Table 2 How the findings reflect essential elements of SDM as described by Makoul et al. [2]

Define/explain problem

The participants inform the patients about the diagnosis and state of health.

Present options

The participants inform the patients to some degree about different antipsychotic medications. If psychological and social treatment options are presented, it is usually as a supplement, not as an alternative, to medication.

Discuss pro/cons

Usually discussed after prescribing an antipsychotic medication and not as part of a SDM process before making the treatment choice.

Patient values/preferences

Some participants mention the importance of providing care in line with patients’ values, but our results do not support that this is participants’ everyday practice.

Discuss patient ability/self-efficacy

The findings do not give a clear answer as to what degree the participants discuss patient ability/self-efficacy.

Doctor knowledge/recommendation

Some participants present an antipsychotic medication to the patients. However, our findings do not support that it is a recommendation based on a SDM process where different options and their pros/cons have been discussed in light of the patients’ values.

Check/clarify understanding

The findings are unclear regarding to what degree the health professionals’ check the patients’ understanding.

Make or explicitly defer decision

The findings suggest that health professionals often make the decision due to the patients’ limited understanding of their own situation. This is a practice more based on a clinical-led model than on SDM.

Arrange follow-up

The participants describe using time to identify what is important for the patients suggesting that they follow-up decisions over time. However, it is unclear how and to what extent this is implemented as part of an overall SDM process.