I think in those kinds of challenging situations....
Maybe I would just preface this by saying that, ideally, these are shared decisions because the patient is listening to the psychiatrist's perspective and input, and we are there to think about hope and recovery. At the same time, we have to listen to a competent patient's perspective and what they want to come up with a decision that forges a path forward for the patient that they find appropriate for them.
Where a patient feels that they perhaps are not getting what they feel they might need from a practitioner, I think the solution would be similar to what patients do when they experience that in many different medical predicaments. There are opportunities to reach out, request a second opinion, ask for a re-evaluation or maybe come to a shared decision around what next steps should be taken, and then maybe have a second opinion.
I think there are different alternatives, but ideally these are transparent, informed conversations between two people who care about somebody's outcome, treatment and care.