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

Background: In contemporary Western liberal society, patient participation has become a key goal in psychiatric healthcare treatment. Health professionals must encourage patients to play an active and involved part in their treatment. According to Danish health law, patients have the right to participate in their treatment, and the mental health system therefore needs to be reformed in order to ensure that treatment is based on individual, liberal, values. However, patient participation is not clearly defined, and it is therefore a challenge to transfer it to clinical practice. Aims: This integrative review's aims are to explore how professionals perceive the challenges regarding patient participation in the treatment course in mental health care. Design: An integrative review. Findings: Seven studies met the inclusion criteria: six employed qualitative methodologies and one utilised a mixed-methods approach. The empirical studies took place in Norway, the UK and Australia, all in a mental health setting. Three themes were identified: ‘Patient participation as collaboration between the healthcare professional and patient’, ‘Challenges to participation’ and ‘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 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 around patient participation, comparing the situation for adult patients with various mental disorders. However, upon reflecting on the included studies, patient participation is not clearly defined, and it is therefore difficult to transfer it to clinical practice.