The relevance of Article 12 of the UNCRPD (supported decision-making) for people with severe or profound intellectual disability

Aim: Article 12 of the UNCRPD obligates signatory nations to ensure all their citizens receive support with decision-making. However, people with severe or profound intellectual disability (ID) are often excluded from this support. This study aimed to identify processes, enablers and barriers to supported decisionmaking for this population. Method: A social constructivist perspective underlies this study. Five people with severe or profound ID and their supporters participated in a six-month supported decision-making intervention. Data from interviews, focus groups, observation, and questionnaires were collected, triangulated, and analysed using an interpretative phenomenological framework. Results: Supporter responsiveness to the expression of preference of those they support was found to be important in enabling supported decision-making for people with severe or profound ID. Effective responsiveness was found to be comprised of three dependent and sequential tasks, acknowledging, interpreting, and acting upon a person’s preference expression. Several factors, organised thematically, were found to impact on this responsiveness. Conclusions: The findings provide a focus for practice and policy efforts related to supported decision-making for people with severe or profound ID.