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Assessment of mental capacity: a flow chart guide

  • Michael Church (a1) and Sarah Watts (a2)
Extract

The Mental Capacity Act 2005 provides a new legal framework within which health and social care professionals (as well as informal carers) must act when providing care and treatment for the estimated 2 million people in England, Wales and Northern Ireland who lack the capacity to make certain decisions for themselves. Although the Mental Capacity Act 2005 Code of Practice provides comprehensive advice on good practice in assessing capacity, it does not identify a specific process to be used. Good clinical practice depends on the exercise of clinical judgement within a valid and contestable process. This article outlines a flow chart (Fig. 1) that can be used to guide the process of capacity assessments in more complex cases, in line with the Mental Capacity Act 2005 and the Code of Practice.

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Copyright
This is an Open Access article, distributed under the terms of the Creative Commons Attribution (CC-BY) license (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted re-use, distribution, and reproduction in any medium, provided the original work is properly cited.
References
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BJPsych Bulletin
  • ISSN: 0955-6036
  • EISSN: 1472-1473
  • URL: /core/journals/bjpsych-bulletin
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Assessment of mental capacity: a flow chart guide

  • Michael Church (a1) and Sarah Watts (a2)
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eLetters

Mental Capacity Act: Are professionals prepared to implement?

Mohammed Ashir, Specialist Registrar in Psychiatry
30 August 2007

We read with interest Church & Watts’ article, August issue, on Mental Capacity Assessment. The Mental Capacity Act 2005 came into effect in April but will be enforced in October this year. However, are clinicians and other health professionals prepared and equipped to implement the Act? Any attempt to clarify capacity assessment as in the flow chart described is helpful. An unpublished survey by the authors of this letter, found many medical professionals, outside mental health , unaware of the Act and have no training in assessing mental capacity. Thisis highly relevant as the Act states “the person who is required to assessan individual’s capacity will be the person contemplating making a decision on behalf of the person who is to be assessed”. Most old age psychiatrists are familiar with requests from general wards to assess “this patient’s capacity” especially when a discharge placement is in question. The Act is clear that having a psychiatric diagnosis (e.g. dementia) does not imply lack of capacity as long as the person passes thecomponents of the capacity test. However, the Code of Practice also lists factors when an “opinion from a professional may be required” to assist inan advisory role. Therefore, come October, will non-psychiatric cliniciansstop sending their referrals or will liaison and old age psychiatrists be flooded with assessment requests? What is now required is a clear and concise guidance policy drawn up jointly by Primary Care, Acute and MentalHealth Trusts. In addition, training must be widely available.

Declaration of interest: none.

Reference

1) Code of Practice for Mental Capacity Act (2005).Available from www.dca.gov.uk

Dr Mohammed AshirSpecialist Registrar in PsychiatrySouth Essex Partnership NHS Foundation TrustBasildon Hospital,Essex, SS16 5NLTel: 01268821180

Dr layth SahibSpecialist Trainee in Psychiatry (4)St Mary's Psychiatric Training Scheme, London
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Conflict of interest: None Declared

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