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Title: Clinical Decision Making and Mental Health Service Use Among Persons With Severe Mental Illness Across Europe
Contributor(s): Cosh, Suzanne  (author)orcid ; Zenter, Nadja (author); Ay, Esra-Sultan (author); Loos, Sabine (author); Slade, Mike (author); De Rosa, Corrado (author); Luciano, Mario (author); Berecz, Roland (author); Glaub, Theodora (author); Munk-Jorgensen, Povl (author); Bording, Malene Krogsgaard (author); Rossler, Wulf (author); Kawohl, Wolfram (author); Puschner, Bernd (author)
Publication Date: 2017-09-01
Early Online Version: 2017-05-15
DOI: 10.1176/
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Abstract: Objective: The study explored relationships between preferences for and experiences of clinical decision making (CDM) with service use among persons with severe mental illness. Methods: Data from a prospective observational study in six European countries were examined. Associations of baseline staff-rated (N=213) and patient-rated (N=588) preferred and experienced decision making with service use were examined at baseline by using binomial regressions and at 12-month follow-up by using multilevel models. Results: A preference by patients and staff for active patient involvement in decision making, rather than shared or passive decision making, was associated with longer hospital admissions and higher costs at baseline and with increases in admissions over 12 months (p=.043). Low patient-rated satisfaction with an experienced clinical decision was also related to increased costs over the study period (p=.005). Conclusions: A preference for shared decision making may reduce health care costs by reducing inpatient admissions. Patient satisfaction with decisions was a predictor of costs, and clinicians should maximize patient satisfaction with CDM.
Publication Type: Journal Article
Source of Publication: Psychiatric Services, 68(9), p. 970-974
Publisher: American Psychiatric Association Publishing, Inc
Place of Publication: United States of America
ISSN: 1557-9700
Fields of Research (FoR) 2008: 110319 Psychiatry (incl. Psychotherapy)
170106 Health, Clinical and Counselling Psychology
Fields of Research (FoR) 2020: 520304 Health psychology
320221 Psychiatry (incl. psychotherapy)
520302 Clinical psychology
Socio-Economic Objective (SEO) 2008: 920410 Mental Health
920204 Evaluation of Health Outcomes
920209 Mental Health Services
Socio-Economic Objective (SEO) 2020: 200409 Mental health
200202 Evaluation of health outcomes
200305 Mental health services
Peer Reviewed: Yes
HERDC Category Description: C1 Refereed Article in a Scholarly Journal
Appears in Collections:Journal Article
School of Psychology

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