support the decision-making abilities and preferences for treatment and recovery of persons with M/SU problems and illnesses.

  • Clinicians and organizations providing M/SU treatment services should:

    • Incorporate informed, patient-centered decision making throughout their practices, including active patient participation in the design and revision of patient treatment and recovery plans, the use of psychiatric advance directives, and (for children) informed family decision making. To ensure informed decision making, information on the availability and effectiveness of M/SU treatment options should be provided.

    • Adopt recovery-oriented and illness self-management practices that support patient preferences for treatment (including medications), peer support, and other elements of the wellness recovery plan.

    • Maintain effective, formal linkages with community resources to support patient illness self-management and recovery.

  • Organizations providing M/SU treatment should also:

    • Have in place policies that implement informed, patient-centered participation and decision making in treatment, illness self-management, and recovery plans.

    • Involve patients and their families in the design, administration, and delivery of treatment and recovery services.

  • Accrediting bodies should adopt accreditation standards that require the implementation of these practices.

  • Health plans and direct payers of M/SU treatment services should:

    • For persons with chronic mental illnesses or substance-use dependence, pay for peer support and illness self-management programs that meet evidence-based standards.

    • Provide consumers with comparative information on the quality of care provided by practitioners and organizations, and use this information themselves when making their purchasing decisions.

    • Remove barriers to and restrictions on effective and appropriate treatment that may be created by copayments, service exclusions, benefit limits, and other coverage policies.

Recommendation 3-2. Coercion should be avoided whenever possible. When coercion is legally authorized, patient-centered care is still applicable and should be undertaken by:

  • Making the policies and practices used for determining dangerousness and decision-making capacity transparent to patients and their caregivers.

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