Connecting Values and Brain Health in Decision-Making: A Global Conversation

Atlantic Fellows Alison Canty, Jayashree Dasgupta, Joyla Furlano, and Aline Nogueira Haas reflect on their global collaboration to explore the application of values-based practice in brain health.

^{Fellows consider brain health over coffee. Photo shared by Alison Canty}

In the summer of 2023, a research seminar led by Panos Alexopoulos, Lecturer Registrar in Global Brain Health, sparked an intriguing follow-up discussion among the Atlantic Fellows over coffee. During the seminar, Panos described his previous work, highlighting the success of values-based practice (VBP) in clinical settings—specifically in psychiatry, orthopedics, and primary care—and emphasized process-oriented decision-making for optimal outcomes. This led us to wonder: Could VBP effectively guide discussions about brain health challenges?

The Role of Values-Based Practice

What began as an academic exchange soon evolved into a collaborative effort involving diverse minds from around the world. Many of us were Atlantic Fellows for Equity in Brain Health who had just completed our one-year fellowship training at GBHI at Trinity College Dublin. Late-night and early-morning Zoom sessions followed over the coming months—a perfect way for us to continue the warmth and good feelings of the fellowship as we returned to life back home.

We discussed how the well established ten principles of VBP could be applied in brain health decision-making, especially during climatic events that could affect anyone, such as heat waves and wildfires. These principles include:

1. Awareness of the role of values
2. Reasoning
3. Knowledge
4. Communication
5. User-centeredness
6. Multidisciplinarity
7. Science-driven processes
8. Partnership
9. The 'two feet' (values plus facts) and
10. 'squeaky wheel' (only noticed when there is conflict) principles. 

Case Studies: Janaina and David

To illustrate our discussions, we developed two vignettes inspired by real cases: Janaina and her family in Amazonian Brazil, and David, who lives alone with age-related chronic disease in a coastal town in Australia. Both face brain health challenges due to similar climate crises and could benefit from values-based decision-making to achieve the best outcomes for their brain health.

Brain health decisions involve a multitude of stakeholders, each with unique values and interests. The strength of VBP lies in its recognition that outcomes depend on understanding and respecting diverse viewpoints.

Collaborative Efforts and Outcomes

Our collaboration led to the development of a short editorial, published in March 2024, followed by a longer perspective paper that identified additional meta-values—mutual regard, reciprocity, autonomy, and an egalitarian attitude—as relevant to the application of VBP in brain health decision-making. We were lucky enough to all be together at the ‘one-year-out’ Global Atlantic Fellows Convening in Oxford when the news came through that the manuscript had been accepted.

Where to Go from Here?

Exploration of the application of VBP in brain health has continued with the next cohort of fellows through a summer training program, led by Panos. This program has generated even more interest in the idea of working together globally to champion empathy, communication, and collaboration for a healthier world.

As we move forward, we invite you to reflect on how values-based practice can be integrated into your own decision-making processes. Together, we can foster a more inclusive and empathetic approach to brain health.

Who Was Involved?

2022-2023 Atlantic Fellows for Equity in Brain Health: Alison Canty (Australia), Jayashree Dasgupta (India), Joyla Furlano (Canada), Aline Nogueira Haas (Brazil). 

GBHI Faculty: Panos Alexopoulos, Iracema Leroi, Irina Kinchin 

Related Publications

Alexopoulos, P., Canty, A., Dasgupta, J., Furlano, J. A., & Nogueira Haas, A. (2024). Brain health and value diversity: A new implementation field for values-based practice?. Psychiatrike = Psychiatriki, 35(1), 13–16. https://doi.org/10.22365/jpsych.2024.001

Alexopoulos, P., Leroi, I., Kinchin, I., Canty, A.J., Dasgupta, J, Furlano, J.A., Haas, A.N. Relevance and Premises of Values-Based Practice for Decision Making in Brain Health. Brain Sci. 2024, 14, 718. https://doi.org/10.3390/brainsci14070718