정신장애인의 자기결정권 존중을 위한 제도 도입: 정신건강 전문가와 소비자의 인식을 중심으로

초록

After the full revision of the Mental Health Welfare Act that is based on the human rights paradigm, the development of a self-decision making support system has become one of the most imperative tasks to be solved in the delivery system of mental health service in South Korea. Regardless of the government’s declarations of developing relevant systems, discussions on specifics are still insufficient. Therefore, this study aims to derive implications for establishing the system by (1) identifying specific self-decision making support systems through literature reviews involving the Convention on the Rights of Persons with Disabilities(CRPD), QualityRights, and overseas cases, and by (2) identifying policy priorities through a survey on stakeholders’ perceptions on the identified systems in terms of awareness, necessity, and urgency involving 293 stakeholders. As a result of the literature review, a total of 16 systems were identified: supporter, procedure-assistance, psychiatric advanced directives, open-dialog, abolishing compulsory hospitalization, good psychiatric practice, shared decision-making, QualityRights(QR) education for professionals, community service system, individualized service system, supported housing and supported employment, crisis shelter, peer support, consumer-run services, consumer policy participation, and advocacy organization. As a result of the survey, the awareness of the 16 systems identified was generally higher among the professionals than consumers, the importance of awareness was similar between the two groups, and the perception of urgency was generally similar, but the perception of consumers was higher than that of professionals. The policy priority was relatively high in establishing community service systems and enhancing consumer participation. Based on these results, implications for establishing a self-decision making support system were discussed.

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