Shared decision making (SDM) is a model of interaction between doctors and patients in which both actors contribute to the medical decision-making process. There is an international consensus across medicine about the importance of SDM interventions, which have raised great interest in mental healthcare over the last decade. Yet SDM is not widely adopted, particularly in the field of psychiatry. The purpose of the present article is to examine, from a patient and physician perspective, the importance of SDM in the management of healthcare with a focus on mental health; it reviews the enablers and barriers (and how to overcome them) to implementing a SDM process in psychiatric practice. SDM models have been developed recently for involving patients with depression in the decision-making process, which could result in augmenting the proportion of patients who adhere to their antidepressant or other treatments for a duration that complies with the current recommendations. To implement this approach, more physicians need training in the SDM approach and access to appropriate tools that help engage in collaborative deliberation, and practice generally needs to be reorganized around the principles of patient engagement.
The world is in the throes of a global health, economic, and mental health crisis with severe physical, societal, and economic ramifications. Modern mental health problems are characterized by their complexity, multisystemic nature, and broad societal impact, making them poorly suited to siloed approaches of thinking and innovation. To solve the unprecedented complexities and challenges associated with the current global crisis, a paradigm shift is needed. Convergence science integrates knowledge, tools, and thought strategies from various fields and is the focal point where novel insights arise. In the context of mental health, convergence involves integration of scientists, clinicians, bioinformaticists, global health experts, engineers, technology entrepreneurs, medical educators, caregivers, and patients; synergy between government, academia, and industry is also vital. A convergence mental health approach will lead to improved outcomes for patients and healthcare systems. Predicate examples of convergence science in adjacent fields to mental health provide a model for the path forward. Further, within the field of mental health, there are examples of convergence science currently in action that include early-stage companies, neuroscience initiatives, public health projects, and unconventional funding mechanisms. The world has a historic opportunity to leverage convergence science to lead to a new era of innovation and progress in global mental health. Contributions for this book come from authors affiliated with the Milken Institute, Asia Pacific Economic Cooperation, Organization for Economic Co-operation and Development, the National Academies of Science, Medicine and Engineering, Stanford University, and Harvard University. This book is written for practitioners and leaders in mental health innovation, including clinicians, researchers, policymakers, investors, entrepreneurs, and philanthropists.
This is an age of convergence, where insights from disparate disciplines are coming together to meet modern challenges. In this chapter, the authors describe the ways convergence science will impact the workflow of future psychiatrists. They anticipate human clinicians to work in close partnership with technology; streamlining, eliminating, and transforming a range of clinical activities. Here, they provide a framework for modernizing perennial skills and present a roadmap for the development of new knowledge. They anticipate that two important areas of knowledge for future psychiatrists will include clinical informatics and data science. The potential of convergence psychiatry will be realized most effectively as they update clinical training to reflect the shift toward transdisciplinary science. The authors advocate for psychiatrists to embrace interaction with emerging technology including highlighting the risk if they fail to do so.
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