Patient participation in mental health care – perspectives of healthcare professionals: an integrative review

Background: In contemporary Western liberal society, patient participation has become a goal in healthcare treatment. The health professionals must encourage the patient to play an active and involved part in the treatment. Patient participation is, according to Danish health law, a right for the patient, and the mental health system therefore needs to be reformed in order that the treatment is based on individual and liberal values. Patient participation is not clearly defined and is thus difficult to implement in mental health.
Aims: To clarify health professionals’ understanding of patient participation in mental health.
Design: The integrative review.
Data sources: The search follows Whittemore’s phases of the integrative review. The first phase focused on patient participation and, synonymously, for patient participation. Phases two, three and four are considered to have identified the sample from the selection criteria: mental healthcare, nurses, focused adult patients, full-text peer review and published in English between 2001-2016. Searches accomplished by the four databases were supported by mesh terms/subject headings.
Findings: Seven studies met the inclusion criteria. Six studies employed qualitative methodologies and one utilised mixed methods. The empirical studies took place in Norway, the UK and Australia in a mental health setting. Three themes were identified: ‘Patient participation as a collaboration between the healthcare professionals and patient’, ‘Challenges to participation’, ‘From a professional’s perspective - what expectations do patients have when participating in decision-making’.
Conclusion: Different synonymous terms describing the patient's active role during the treatment, user participation, collaboration, partnership, user involvement and patient participation are linked to a recovery-oriented approach, shared decision-making, shared ownership and care plans. This integrative review achieves specific knowledge of the involvement seen comparing adult patients with various mental disorders. However, reflecting the included studies, involvement is not clearly defined and is therefore difficult to transfer to the clinical practice.