This review examines whether mental health consumers are asked how they want legal services to be provided in studies of civil mental health jurisdictions, and the extent to which consumer researchers were involved in these studies. A Consumer-perspective Critical Reflection Tool was applied to assess consumer involvement and alignment with human rights frameworks. Consumer leadership and participation were largely absent in the studies identified. Only one study included consumer researchers, and none reported consumer leadership in setting agendas, design, data collection, analysis, or evaluation. Participants' voices were frequently missing, supported decision-making was rarely operationalised, and intersectionality received little attention. Many studies adopted paternalistic or therapeutic frames that positioned lawyers as protective rather than representative of clients' expressed preferences. Few papers articulated concrete implementation plans for change or strategies to build consumer knowledge. The findings indicate a systemic disconnect between the rights rhetoric of civil mental health law and the practices of legal representation. Legal services and research should reorient to consumer-led, CRPD-consistent approaches, embed supported decision-making, and ensure routine, meaningful elicitation and documentation of consumers' will and preferences to guide advocacy and adjudication.
Maylea et al. (Mon,) studied this question.