Shared decision-making refers to a process of health care delivery in which practitioners and clients seeking help for problems or disorders collaborate to access relevant information and to enable client-centered selection of health care resources. Though nearly all clients express a desire for more information, preferences for participation in health care decisions vary by individual and by illness. Two common strategies to promote shared decision-making are communication training for clients and clinicians, and decision aids to provide targeted information and values clarification. Research in several areas of medicine shows that active client participation results in a variety of benefits, from increased satisfaction to decreased symptom burden. Many current mental health interventions promote client-centered care, client choice, and self-directed care, but research on shared decision-making in mental health for clients with severe and persistent mental illness is just beginning.