• Steven K Dobscha, Risa Cromer, Aysha Crain, and Lauren M Denneson.
• Center to Improve Veteran Involvement in Care (CIVIC), VA Portland Health Care System, PO Box 1034 (R&D66), Portland, OR 97207, USA Mental Health and Clinical Neurosciences Division, VA Portland Health Care System, PO Box 1034 (R&D66), Portland, OR 97207, USA Department of Psychiatry, Oregon Health & Science University, 3181 Sam Jackson Park Rd, Portland, OR 97239, USA.
• Int J Qual Health Care. 2016 Jun 1; 28 (3): 355-62.

ObjectiveEnhanced patient involvement in care has the potential to improve patient experiences and health outcomes. As such, large national and global healthcare systems and organizations, including the US Department of Veterans Affairs (VA), have made patient-centered care a primary goal. Little is known about mental health clinician perspectives on, and experiences with, providing patient-centered care. Our main objective was to better understand VA mental health clinicians' perceptions of patient-centered care, and ascertain possible facilitators and barriers to patient-centered practices in mental health settings.DesignQualitative study of six focus groups conducted in late 2013.Setting And ParticipantsThirty-five mental health clinicians and staff from a large VA Medical Center.OutcomesTranscripts were analyzed using an inductive and deductive thematic analysis approach.ResultsParticipants described patient-centered care ideally as a process of shared discovery, and expressed general enthusiasm for patient-centered care. Participants described several ongoing patient-centered care practices but conveyed concerns about the practicalities of its full implementation. Participants expressed a strong desire to change the current biomedical culture and policies of the institution that may hinder clinicians' flexibility and clinician-clinician collaboration when serving patients. In particular, clinicians worried about being held responsible for addressing all of the needs or goals that a patient may identify.ConclusionsIf patient-centered care is to be practiced fully in mental health settings, healthcare institutions need to develop multimodal strategies to enhance clinician-clinician and clinician-patient collaborations to promote and support a focus on discovery and shared accountability for outcomes.© The Author 2016. Published by Oxford University Press in association with the International Society for Quality in Health Care; all rights reserved.

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