Understanding mental health clinical decision-making: A clinical vignette study

Conference Proceeding

Lauren Burns

Abstract

Some mental health diagnoses such as Bulimia Nervosa, Anxiety Disorder, and Bipolar Disorder are seen more often in patients with certain demographics. However, patient factors such as gender, age and socioeconomic status are shown to unintentionally influence diagnostic, treatment and referral decisions. Therefore, using fictitious case studies (co-produced by medical practitioners) it was tested to see whether by only changing the patient factor can differences in clinical decision-making be seen. Methods/Approach: Participants were General Practitioners, as they are many people’s first choice when seeking mental health support and are heavily involved in patients’ mental health care. Participants were exposed to three clinical cases (one depicting Bulimia Nervosa, one Anxiety Disorder, and another Bipolar Disorder). However, participants were randomly allocated to condition 1, condition 2 or the control version of the clinical case for each disorder.  Condition 1 and 2 would be the patient demographic; for Bulimia Nervosa the demographic was sex (male versus female), Anxiety Disorder was age (young versus old), and Bipolar Disorder was paired with socioeconomic status (high versus low).  Results: The differences between treatment, diagnostic and referral decisions based on patient demographics will be presented and discussed. The methodological challenges and benefits of using clinical vignettes (case studies) to explore decision-making in mental health will also be discussed. Conclusion: The results of this project will be used to; better understand the rationale behind clinical decisions, identify where inconsistencies between decisions lie, and assist Clinicians to make better informed mental health-related decisions.

Relevant Publications in Abnormal and Behavioural Psychology