Physical Health Decision-Making Autonomy Preferences for Adults with Severe Mental Illness in Integrated Care

ABSTRACT

People with severe mental illness (SMI) often have physical health comorbidities that are associated with high morbidity and mortality rates. Although work is being done to integrate physical and behavioral health care in order to address the primary health-care needs of persons with SMI, very little is known about their health-care behaviors and how they make their treatment decisions. We used a cross-sectional, survey design to explore the relationship between variables related to decision-making autonomy preferences for persons with SMI (N = 95) who were seen in an integrated health-care clinic. Descriptive and bivariate analyses revealed that the majority of participants in this sample preferred shared decision making in their physical health care, that male participants desired higher autonomy in decision making, and that lower perceived autonomy support from the physician was related to higher desired autonomy in decision making The findings suggest that social workers and other mental and physical health providers should explore the unique decision-making autonomy preferences of primary care service users with SMI, as these preferences vary among clients, and that honoring individual preferences would provide a more person-centered care environment.

KEYWORDS:

• Decision-making autonomy preferences
• integrated care
• severe mental illness