Supported Decision-Making (SDM) for New Americans with Disabilities

A project conducted by LEND Trainee Sabitri Rayamajhi in partnership with Disability Rights Center – NH.

Background Information

In the summer of 2021, Supported Decision Making (SDM) became a legally recognized alternative to guardianship for adults with disabilities and their families.

Through SDM, individuals with disabilities can get help to make their own decisions. SDM is an alternative to guardianship. It is flexible in how it is applied from individual to individual and even how it is applied to the same individual over time.

Project Summary

For her LEND capstone project, Sabitri concentrated on supported decision-making (SDM). She collaborated with a new American family, guiding it to support the teenage son, who has mental health and developmental disabilities, through the principles of SDM. She found that the family navigated not only the complexities of their son’s needs but also the cultural and language barriers inherent to their new American identity. Sabitri crafted a culturally aware educational strategy to inform new Americans with disabilities, as well as their families and supporters, about SDM. Recognizing the rich cultural diversity from which new Americans come, Sabitri’s approach took into account the varied perspectives on disability that different cultures bring.

Download Sabitri’s LEND Capstone Project Poster

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About Sabitri Rayamajhi, MPH, NH LEND

Sabitri Rayamajhi is a graduate student at the University of New Hampshire in the field of social work. Sabitri also has a master’s in public health from the University of Bedfordshire, England. She has worked nationally and internationally in the field of public health and social work including child welfare, mental health, and developmental disabilities. She has spent almost a decade working in the field of health and human services.

In recent years, Sabitri’s work experience and her degree provided her with an opportunity to work on steering committees for the National Alliance of Mental Illness (NAMI NH). At NAMI, she has worked as community support staff in the children’s department, supporting children of families who have serious mental health issues. Sabitri also collaborated with Boston Children’s Hospital, North America Family Institute, the Institute on Disability (IOD), Waypoint, and Keene State College to increase community engagement with the New American community. Her work experience has enhanced Sabitri’s interests and knowledge to better serve children and families with disabilities.

Serving and advocating for children with disabilities has always been important to Sabitri. In the last eight years, she has been working as a home care provider with an individual who has mental and physical health challenges. In serving the individual’s needs, the tasks she performs include encouraging the individual to advocate for himself, assisting him with medical appointments, connecting him with needed resources, making him aware of any abuses/maltreatment by others, and helping him find a job.

Additional Resources


Disability Rights Center – New Hampshire is a statewide non-profit organization dedicated to eliminating barriers for people with disabilities across New Hampshire. DRC is the federally designated protection and advocacy agency for New Hampshire and has authority under federal law to conduct investigations in cases of probable abuse or neglect.

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