Triadic Perspectives on Decision Making in Psychiatry: A Qualitative Study on Service Users, Caregivers and Healthcare Professionals in Latvia

Background/Objectives: Decision-making in mental health care is essential for personal autonomy and a cornerstone of person-centered, rights-based psychiatric care. This study aimed to explore and describe the perceptions and experiences of decision-making in psychiatric care from the perspectives of service users, caregivers, and healthcare professionals. It also examined the decision-making contexts that either facilitate or hinder these practices. Methods: An exploratory-descriptive qualitative design using semi-structured interviews was employed. A total of 21 interviews were conducted with 8 service users, 6 caregivers, and 7 healthcare professionals. The interviews were transcribed verbatim and analyzed using inductive content analysis. Results: Four main categories emerged: (1) Antecedents for decision-making: a) mental healthcare factors, b) service user factors; (2) Challenges in decision-making; (3) Consequences of decision-making: a) benefits, b) risks, c) burden; and (4) Recommendations for better decision-making: a) informational support, b) other help and support. Conclusions: This study highlights the complexity of decision-making in Latvian psychiatric care, as perceived by service users, caregivers, and professionals. All participants identified both benefits and risks in the decision-making process. Factors influencing decision-making stemmed from the mental health system and the service user’s personal circumstances. Systemic improvements, including better informational support and communication, are needed to strengthen decision-making agency in psychiatric care.