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A health care approach that involves service users in decisions concerning their own health. It considers service users’ beliefs, values, support system, and experiences in co-creating an action plan to address their distinct health care goal [this is de novo based on diverse publications about person-centered care].
care
health
mental
person-centered
Historically, clinical medicine has primarily focused on diagnosing and treating patients’ symptoms. Over the last few decades, there has been a notable shift to increase patients’ involvement in their own mental health care [1][2] and in how their relationship with clinicians is understood [3].
The definition of person-centered mental health care (PCMHC) has evolved over time alongside the definition for general person-centered care (PCC) as there have been gradual shifts in the culture of health care. There is an increasing recognition of the importance of an individual’s own experience of their health, their values and their community and how it should be a basic human right to have access to care that empowers people and communities to be involved in decisions about their own mental health. In order for this to be possible, a supportive system needs to be in place and the current system needs to change. With any shift in culture and defining of new terms, there are a variety of ideas brought forward and efforts to define the terms in theory and in practice.
The idea of PCC began to gain strength during the latter half of the 20th century. It can be linked back to Greek origins of the word “diagnosis”—to identify the disorder (“dia”) and to understand the person (“diagignoskein”). In 1957, Carl Rogers [4] proposed six client-centered care conditions which allow for positive personal change. In 2000, Mead and Bower [5] published an article on patient-centeredness which was a review of the growing body of literature advocating for patient-centered care. They described how some of the common elements defining patient-centered care included understanding the patient as a person, sharing power and responsibility, focusing on the therapeutic alliance and recognizing the care provider as a person.
Although the term patient-centered care continues to be used today, person-centered care is now more commonly accepted as it signifies patients as unique individuals who have connections within their community [3][6][7]. In 2007, the World Health Organization (WHO) published a policy framework on people-centered health care [8]. Their definition of people-centered care was rooted in principles such as human rights and dignity, non-discrimination, participation and empowerment, access and equity, and a partnership of equals. This was further supported and expanded by the UN Convention on the Rights of Persons with Disabilities, which came into force in 2008 [9]. This increased awareness of the importance of person-centered care for people with disabilities, including mental health issues.
The concept of person-centered mental health care has evolved to include respect, empowerment and compassion for the whole person receiving care, strong relationships between the person receiving care, their community, and care providers, improved access, and health care environments and systems which support and sustain this type of care over time. An example of these concepts is taking shape in Australia with the government’s approach entitled Vision 2030 [10]. Vision 2030 supports a person-centered approach to mental health care by ensuring service users play a central role in their care and in the choice, design and delivery of services that support them. Vision 2030 also acknowledges the impact of social determinants of health and embraces a recovery approach. In line with this vision, research has been focused on giving service users a voice in defining goals, priorities and gaps in mental health care and recovery. Some of priorities of service users include authentic and trusting relationships, experiences of connection and belonging and the value of contributing to one’s community [10].
These definitions have many similarities, including a shift towards greater understanding, respect, empowerment and compassion for the whole person receiving care, fostering strong relationships between the person receiving care, their community, and care providers, improving access, and designing health care environments and systems which support and sustain this type of care over time [11].
This entry aims to provide an overview of person-centered mental health care as it relates to policies, practices, challenges, stigma, culture, and economics. Throughout, the authors will refer to general person-centered care information for conceptual context, and highlight issues and examples specifically related to mental health where appropriate.
References
- Francis, C.J.; Johnson, A.; Wilson, R.L. Supported Decision-Making Interventions in Mental Healthcare: A Systematic Review of Current Evidence and Implementation Barriers. Health Expect. 2024, 27, e14001.
- Ekman, I.; Swedberg, K.; Taft, C.; Lindseth, A.; Norberg, A.; Brink, E.; Carlsson, J.; Dahlin-Ivanoff, S.; Johansson, I.-L.; Kjellgren, K.; et al. Person-Centered Care--Ready for Prime Time. Eur. J. Cardiovasc. Nurs. 2011, 10, 248–251.
- Gask, L.; Coventry, P. Person-Centred Mental Health Care: The Challenge of Implementation. Epidemiol. Psychiatr. Sci. 2012, 21, 139–144.
- Rogers, C.R. The Necessary and Sufficient Conditions of Therapeutic Personality Change. J. Consult. Psychol. 1957, 21, 95–103.
- Mead, N.; Bower, P. Patient-Centredness: A Conceptual Framework and Review of the Empirical Literature. Soc. Sci. Med. 2000, 51, 1087–1110.
- Harding, E.; Wait, S.; Scrutton, J. The State of Play in Person-Centred Care: A Pragmatic Review of How Person-Centred Care Is Defined, Applied and Measured, Featuring Selected Key Contributors and Case Studies Across the Field; The Health Policy Partnership: London, UK, 2015; Available online: https://www.healthpolicypartnership.com/app/uploads/The-state-of-play-in-person-centred-care.pdf (accessed on 31 October 2024).
- Nelson, M.L.A.; MacEachern, E.; Prvu Bettger, J.; Camicia, M.; García, J.J.; Kapral, M.K.; Mathiesen, C.; Cameron, J.I.; American Heart Association Stroke Council; Council on Cardiovascular and Stroke Nursing; et al. Exploring the Inclusion of Person-Centered Care Domains in Stroke Transitions of Care Interventions: A Scientific Statement from the American Heart Association. Stroke 2024, 55, e169–e181.
- World Health Organization People-Centred Health Care: A Policy Framework 2007. Available online: https://www.who.int/publications/i/item/9789290613176 (accessed on 11 October 2024).
- United Nations Convention on the Rights of Persons with Disabilities (CRPD)|Division for Inclusive Social Development (DISD) 2006. Available online: https://www.ohchr.org/en/instruments-mechanisms/instruments/convention-rights-persons-disabilities (accessed on 31 December 2024).
- Paton, J.; Carrington, A.; Gentle, E.; Horsefall, D. “I Am More than My Diagnosis”: Amplifying the Voice of Consumers in the Design and Delivery of Mental Health Services. Aust. J. Rural. Health 2024, 32, 1140–1149.
- The Picker Principles of Person Centred Care. Available online: https://picker.org/who-we-are/the-picker-principles-of-person-centred-care/ (accessed on 31 October 2024).
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