Exploring Psychological Wellbeing Practitioners' experiences of offering choice and engaging in Shared Decision Making with people with depression

Background: In 2022, the National Institute for Health and Care Excellence (NICE) made changes to their guideline regarding treatment of depression in adults. The NICE (2022) guideline changes included emphasis on the use of Shared Decision Making (SDM). SDM is an area of increasing research, but research in the UK is limited for Primary Care services. Aims: This research aimed to explore if current levels of choice matched what was proposed in the NICE (2022) guideline. Additionally, this research aimed to explore experiences of Psychological Wellbeing Practitioners (PWPs) in offering choice and engaging in SDM. Finally, this research aimed to explore barriers and facilitators to SDM in services. Method: This study utilised a mixed method approach, consisting of a survey and interviews. In total, 93 participants took part in the survey, and 12 participants took part in interviews. All participants were either qualified or trainee PWPs. Survey data was analysed with IBM SPSS statistics. Interview data was analysed using Braun and Clarke’s (2022) Reflexive Thematic Analysis. Findings: Analysis of the interviews produced 5 main themes “Mixed messages: The disparity between policy and training and in service practice”, “Service pressures prevent wider use of SDM”, “Upstairs downstairs: How established hierarchies and beliefs about the PWP role impact on opportunities to engage in SDM”, “PWPs beliefs and experiences of using SDM in practice” and “Areas of hope: identified areas of good practice and ways to move towards increasing SDM”. Analysis of the survey data provided descriptive statistics highlighting the current level of choice and knowledge of SDM. Conclusions: Current levels of SDM for individuals presenting with depression do not appear to meet the levels recommended by NICE (2022). Key barriers to this include lack of time and resources, as well as external pressures regarding targets and funding.