Shared Risk Taking: Shared Decision Making in Serious Mental Illness

• DOI: 10.1176/appi.ps.202000156
• Publication Date: 2021-02-09T08:04:08Z
• Authors: Yaara Zisman-Ilani; Paul H. Lysaker; Ilanit Hasson-Ohayon
• Keywords: 03 medical and health sciences; Risk-Taking; 0302 clinical medicine; Communication; Mental Disorders; Decision Making; Humans; Patient Participation; Decision Making, Shared; 3. Good health

Shared decision making (SDM) is an interpersonal health communication model that is underutilized with people with serious mental illness. Although research has emphasized the role of patient capacity-, clinician-, and system-related barriers in SDM underutilization, the risk taking that affects SDM with people with mental illness is less often discussed. This Open Forum presents a reconceptualization of SDM as a process of shared risk taking that often occurs during different phases of illness management and recovery. The concepts of intersubjectivity, meaning making, and metacognition are offered to inform clinical interventions needed to address risk in SDM.