TABLE 9-4 Recommendations for State Policy Makers

Overarching Recommendation 1. Health care for general, mental, and substance-use problems and illnesses must be delivered with an understanding of the inherent interactions between the mind/brain and the rest of the body.

Rule 5. Evidence-based decision making—Patients should receive care based on the best available scientific knowledge. Care should not vary illogically from clinician to clinician or from place to place.

Rule 8. Anticipation of needs—The health system should anticipate patient needs, rather than simply reacting to events.

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.

  • Obtaining the best available comparative information on safety, effectiveness, and availability of care and providers, and using that informa- tion to guide treatment decisions.

  • Maximizing patient decision making and involvement in the selection of treatments and providers.

Aim of patient-centered care—Providing care that is respectful of and responsive to individual patient preferences, needs, and values and ensuring that patient values guide all clinical decisions.

Rule 2. Customization based on patient needs and values—The system of care should be designed to meet the most common types of needs, but have the capability to respond to individual patient choices and preferences.

Rule 3. The patient as the source of control—Patients should be given the necessary information and the opportunity to exercise the degree of control they choose over health care decisions that affect them. The health system should be able to accommodate differences in patient preferences and encourage shared decision making.

Rule 7. The need for transparency—The health care system should make information available to patients and their families that allows them to make informed



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