The disability self‐direction movement: Considering the benefits and challenges for an Australian response

Abstract

The following article provides a snapshot of the current self-direction movement within the disability sector across the industrialised world, with particular emphasis on the Australian context. As a global movement, self-direction has been in progress for several decades through a variety of implemented responses. Despite implementation variation, all self-direction models aim to facilitate individual control and decision making in care and support services. We describe self-direction, its various models and programs, and explore its benefits and challenges. We conclude by making broad recommendations for decision makers involved in self-direction. In particular, we offer a hierarchical decision tree that can be used to inform policy decisions at a systems -government policy -and organisational level.

Perspectives of self-direction: a systematic review of key areas contributing to service users’ engagement and choice-making in self-directed disability services and supports

“…, Sims & Cabrita Gulyurtlu ), three for people with disabilities with degenerative conditions (Mitchell , ,b), seven for groups with a variety of disabilities (Mitchell , Crozier et al . , Dew et al . , Junne & Huber , Kendall & Cameron , Lombe et al .…”

“…On the other hand, carers have also identified planning and budgeting within the self‐directed model as a challenging process (Crozier et al . , Dew et al . , Junne & Huber , Kendall & Cameron , Timberlake et al .…”

“…, Sims & Cabrita Gulyurtlu ) and people with other disabilities, who have significant support needs (Crozier et al . ). One study has suggested that shared decision‐making about personal support, care and treatment – including personal management of their health budget – can result in improved care‐related quality of life and psychological well‐being, together with some cost‐savings to the government (Jones et al .…”

“…, Sims & Cabrita Gulyurtlu ) and 2012 (Crozier et al . ) have emphasised that limited research in the area exists, and as a result it is difficult to ascertain the perspectives of service users and professionals about self‐directed approaches to service provision, and how self‐directed approaches impact the health and social care of service users. For example, Crozier et al .…”

“…For example, Crozier et al . () reviewed the impact of self‐directed care systems and models for people with disability over a 12‐year period, 2000–2012. The authors found that the implementation of self‐directed approaches was variable, but more importantly, that the unique views of service users were not well understood.…”