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Experiences of treatment decision making for young people diagnosed with depressive disorders a qualitative study in primary care and specialist mental health settings
Simmonsetal.BMCPsychiatry2011,11:194
/1471-244X/11/194
RESEARCH ARTICLE
OpenAccess
Experiencesoftreatmentdecisionmakingfor
youngpeoplediagnosedwithdepressive
disorders:aqualitativestudyinprimarycareand
specialistmentalhealthsettings
MagentaBSimmons1*,SarahEHetrick2andAnthonyFJorm1
Abstract
Background:Clinicalguidelinesadvocatefortheinclusionofyoungpeopleexperiencingdepressionaswellas
theircaregiversinmakingdecisionsabouttheirtreatment.Littleisknown,however,aboutthedegreetowhich
thesegroupsareinvolved,andwhethertheywanttobe.Thisstudysoughttoexploretheexperiencesanddesires
ofyoungpeopleandtheircaregiversinrelationtobeinginvolvedintreatmentdecisionmakingfordepressive
disorders.
Methods:Semi-structuredinterviewswerecarriedoutwithtenyoungpeopleandfivecaregiversfromone
primarycareandonespecialistmentalhealthserviceabouttheirexperiencesandbeliefsabouttreatmentdecision
making.Interviewswereaudiotaped,transcribedverbatimandanalysedusingthematicanalysis.
Results:Experiencesofinvolvementforclientsvariedandwereinfluencedbyclientsthemselves,cliniciansand
servicesettings.Forcaregivers,experiencesofinvolvementweremorehomogenous.Desireforinvolvementvaried
acrossclients,andwithinclientsovertime;however,mostclientswantedtobeinvolvedatleastsomeofthetime.
Bothclientsandcaregiversidentifiedbarrierstoinvolvement.
Conclusions:Thisstudysupportsclinicalguidelinesthatadvocateforyoungpeoplediagnosedwithdepressive
disorderstobeinvolvedintreatmentdecisionmaking.Inordertomaximiseengagement,involvementin
treatmentdecisionmakingshouldbeofferedtoallclients.Involvementshouldbenegotiatedexplicitlyand
repeatedly,asdesireforinvolvementmaychangeovertime.Caregiverinvolvementshouldbenegotiatedonan
individualbasis;however,allcaregiversshouldbesupportedwithinformationaboutmentaldisordersand
treatmentoptions.
Background
proportion ofthoseyoungpeopleexperiencing depres-
Experiencingdepressionasachildoradolescentcanhave sion will notaccess treatment [5,6], andforthose who
asignificantimpactonthesocia
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