Publish date: 1 August 2025
“We recognise and celebrate individual differences in interests, beliefs and personalities that make us each unique in our daily lives. But how do these intrinsic factors influence our decision-making in mental health detention and care?”
A thought-provoking new publication in BMJ General Psychiatry, authored by four Psychiatry trainees, now in higher training, explores how clinicians’ personality traits, including risk aversion, conscientiousness, and extraversion may influence their approach to patient care. The paper focuses particularly on decisions to detain, or in other words, involuntarily admit patients for mental health assessment or treatment under the Mental Health Act (MHA).
The authors noted that this paper is not about drawing hard lines and making judgement on clinicians and their decision-making, but rather an invitation to reflect and bring more self-awareness into practices.
Dr Brandon Wong, Specialist Registrar in Psychiatry said: “The idea was born from a casual conversation among four trainees, including myself, celebrating our move into higher training while talking about the complexities of MHA assessments. The talk later turned into something deeper.”
Despite standardised training and legal frameworks, the team noticed how personal traits might subtly influence clinical decisions. Dr Brandon added: “Even when applying the same criteria, we sometimes reached different conclusions. We started asking if it is just experience or does who we are play a bigger role in decision-making.”
The publication offers a new perspective on decision-making in psychiatry, particularly given the complex considerations surrounding the nature of involuntary detention. In other words, compulsory admission of patient to a psychiatric hospital. The paper also suggests that decisions may partly originate from individual personality traits, like risk appetite, highlighting an important but underexplored area where psychiatry may lag behind other fields in factoring personality into clinical judgment.
Dr Brandon added: “We’re not trying to categorise anyone. We hope to ultimately promote more equitable and ethically sound care and support in our clinical practices.”
Read the full paper on the BMJ website: https://gpsych.bmj.com/content/38/3/e102065.