Comparing patients' and staff members' attitudes: Does patients' competence to disagree mean they are not competent?

The ability to process and compare the benefits and risks of a proposed tre atment is considered an important component of being competent to make trea tment decisions. Whether psychiatric patients' expressed treatment, choice reflects their personal preferences or a deficit in their decision-making p rocess is unclear The aim of the study was to assess the extent to which pa tients and staff agree or not on various treatment-related issues. A litera ture search was conducted to identify published articles comparing tale per ceptions and attitudes of staff and patients toward various treatment issue s. Twenty-Eight published articles over the last 40 years were located and their main findings summarized. Analysis of the findings revealed disagreem ent between patients and staff in 26 of the 28 articles. The consistency of the disagreement over time and across studies suggests that the disagreeme nt might have more to do with the fundamental difference between being a pa tient and a staff member rather than a patient's cognitive deficits or psyc hopathology. It is crucial that both patients and staff work toward buildin g bridges when discord appears consistent and pervasive.