Supported Decision Making in Serious Mental Illness

Psychiatry
Dilip V JesteElyn R Saks

Abstract

Making decisions is central to the exercise of control over one's well-being. Many individuals with serious mental illness (SMI) experience limitations in their decision-making capacity. These individuals have often been placed under legal guardianship and substitute decision makers have been appointed to make decisions on their behalf. More recently, supported decision making (SDM) has emerged as a possible alternative in some cases. SDM involves recruitment of trusted supports to enhance an individual's capacity in the decision-making process, enabling him or her to retain autonomy in life decisions. This overview examines issues associated with decision-making capacity in SMI, frameworks of substitute decision making and SDM, and emerging empirical research on SDM. This is an overview of the medical and legal literature on decision making capacity and supported decision making for persons with SMI. Many but not all individuals with SMI exhibit decrements in decision-making capacity and skill, in part due to cognitive impairment. There are no published data on rates of substitute decision making/guardianship or SDM for SMI. Only three empirical studies have explored SDM in this population. These studies suggest that SDM is vi...Continue Reading

References

Apr 1, 1995·Law and Human Behavior·Paul S Appelbaum, Thomas Grisso
Sep 2, 2004·Journal of the Royal Society of Medicine·Alec Buchanan
Dec 20, 2005·Journal of Psychiatric Research·David J MooreDilip V Jeste
Mar 15, 2006·Archives of Internal Medicine·David I ShalowitzDavid Wendler
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Aug 24, 2016·Archives of Clinical Neuropsychology : the Official Journal of the National Academy of Neuropsychologists·Barton W Palmer, Alexandrea L Harmell

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Citations

Jun 18, 2019·International Psychogeriatrics·Awais Aftab, Dilip V Jeste
May 2, 2020·JMIR Mental Health·Reham AHameed Shalaby, Vincent Io Agyapong
Aug 26, 2020·Journal of Geriatric Oncology·Siri RostoftMarije E Hamaker
Feb 16, 2019·Disability and Health Journal·Nicole AgaronnikLisa I Iezzoni
May 1, 2021·Vaccines·Nunzia CannovoMariano Cingolani
Jul 22, 2021·Clinical Interventions in Aging·Cathal O'CionnaithCarmelle Peisah
Oct 6, 2021·International Psychogeriatrics·Barton W Palmer
Nov 30, 2021·Psychiatric Services : a Journal of the American Psychiatric Association·Amy L ShearerDmitry Khodyakov

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