At the center of decision making in mental health services and interventions research: Patients, clinicians, or relationships?

Wills and Holmes-Rovner (2006) highlight the fact that despite growing interest in the role of patient preferences and shared decision making with clinicians in the general health services research community, relatively little is known about the impact of these preferences and processes on actual decisions, service delivery engagement, or intervention outcomes in the mental health field. This commentary expands on three important points raised in Wills and Holmes- Rovner's article: (a) the need for more and better research on values assessment, (b) contextual factors in the decision-making process, and (c) the measurement of patient preferences regarding their level of involvement in decision making.