The Role of Patient Activation in Psychiatric Visits

Objective-This study identified ways that consumers of mental health services are active participants in psychiatric treatment.Methods-Self-reported activity in treatment and observations of audio recorded psychiatric visits were examined.Four providers (3 psychiatrists and one nurse practitioner) and 10 of their consumers with severe mental illness (40 total) were recruited.Consumers completed questionnaires on patient activation, illness self-management and medication attitudes on the day of a psychiatric visit.The visit was audiotaped, transcribed, and thematically analyzed.Providers reported diagnosis, substance abuse, and medication adherence.Results-Self-reported patient activation was positively related to illness self-management and negatively related to substance abuse.Consumers were active in partnership building, seeking and displaying competence, and directing treatment; however, there was little relationship between selfreported activation and observed behaviors.Conclusions-Consumers are active in a variety of ways; but, similar to other populations, the relationship to self-reported desire for involvement is not direct.Living successfully with chronic health conditions requires active collaboration in managing illness --consumer and health care provider working together to identify problem areas, set goals, learn self-management skills, and participate in follow-up (1).An active partnership is critical because the majority of time spent managing chronic illnesses takes place when the consumer is on his/her own in the community rather than in the provider's office.Further,