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Key components of supporting and assessing decision making ability.

Paul Webb1, Gavin Davidson2, Rosalie Edge3

  • 1Praxis Care, 25-31 Lisburn Road, Belfast, Northern Ireland BT9 7AA, UK.

International Journal of Law and Psychiatry
|September 5, 2020
PubMed
Summary

This study explores decision-making support for individuals with mental health or learning disabilities. Findings suggest current assessment methods may not align with personal experiences, highlighting needs for improved training and services.

Keywords:
AssessmentIntellectual disabilitiesLearning disabilitiesMental capacityMental healthTrainingUNCRPD

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Area of Science:

  • Legal and ethical aspects of decision-making capacity.
  • Disability rights and supported decision-making frameworks.
  • Mental health and cognitive function research.

Background:

  • Individual autonomy is a cornerstone of democratic societies, reinforced by laws and international conventions like the UN Convention on the Rights of Persons with Disabilities (UNCRPD).
  • Article 12 of the UNCRPD mandates equal recognition before the law, necessitating accessible support and safeguards for decision-making.
  • Significant debate exists regarding theoretical underpinnings and practical challenges in assessing and supporting decision-making ability.

Purpose of the Study:

  • To present key components of decision-making support and assessment processes.
  • To inform service development and training for supporting individuals with impaired decision-making capacity.
  • To explore the decision-making experiences of people with mental health problems and/or learning disabilities.

Main Methods:

  • Qualitative, participatory research project.
  • Exploration of decision-making experiences of individuals with mental health problems and/or learning disabilities.
  • Analysis of conventional capacity assessment components (understand, retain, use/weigh, communicate).

Main Results:

  • Individuals' lived experiences of decision-making do not typically align with the four conventional assessment components.
  • Current approaches to supporting decision-making may not explicitly address assessment processes.
  • Considering support across all functional test aspects can enhance comprehensiveness.

Conclusions:

  • Effective support and assessment of decision-making ability present significant challenges.
  • Implications for training, service development, and practice require careful consideration.
  • Aligning support strategies with individual experiences is crucial for enhancing autonomy.