In the field of mental health there is a growing impulse to participatory practices. In addition to the opening of the assistance contexts to these approaches, the first person movements, active at an international level since the 60s, have facilitated processes such as psychiatric deinstitutionalization. More recently, the concepts of empowerment, resilience and recovery emerge. All these concepts have helped the advance of a more personalized way of attention focused on prevention. However, until very recently, the patient’s preferences for shared decision making regarding treatments in the field of mental health were not systematically contemplated.
Regarding the evidence of this approach, a meta-analysis evidences the preference of users for psychological treatments over pharmacological treatments, and one study shows that respecting the preferences of users with depression in terms of preference for the use of drugs or psychotherapy improves the results regardless of the direction of the choice. These results are replicated in the field of preferences by the focus of treatment within psychotherapy. In addition to improving results, respect for patient preferences increases satisfaction and adherence to treatment.
The field of bioethics has highlighted the importance of respecting and promoting the autonomy of all users and has developed a great debate on shared decision-making. Recognizing this importance, some authors of legal medicine are promoting the step from informed consent to informed participation on therapeutic alternatives.
At this moment of growth in the promotion of shared decision-making and respect for patient preferences, we believe it is necessary to evaluate what is the reality and possible obstacles in the Catalan context. In this presentation we will address two questions: What is the reality regarding the incorporation of preferences in decision-making in Catalan mental health services? What obstacles are there for its incorporation?