| Sumario: | The concept of relational autonomy was used to investigate how people with substance use disorders (SUDs) exercise their autonomy when using mental health services, according to stakeholders' perspectives. A qualitative study, using a critical approach, was conducted with participants from a mental health service facility. We performed in-depth individual and group interviews with 15 participants, conducted observations, and analyzed patients' records and service reports. People with SUDs' autonomy were constrained by three relational dimensions: (a) the broader social context of coercion and its influence on the values and attitudes of stakeholders; (b) the oppressive systems and structures within the treatment setting; and (c) the limited personal capacity to exercise autonomy in people with SUDs. This work revealed the multidimensionality of people with SUDs' limitations in exercising their autonomy within a mental health care setting. An understanding of autonomy as relational could promote reflection and stimulate innovation when approaching patients within these facilities.
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