

In my view, that discussion should begin long before surgery day, so a patient has time to balance the risks and benefits before moving forward with a decision.

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Alison M. Heru, M.D.
Professor of Psychiatry, University of Colorado Denver

In the NES Program at University of Colorado Health, a six-month program combining neurology and psychiatry treatment for non-epileptic or non-electrical seizures, psychiatrist Dr. Alison Heru makes shared decision making an integral part of practice.

In my experience, shared decision making yields the best results in treatment. When patients feel like they have participated in choosing the treatment and are able to ask questions and weigh alternatives, they are more likely to feel they have selected the treatment that is the best for them and have a stronger stake in the outcome.

At the NES program (addressing non-electrical seizures), there’s not clear evidence for which treatment approach will be best for each patient. It’s my role, then, to make sure we make the correct diagnosis, provide information about the treatment modalities available, and decide together with the patient (and the patient’s family, unless not available) on the treatment plan. I won’t tell the patient what to do or to force a choice on them, but I will offer my opinion.

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Families for Depression Awareness for Care for Your Mind

Your teenager has been diagnosed with a mood disorder and the clinician is talking with her or him about treatment. What is your role as a parent in the shared decision making model? How can you participate?

At Families for Depression Awareness, we believe that parents can play an essential role in recognizing and addressing mood disorders in their children. When you’re worried about a teen in your life, you might need to take crucial actions in a crisis situation, convince a reluctant teen to go to a mental health provider, or be supportive in finding and accessing mental health care.

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