From Substitute to Supported Decision Making: Practitioner, Community and Service-user Perspectives on Privileging Will and Preferences in Mental Health Care
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Gordon, Sarah
Gardiner, Tracey
Gledhill, Kris
Tamatea, Armon
Newton-Howes, Giles
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MDPI AG
Abstract
Compliance with the Convention on the Rights of Persons with Disabilities (CRPD) re-quires substitute decision making being abolished and replaced with supported decision making. The current exploratory study involved a series of hui (meetings) with subject matter experts across the spectrum of the mental health care system to identify interventions facilitative of supported decision making; and the prioritisation of those in accordance with their own perspectives. A mixed-methods approach was used to categorise, describe and rank the data. Categories of intervention identified included proactive pre-event planning/post-event debriefing, enabling options and choices, information provision, facilitating conditions and support to make a decision, and educa-tion. The category of facilitating conditions and support to make a decision was prioritised by the majority of stakeholders; however, people from Māori, Pasifika, and LGBTQIA+ perspectives, who disproportionally experience inequities and discrimination, prioritised the categories of proactive post-event debriefing/pre-event planning and/or information provision. Similar attributes across categories of intervention detailed the importance of easily and variably accessible options and choices and how these could best be supported in terms of people, place, time, material resources, regular reviews and reflection. Implications of these findings, particularly in terms of the operation-alisation of supported decision making in practice, are discussed.
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Convention on the Rights of Persons with Disabilities, human rights, indigenous peoples, mental distress, supported decision making, 4203 Health Services and Systems, 42 Health Sciences, 44 Human Society, 48 Law and Legal Studies, 4409 Social Work, Mental Health, Clinical Research, Behavioral and Social Science, 7.1 Individual care needs, 3 Good Health and Well Being, Toxicology
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International Journal of Environmental Research and Public Health, ISSN: 1660-4601 (Print); 1660-4601 (Online), MDPI AG, 19(10), 6002-. doi: 10.3390/ijerph19106002
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© 2022 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
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Except where otherwise noted, this item's license is described as Creative Commons Attribution (CC BY) license