Shared decision making in child and adolescent mental health care

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The team succeeded in empowering young service users to engage in shared decision making by trialling collaborative working at four sites. This gave front-line practitioners and their managers focused support and structural arrangements to make radical changes to the way they engaged with young people.

Key findings:

• Shared decision making radically changed the way clinicians interacted with service users, making relationships with young people and their parents more open.
• Young people felt more engaged in their care and more committed to following care plans that they’d been involved in developing.
• Shared decision making supported clearer conversations and negotiations even in high-stress situations.
• There was some evidence of improved outcomes in relation to aggressive behaviour on inpatient wards.

The team was commissioned by the Department of Health to develop a range of free tools and training resources to help child mental health professionals use shared decision making in clinical practice. The team is also developing a learning and support network for child and adolescent mental health services engaged in shared decision making.

Challenges

• Data comparison across the four sites was not possible because of limitations with IT systems and the wide variety of services provided at the sites.
• Collecting detailed evidence about outcomes was difficult due to existing administration pressures at the sites.
• It was only possible to collect relevant and accurate non-attendance data for one of the sites.

Supporting Dissemination

This project has been given further support through a Spreading Improvement award to help disseminate learning and maximise the impact of the approach across the health service at a local, regional or national level.

Funding will be used to develop a blended learning structured course comprised of regional masterclasses and online training materials. The course (which will be targeted at commissioners, service providers and service users) seeks to ensure that patient centred-care is at the heart of commissioning, performance management and service selection decisions across CAMHS in England. The project team will create and share impact and learning reports with stakeholders. At the end of the project there will be a national showcase event to disseminate the learning of the project nationally.