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Despite studies showing that students who have more self-determination—those who make more decisions and have more control over their lives—have more successful educational experiences and adult lives, research and scholarship document the existence of a "School-to-Guardianship Pipeline." There, educational professionals recommend that parents seek guardianship over their children with disabilities, without explaining or exploring other options that may preserve or build their self-determination. This article documents the importance of self-determination to life and educational outcomes for people with disabilities, and summarizes research showing how overbroad and undue guardianship—guardianships that remove more rights than necessary or that remove rights from someone who is able to exercise them independently or with support—can decrease quality of life. Then, the authors show how Supported Decision-Making can serve as an alternative to guardianship and a way to enhance self-determination, and recommend ways to incorporate supported decision-making into special education supports and services.

The United Nations Convention on the Rights of Persons with Disabilities (CRPD) recognized that people with disabilities should have the right to exercise their legal capacity and identified 'supported decision-making' as a means by which people with disabilities can be directly involved in decisions that impact their lives. Offering an overview of its emergence in the disability field and highlighting emerging research, theory, and practice from legal, psychology, education, and health fields, this volume provides a much-needed theoretical and evidence base for supported decision-making. Evidence and strengths-based frameworks for understanding disability, supports, and their roles in promoting supported decision-making are synthesized. The authors describe the application of a social-ecological approach to supported decision-making, and focus on implications for building systems of supports based on current environmental demands. This volume introduces and explains empirical research on critical elements of supported decision-making and the applications of supported decision-making that enhance outcomes, including self-determination and quality of life

Supported decision-making is at the forefront of modern disability research. This is due to Article 12 of the Convention on the Rights of Persons with Disabilities (CRPD), which creates a state obligation to provide support for the exercise of legal capacity. This turned the practice of supported decision-making into a human rights imperative. Government and funding agencies are increasingly focusing their attention on the area. Researchers are similarly increasing their interest in the field. The impending danger is that the rush of interest in the area will overshadow the original intention of supported decision-making: to ensure that people with cognitive disability are provided with the freedom and the tools to participate as equal citizens and for every individual to be free to direct their own life. This article explores the theoretical foundations of supported decision-making and the evolution of supported decision-making research. It explains the research that is emerging in leading jurisdictions, the United States and Australia, and its potential to transform disability services and laws related to decision-making. Finally, it identifies areas of concern in the direction of such research and provides recommendations for ensuring that supported decision-making remains protective of the rights, will and preferences of people with cognitive disability.

Guardianship is a complicated legal concept, which is further complicated by differences from state to state in the framing and implementation of distinctly different forms. Few professionals explain the long-term consequences of obtaining guardianship or provide the range of alternatives available to support an adult with disabilities. This study reports descriptive data from a national survey on guardianship and people with disabilities. The results indicate that regardless of who provides information about guardianship, and regardless of disability classification, full guardianship is consistently discussed most frequently while other options are rarely discussed. We describe implications for practice and provide recommendations. Specifically, supported decision making is described as one potential alternative to legal guardianship that, according to these data, is the least frequently discussed with parents, but which has the potential to avoid many of the legal and social pitfalls that guardianship presents. Limitations and current research needs are described.

OBJECTIVE:Making decisions is central to the exercise of control over one's well-being. Many individuals with serious mental illness (SMI) experience limitations in their decision-making capacity. These individuals have often been placed under legal guardianship and substitute decision makers have been appointed to make decisions on their behalf. More recently, supported decision making (SDM) has emerged as a possible alternative in some cases. SDM involves recruitment of trusted supports to enhance an individual's capacity in the decision-making process, enabling him or her to retain autonomy in life decisions. This overview examines issues associated with decision-making capacity in SMI, frameworks of substitute decision making and SDM, and emerging empirical research on SDM. METHOD:This is an overview of the medical and legal literature on decision making capacity and supported decision making for persons with SMI. RESULTS:Many but not all individuals with SMI exhibit decrements in decision-making capacity and skill, in part due to cognitive impairment. There are no published data on rates of substitute decision making/guardianship or SDM for SMI. Only three empirical studies have explored SDM in this population. These studies suggest that SDM is viewed as an acceptable and potentially superior alternative to substitute decision making for patients and their caretakers. CONCLUSIONS:SDM is a promising alternative to substitute decision making for persons with SMI. Further empirical research is needed to clarify candidates for SDM, decisions in need of support, selection of supporters, guidelines for the SDM process, integration of SDM with emerging technological platforms, and outcomes of SDM. Recommendations for implementation of and research on SDM for SMI are provided.