Patients' perspectives on care pathways and informed shared decision making in the transition between psychiatric hospitalization and the community.

Rationale, Aims, and Objectives: Patients with mental health problems experience numerous transitions into and out of hospital. This study explores former patients' views of pathways in transition between district psychiatric hospital centres (DPCs) and community mental health services.
Method: A descriptive qualitative design was chosen. Three focus group interviews with a total of 10 informants from five different communities were conducted. Interviews were transcribed and analysed thematically where themes describe promoting or inhibitory factors to the transition phase.
Results: The informants shared their experiences on issues promoting and preventing successful care pathways in mental health. Four main paired themes were identified: (a) patient participation/activation/empowerment versus paternalism and institutionalization, (b) patient-centred care versus care interpreted as humiliation, (c) interprofessional collaboration or teamwork versus unsafe patient pathways in mental health services, and (d) sustainable integrated care versus fragmented, noncollaborative care.
Conclusions: Shared decision making was reported more precisely as informed shared decision making. Shared information between all parties involved in care pathways is key.
(© 2019 Norwegian University of Science and Technology. Journal of Evaluation in Clinical Practice Published by John Wiley & Sons Ltd.)