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Clinical guidance recommends for risk to be identified and managed collaboratively with the individual, but studies indicate that this may not be happening in practice. The aim of this study was to identify the barriers and enablers to collaborative risk assessment and management based on shared decision-making from service users\u2019 perspectives. A qualitative approach using semi\u2010structured interviews was employed. The Theoretical Domains Framework for behaviour change, which consists of fourteen theoretical domains that have been found to influence behaviour, informed data collection and analysis. Thirteen service users living with severe mental illness took part in an interview. The majority of participants reported not having been involved in the identification of their risk and most were unaware of the information included in their risk management plan. Perceived barriers to involvement were power dynamics between professionals and service users, difficulty talking about sensitive risk topics, and the emotional impact of engaging in these discussions. Perceived enabling factors for involvement included the possibility of gaining a better understanding of risk issues, and discussion about risk enhancing the individual\u2019s ability to maintain their own well-being and safety. Most participants expressed a willingness to be involved in shared decision-making and believed that their friends and family would enable them to be involved. The findings of this study offer valuable insights for targeting behaviour change in future intervention design that seeks to increase shared decision-making in risk assessment and management with individuals with severe mental illness.<\/jats:p>","DOI":"10.1371\/journal.pmen.0000157","type":"journal-article","created":{"date-parts":[[2024,11,13]],"date-time":"2024-11-13T18:34:38Z","timestamp":1731522878000},"page":"e0000157","update-policy":"https:\/\/doi.org\/10.1371\/journal.pmen.corrections_policy","source":"Crossref","is-referenced-by-count":7,"title":["Barriers and enablers to shared decision-making in assessment and management of risk: A qualitative interview study with people using mental health services"],"prefix":"10.1371","volume":"1","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-6732-1317","authenticated-orcid":true,"given":"Nafiso","family":"Ahmed","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lisa","family":"Reynolds","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sally","family":"Barlow","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kathleen","family":"Mulligan","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nicholas","family":"Drey","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3286-9846","authenticated-orcid":true,"given":"Alan","family":"Simpson","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"340","published-online":{"date-parts":[[2024,11,13]]},"reference":[{"key":"pmen.0000157.ref001","unstructured":"Royal College of Psychiatrists. 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