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Psychologists' perspectives on supported decision making in Ireland.

E Rogers1,2,3, M Pilch2,4, B E McGuire2

  • 1Brothers of Charity Services, Ireland.

Journal of Intellectual Disability Research : JIDR
|January 25, 2020
PubMed
Summary

Psychologists find that adults with intellectual disabilities are often excluded from decision-making despite the 2015 Legal Capacity Act. Support and training are crucial for authentic decision-making processes.

Keywords:
UNCRPDintellectual disabilitiesmental capacitysupported decision makingthematic analysis

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Area of Science:

  • Legal capacity and decision-making in intellectual disability.
  • Psychological perspectives on capacity assessment.

Background:

  • The Irish Legal Capacity Act 2015 introduced new legal frameworks.
  • Focus on decision-making capacity for adults with intellectual disabilities.

Purpose of the Study:

  • Examine psychologists' views on decision-making capacity.
  • Identify key issues for adults with intellectual disabilities.

Main Methods:

  • Qualitative exploratory study using a social constructionist framework.
  • 15 clinical psychologists recruited via purposive and snowballing sampling.
  • Semi-structured interviews analyzed thematically.

Main Results:

  • Six themes emerged: presumption of capacity vs. culture of incapacity, decision-making as a process, authenticity, need for support/training, psychology's contribution, and future directions.
  • Exclusion of individuals with intellectual disabilities from decision-making processes.
  • Challenges identified: systemic, resource, and attitudinal.

Conclusions:

  • Functional approach to decision-making is welcomed.
  • Substituted decision-making is necessary within a support framework.
  • Supporting decision-making is an ongoing process requiring systemic change.