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The meaning of illness is individualized to each person who experiences an alteration in health. In contrast, disease is a medical term indicating a pathological change in the structure and function of the body or mind. It is a condition that has specific symptoms and boundaries.
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When a person's physical, emotional, intellectual, social development or spiritual functioning is compromised, this deviation from a healthy normal state is called illness. Illness creates stress that in turn harms individuals. Irritation, anger, denial, hopelessness, and fear are behavioral and emotional changes an individual experiences in the phases of illness. A variety of factors influence a person's health and well-being.
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Health is a condition of the body, mind, and spirit where an individual remains free from illness. Similarly, wellness is an active state, including living a lifestyle that promotes physical, mental, and emotional health. Physical health is critical for the overall well-being and can be affected by lifestyle, activity level, diet, and behavior. The highest attainable standard of health is a fundamental and universal human right. Consider Lisa, a fifteen-year-old born with congenital...
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Supported Decision Making in Serious Mental Illness.

Dilip V Jeste, Graham M L Eglit, Barton W Palmer

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    Supported decision making (SDM) offers a promising alternative to guardianship for individuals with serious mental illness (SMI). Research suggests SDM is acceptable and potentially superior, but more studies are needed.

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    Area of Science:

    • Neuroscience and Psychiatry
    • Legal Studies
    • Rehabilitation Medicine

    Background:

    • Individuals with serious mental illness (SMI) often face challenges with decision-making capacity.
    • Legal guardianship and substitute decision-making are common but may limit autonomy.
    • Supported decision making (SDM) is an emerging alternative that utilizes personal support networks.

    Purpose of the Study:

    • To review the literature on decision-making capacity in SMI.
    • To examine frameworks of substitute decision making and SDM.
    • To explore emerging empirical research on SDM for individuals with SMI.

    Main Methods:

    • Literature review of medical and legal texts.
    • Analysis of existing frameworks for decision support.
    • Examination of empirical studies on SDM in SMI populations.

    Main Results:

    • Many individuals with SMI experience impaired decision-making capacity, often due to cognitive deficits.
    • There is a lack of data on the prevalence of guardianship and SDM in SMI.
    • Preliminary studies indicate SDM is perceived as acceptable and potentially better than substitute decision-making by patients and caregivers.

    Conclusions:

    • SDM presents a viable and potentially advantageous alternative to substitute decision-making for individuals with SMI.
    • Further research is essential to define SDM eligibility, processes, and outcomes.
    • Recommendations for implementing and researching SDM in SMI are provided.