Clinical decision making and mental health service use among persons with severe mental illness across Europe

Suzanne Cosh, Nadja Zenter, Esra Sultan Ay, Sabine Loos, Mike Slade, Corrado De Rosa, Mario Luciano, Roland Berecz, Theodora Glaub, Povl Munk-Jørgensen, Malene Krogsgaard Bording, Wulf Rössler, Wolfram Kawohl, Bernd Puschner

Research output: Contribution to journalArticle

3 Citations (Scopus)


Objective: The study explored relationships between preferences for and experiences of clinical decision making (CDM) with service use among persons with severe mental illness. Methods: Data from a prospective observational study in six European countries were examined. Associations of baseline staff-rated (N=213) and patient-rated (N=588) preferred and experienced decision making with service use were examined at baseline by using binomial regressions and at 12-month follow-up by using multilevel models. Results: A preference by patients and staff for active patient involvement in decision making, rather than shared or passive decision making, was associated with longer hospital admissions and higher costs at baseline and with increases in admissions over 12 months (p=.043). Low patient-rated satisfaction with an experienced clinical decision was also related to increased costs over the study period (p=.005). Conclusions: A preference for shared decision making may reduce health care costs by reducing inpatient admissions. Patient satisfaction with decisions was a predictor of costs, and clinicians should maximize patient satisfaction with CDM.

Original languageEnglish
Pages (from-to)970-974
Number of pages5
JournalPsychiatric Services
Issue number9
Publication statusPublished - Sep 1 2017


ASJC Scopus subject areas

  • Psychiatry and Mental health

Cite this

Cosh, S., Zenter, N., Ay, E. S., Loos, S., Slade, M., De Rosa, C., Luciano, M., Berecz, R., Glaub, T., Munk-Jørgensen, P., Bording, M. K., Rössler, W., Kawohl, W., & Puschner, B. (2017). Clinical decision making and mental health service use among persons with severe mental illness across Europe. Psychiatric Services, 68(9), 970-974.