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Judgements about deprivation of liberty made by various professionals: comparison study

  • Ruth Cairns (a1), Penelope Brown (a2), Hugh Grant-Peterkin (a2), Mizanur R. Khondoker (a3) (a4), Gareth S. Owen (a5), Genevra Richardson (a6), George Szmukler (a7) and Matthew Hotopf (a5)...
Abstract
Aims and method

A group of lawyers, psychiatrists, best interest assessors and independent mental capacity advocates were asked to make binary judgements about whether real-life situations in 12 vignettes amounted to deprivation of liberty. Kappa coefficients were calculated to describe the level of agreement within each professional group and for the total group of professionals.

Results

There was total agreement between all professionals about deprivation of liberty in only 1 of the 12 cases. The overall level of agreement for judgements made by all professionals was ‘slight’ (κ=0.16, P < 0.01).

Clinical implications

There are practical difficulties involved in making reliable deprivation of liberty judgements within the Deprivation of Liberty Safeguards (DoLS) legislation. A clear interpretation of deprivation of liberty is necessary to facilitate professionals' decision-making in this area.

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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.
Corresponding author
Ruth Cairns (ruth.cairns@kcl.ac.uk)
Footnotes
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Declaration of interest

None.

Footnotes
References
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1 Department of Health. Deprivation of Liberty Safeguards: Code of Practice to Supplement the Main Mental Capacity Act 2005 Code of Practice. TSO (The Stationery Office), 2008.
2 Great Britain Parliament Joint Committee on Human Rights. Legislative Scrutiny: Mental Health Bill. Fourth Report of Session 2006–07. TSO (The Stationery Office), 2007.
3 Weereratne, A, Hatfield, S, Burnham, U, Gerry, A. Butterworths New Law Guide: Mental Capacity Act 2005 – Personal Welfare Decisions. LexisNexis, 2008.
4 Richardson, G. Mental capacity at the margin: the interface between two Acts. Med Law Rev 2010; 18: 122.
5 Cairns, R, Richardson, G, Hotopf, M. Deprivation of liberty: Mental Capacity Act safeguards versus the Mental Health Act. Psychiatrist 2010; 34: 246–7.
6 Shah, A, Heginbotham, C. Newly introduced deprivation of liberty safeguards: anomalies and concerns. Psychiatrist 2010; 34: 243–5.
7 Cairns, R, Brown, P, Grant-Peterkin, H, Owen, G, Richardson, G, Szmukler, G, et al. Mired in confusion: making sense of the deprivation of liberty safeguards. Med Sci Law 2011; in print.
8 HL v UK (2005) 40 EHRR 437.
9 JE and DE v Surrey County Council (2006) EWHC 3459 (Fam).
10 Landis, JR, Koch, GG. The measurement of observer agreement for categorical data. Biometrics 1977; 33: 159–74.
11 Selmes, T, Robinson, J, Mills, E, Branton, T, Barlow, J. Prevalence of deprivation of liberty: a survey of in-patient services. Psychiatrist 2010; 34: 221–5.
12 NHS Information Centre, Community and Mental Health. Mental Capacity Act 2005, Deprivation of Liberty Safeguards Assessments (England) – First Report on Annual Data, 2009/10. Health and Social Care Information Centre, 2010 (http://www.ic.nhs.uk/pubs/mentalcapacity0910).
13 Department of Health. Briefing on Mental Capacity Act Deprivation of Liberty Safeguards. Department of Health, 2010 (http://www.dh.gov.uk/en/PublicationsandStatistics/Publications/PublicationsPolicyandGuidance/DH_116351).
14 Cairns, R, Maddock, C, Buchanan, A, David, AS, Hayward, P, Richardson, G, et al. Reliability of mental capacity assessments in psychiatric in-patients. Br J Psychiatry 2005; 187: 372–8.
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BJPsych Bulletin
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Judgements about deprivation of liberty made by various professionals: comparison study

  • Ruth Cairns (a1), Penelope Brown (a2), Hugh Grant-Peterkin (a2), Mizanur R. Khondoker (a3) (a4), Gareth S. Owen (a5), Genevra Richardson (a6), George Szmukler (a7) and Matthew Hotopf (a5)...
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