<p>People with intellectual and developmental disabilities have long been subject to guardianship. Through this process, individuals lose all or most of their rights which may result in negative mental health outcomes. While some individuals benefit from guardianship, there are others that could suffer psychosocial detriment from having their rights and decision-making capabilities removed. Through the literature, we seek to learn about mental health outcomes, what changes to the system have been explored, and the current standard of practice surrounding guardianship. Additionally, we explore discussions regarding alternatives to guardianship and how they can support individuals in decision-making without removing all of their rights. Advocates must be aware of the process of guardianship, alternatives to guardianship, as well as the potential effects guardianship can have. Recommendations for research, based on the discussion of the literature, include longitudinal studies on the effects of guardianship and its alternatives on the mental health of those subject to it.</p>