What is Shared Decision Making (SDM)?


Patient in GP roomShared decision-making is a process through which patients and doctors work together to identify the treatment option(s) that best suit the individual patient. In the doctor-patient relationship, the doctor contributes their expert knowledge in diagnosis, available treatment options and likely outcomes of treatment, and the patient brings their expertise in the form of their own values, beliefs, circumstances and attitude towards the potential pros and cons of the available options. Shared decision-making combines these two areas of expertise in a balanced discussion in order to reach the best decision for the patient. This process benefits not only individuals but the health care system as a whole. Shared decision-making practices are actively encouraged by the NHS and they assert that the best care is provided when patients are fully involved in decision-making regarding their own care, instead of decisions being made for the patient by doctors alone -"no decision about me, without me".

Further information about shared decision making, please visit the following websites:

Why was this educational film created?

Many adults accessing mental health service users and their families/friends, mental healthcare practitioners, service commissioners and the general public may be unaware of the existence and potential benefits of engaging in SDM. An educational film that focuses on SDM about therapeutic options in the context of mental health is needed for use as an teaching / training aid for mental health practitioners, and as a medium to raise awareness of the existence, guiding principles and potential benefits of SDM in mental health treatment and care for facilitating the recovery process (by supporting empowerment and autonomy) in the general public, people accessing primary care services for mental health problems and primary care mental health providers/practitioners.

Depression in adults is used as example, using a story-based approach to facilitate the development of knowledge and understanding on how individuals accessing primary care for mental health problems make choices based on what is important to them (i.e., their preferences and values with regards to the available options for treatment). The film was co-produced with 'experts by experience' in order to ensure it reflects their perspectives, priorities and lived experiences of depression.

This is the first production of a film focusing on SDM in the context of mental health treatment and care using depression as an exemplar, which has been co-produced by staff at Newcastle University and members of a local mental health charity (Moving Forward Newcastle).

Who is the film aimed at?

The target audience for the film is diverse and includes students enrolled on a broad range of under- and post-graduates programmes (e.g., medicine, public health, social work and psychology); including the general public, mental health practitioners and mental health service commissioners.

Why focus on SDM in Primary Care for Depression?

Below is a list of the most common symptoms of depression. As a general rule, if you have experienced four or more of these symptoms, for most of the day nearly every day, for over 2 weeks, then you should seek help (Depression Alliance 2013):

Depressed woman

In 2010/11 there were approximately 4.8 million people with depression in England, and depression will affect 1 in 5 of us at some point in our lifetime.

Depression is the third most common reason for visiting a general practitioner (GP), with the majority of depression in adults (~80%) is managed in primary care by GPs and Improving Access to Psychological Therapies (IAPT) Services, which was rolled out nationally during 2007.

There are real choices between the available therapeutic options for the treatment of depression that are sensitive to individual's preferences and values (conditions ideal for SDM) in many ways. There are (i) varying individual preferences for different self-management, medical (drugs) or psychological therapeutic options (psychological therapies and counselling); and (ii) different pros and cons in terms of likelihood of helping with recovery and the risk of unwanted consequences or side effects.

Further information about depression, please visit the following websites: