- Embed lived and living experience leadership with formal authority and resourcing, recognising peer expertise as central rather than supplementary.
- Make supported decision-making, shared formulation and relational continuity mandatory system mechanisms to ensure rights-based, person-centred care across disciplines and settings.
- Redesign scalable models to protect agency, relational safety and equity; otherwise they drift to managerial, task-focused practices that undermine suicide prevention and safety.
J Multidiscip Healthc. 2026 May 18;19:600579. doi: 10.2147/JMDH.S600579. eCollection 2026.
ABSTRACT
PURPOSE: Person-centred care is widely endorsed in mental health policy yet remains inconsistently enacted in multidisciplinary practice, particularly where services default to diagnostic dominance, risk management, and service-led priorities. This critical review examines what is required to operationalise person-centred, rights-based care across disciplines and settings, positioning lived and living experience as core expertise rather than a supplementary perspective and considering implications for suicide prevention.
METHODS: A critical review of peer-reviewed and grey literature was undertaken, focusing on person-centred and multidisciplinary mental health care. Five commonly used approaches were compared: the Optimal Health Program, the Strengths Model, Open Dialogue, traditional case management, and Behaviour Support Planning. Models were examined against mechanisms consistently associated with high-quality care, including supported decision-making, shared formulation, relational continuity, lived experience leadership, integration of physical and social determinants of health, and management of coercion risk in acute settings.
RESULTS: Alignment with person-centred, rights-based care was strongest when supported decision-making was routine rather than discretionary, care was relational and meaning-oriented and lived and living experience leadership was embedded with formal authority and resourcing. Approaches that are easier to standardise and scale were more likely to drift toward managerial and task-focused practices unless deliberately redesigned to protect agency, relational safety, and person-defined goals. These mechanisms were particularly important for suicide prevention and for people experiencing intersecting vulnerabilities, including trauma, disability, chronic physical illness, substance use, housing insecurity, family violence, racism, stigma, justice involvement, neurodivergence, and geographic isolation.
CONCLUSION: Rather than advocating a single branded model, this review supports a shift toward system-wide mechanisms and minimum standards that travel with the person across settings. Prioritising supported decision-making, shared formulation, relational continuity, equity-oriented responses, and lived and living experience governance offers a practical pathway to make person-centred care more consistent, accountable, and safer, particularly in acute, crisis, and rural contexts, to embed suicide prevention within everyday multidisciplinary practice.
PMID:42164074 | PMC:PMC13186572 | DOI:10.2147/JMDH.S600579
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