Supported Decision-­Making: Giving Mental Health a Voice

Date: 
Friday, July 1, 2016

The Imapct

Led by Elyn Saks, a consumer and renowned mental health law expert, Saks Institute will develop and promote adoption of a new Supported Decision-­Making (SDM) approach customized for people with mental illness – a capability that does not exist today. The profound benefit is the patient being listened to, respected, offered options, and given a more active role in planning his/her own care. Families will benefit by partnering with their loved one and supporting his/her sensible choices for optimal wellness. When people have increased self­-determination (control over their lives) they have improved life outcomes: are more likely to be employed, build relationships, enjoy stable family life, live in the community, contribute to society, and have greater physical and mental health. Expected results with Saks’ SDM approach include tangible increases in treatment cooperation, decreased health costs, with intangible benefits of respect, dignity, and patients having a voice in their own care.

“No one would ever say someone with a broken leg is less than a whole person, but people say or imply that all the time about people with mental illness.” As a consumer and legal expert, Elyn Saks knows personally the journey of living with a mental illness. Choice is a hallmark of personhood. For centuries, society has responded to people with disabilities, illness, and those in crisis, by taking choice away – even though decades of research has shown that incorporating choice results in positive outcomes. Saks’ SDM approach will, for the first time, give patients the ability to plan their own care, relative to an individual’s unique mental health situation and competency, with dignity and respect. It is estimated 20­-25% of the population has a lifetime risk of mental illness. Knowing SDM has been successful for other populations (such as dementia and intellectual disabilities) the question is not, “Why now?” but rather, “How soon can SDM be brought to those with mental illness?”

Potential Impact

The long­-term goal is to empower individuals to become high-­functioning members of society. Supported DecisionMaking (SDM) empowers the individual by giving the ability, rights, and opportunity to plan their care for increased treatment compliance, dignity, and fewer negative impacts to the community. Anticipated long-­term impacts with Saks’ new SDM approach for those with mental illness include increased physical and mental health for the individual sustained over time, improved relationships and stability within their families, the ability to become (and remain) employed, and chance to contribute positively to their communities. As Elyn’s story is a testament, high-functioning people with mental illness are able to optimize their health and greatest professional aspirations, exercising their abilities successfully and contribute to their jobs, relationships, families, and communities in meaningful ways. Public stigma will also be reduced as the public at large will gain greater respect to realize the potential of those living with mental illness. The Saks’ SDM approach could serve as a catalyst for long-­term empowered care with the patient as the architect of his/her life.

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