Tools for Increased Autonomy: Supported Decision-Making and Psychiatric Advance Directives

Dana Lloyd, Stephanie Diaz and Devon Orland

People with a variety of disabilities, including mental illness, are often vulnerable to systems and services that infringe upon their autonomy, up to and including guardianship. Despite decades of legal battles, systemic overhauls, and policy change, people with disabilities still face many barriers to having full autonomy and true dignity and have not always been afforded the right to manage and direct their own lives, a right many people without disabilities take for granted.

However, there is a multitude of evidence that we can build systems of supports to facilitate greater self-determination. Alternatives to guardianship exist that protect rights, improve outcomes, and promote recovery and growth. The Americans with Disabilities Act, concludes in its Findings that:

physical and mental disabilities in no way diminish a person’s right to fully participate in all aspects of society, but that people with physical or mental disabilities are frequently precluded from doing so because of prejudice, antiquated attitudes, or the failure to remove societal and institutional barriers.

By creating, implementing, promoting, and pursuing alternatives to guardianship such as Supported Decision-Making and Psychiatric Advance Directives we can work to remove those barriers.

This interactive workshop will introduce the principles of Supported Decision-Making and review Psychiatric Advance Directives as tools to ensure autonomy, dignity, and choice. In addition, we will highlight some of the changing legal landscape in multiple jurisdictions, the legal impact of guardianship on people with disabilities, and the legal safeguards presented through other means.


  1. As a result of this activity, the participant will be able to list three benefits of using Supported Decision-Making and/or a Psychiatric Advanced Directive to retain decision making control.
  2. As a result of this activity, the participant will be able to describe two principles of supported decision-making and their impact on self-determination, autonomy, and choice.
  3. As a result of this activity, the participant will be able to identify opportunities to implement Supported Decision-Making strategies and/or a Psychiatric Advanced Directive.
  4. Lawyers will leave with a broad understanding of alternate legal strategies.

I Decide Georgia "Georgia’s first and preferred option for decision-making resources, tools, and coaching that provides viable, sustainable alternatives to guardianship"