Te Kete Rongomau: Enabling supported decision-making through mental health advance will and preference statements (V)
Sarah Gordon1, University Of Otago Wellington 1University Of Otago Wellington
Abstract
The expert committee that sits under the UN Convention on the Rights of Persons with Disabilities (UNCRPD) has directed countries that have ratified the CRPD, including Aotearoa New Zealand, to abolish substitute decision-making (where another makes [in our case] mental health decisions on someone else’s behalf – e.g. the courts) and replace it with supported decision-making (where individuals are supported to make their own mental health decisions based on their will and preferences) in law and mental health practice. For many jurisdictions this will require a change to mental health law. However, new legislation will not in itself be transformative – instead, any legislation must be supported by changes in practice [1]. Our foundational work involved service users and providers identifying and prioritising supported decision-making interventions that have the potential to lead to the greatest improvements in mental health outcomes [2]. Pre-event planning and post-event debriefing were strongly endorsed forms of intervention, particularly by stakeholders who face the most inequity. Advance preference statements can successfully facilitate pre-event planning, especially at times when communicating will and preferences is difficult. This paper will involve a presentation on the progress we have made since embarking on a comprehensive project to create, implement and evaluate mental health advance preference statements as supported decision-making tools in Aotearoa New Zealand.
[1] New Zealand Government (2018). He Ara Oranga: Report of the government inquiry into mental health and addiction. Wellington: New Zealand Government.
[2] Gordon, S., Gardiner, T., Gledhill, K., Tamatea, A., & Newton-Howes, G. (2022). From Substitute to Supported Decision Making: Practitioner, Community and Service-User Perspectives on Privileging Will and Preferences in Mental Health Care. International Journal of Environmental Research and Public Health, 19(10), 6002.
Biography
Sarah’s personal experience of mental illness shaped her university study with the areas of psychology, medical law, bioethics, and psychological medicine being the focus through to PhD level. Combining this theoretical education and personal experience, Sarah has spent the last 20 years working and advocating for an improved mental health sector and societal perceptions of mental health from the perspective of a person who personally experiences mental illness.
Since 2011 Sarah has worked as a service user academic with the Department of Psychological Medicine, University of Otago. Through this role, she has promoted and progressed service user-led and co-produced education and research.
This work has resulted in the establishment of “World of Difference” – a service user academia education and research team, which Sarah currently leads. The education and research programs being led or co-produced by the World of Difference team are focused on ending discrimination, and promoting recovery, inclusion, and respect for the human rights of people who experience mental distress.
Sarah is one of the Principal Investigators of Te Kete Rongomau: Enabling supported decision-making through mental health advance will and preference statements.