Choice is a fundamental principle of the recovery process. Providing choices and options in care delivery produces better outcomes for individuals with severe mental health conditions by fulfilling the psychological needs of competence, autonomy, and relatedness. Reduced choices can exacerbate poor mental health and consumer choice is an essential characteristic of evidence-based practice. Due to stigma and discrimination, individuals given diagnoses of SMI’s are more likely to experience less choice related to housing, education, employment, and community inclusion. People of color and those who identify as LGBTQ+ are even further restricted with choice as their options are reduced to those treatment providers who are culturally competent and/or who share their culture and traditions.
Providing choices and options in your practice allows for individuals to be active in their care. It empowers the individual and promotes internal motivation while developing a more trusting and collaborative relationship between the clinician/patient. Providing treatment options gives ownership through the ability to ask questions and come to an informed decision. For example, offering medication options to an individual, such as two medically appropriate antipsychotics, can allow the individual to view medication as a tool for recovery versus a mechanism for control. When referring individuals to a provider or community-based resource, options should be presented so that the person can exercise agency in their care. Tools such as SMI Adviser’s My Mental Heath Crisis Plan app, which allows for an individual to have a voice in treatment decisions while in crisis, should be utilized to foster self-advocacy. In situations where an individual struggles to make decisions related to their care, supported decision making should be utilized.
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