Good decision making in mental health care

24.9.2026

Bear Psychology Podcast

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If you or someone you know receives mental health care do you feel confident in the services being provided? Or are you left with question or concerns? Mental health awareness and treatment has grown into a global priority. One in five experience mental illness in their lifetime, and those who suffer are coming forward in unprecedented numbers. As more people seek care, we must also reflect on whether providers are meeting demands through existing systems and mental health care approaches.

In their book, Managing Uncertainty in Mental Health Care, Drs. Patricia Rockman and José Silveira critically examine core assumptions informing the primary approaches currently used to assess mental illness in clinical settings, with an emphasis on clinician certainty. They illustrate how current diagnostic frameworks relate to clinician decision making and if overconfidence may lead to errors in judgment. Silveira and Rockman consider potential strategies for lessening the impact of possible errors.

This book reflects on the possibility of errors in clinical judgment, independent of competence and experience, and the need to apply mental health practices that address the needs of the client.

Rockman and Silveira address the issue of clinical error and provide a novel perspective in the application of reducing harm in practice.

DESCRIPTION OF THE AUTHORS -

Patricia Rockman Monday, CCFP, FCFP is a physician with a focused practice in mental health. She is also an associate professor at the University of Toronto, Department of Family and Community Medicine cross appointed to Psychiatry. Patricia Rockman is a co-author of a number of books on mindfulness-based programs. She is a trained Yoga teacher and has been teaching about stress, psychotherapy, mindfulness, change management and other mental health issues for over thirty-five years.

José Maria Alves da Silveira B.Sc., M.D., FRCPC, DABAM

Dr. José Silveira is currently an Associate Medical Director with the Ontario Medical Association Physician Health Program. He is certified by the Royal College of Physicians and Surgeons of Canada in Psychiatry and is a Diplomate of the American Board of Addiction Medicine.

Dr. Silveira is an Adjunct Associate Professor in the Department of Psychiatry, Faculty of Medicine at the University of Toronto in Canada. His academic promotion recognized his Creative Professional Activity and its positive impact on aiding clinicians across multiple disciplines in managing complexity and uncertainty in mental health and addictions. José's expertise has developed over the course of 28 years and a variety of roles.

Dr. Silveira has chaired committees reviewing adverse events in clinical practice; provided oversight as Chief and Medical Director of an inner-city hospital mental health and addiction program; and has been Co-Chair of the Medical Advisory Council of one of Canada's largest academic health science centers. Throughout his roles he remained active in clinical practice. His attention to uncertainty and the impact on both clients and clinicians has also been informed by reviews of numerous client complaints relating to mental health and addiction clinician care; serving for both defense and complainants in civil and criminal cases, and review of cases for Coroner's Inquests.

He is a coauthor of the book, Managing Uncertainty in Mental Health Care, published by Oxford University Press in November 2021.

What critics are saying about the book - "This book is about coming to grips with the uncertainty and complexity inherent to the assessment of people presenting with possible mental disorders. It is an exploration of the impact of objective uncertainty on clinical judgment and decision making and its relevance to mental health care."

If you are interested in learning more about irreducible uncertainty and complexity on approaches to clinician training, then this podcast is for you.