Book contents
- Mental Capacity Legislation
- Mental Capacity Legislation
- Copyright page
- Contents
- Contributors
- Foreword
- Preface
- Editors’ Note
- Chapter 1 Introduction
- Chapter 2 The Assessment of Mental Capacity
- Chapter 3 Best Interests
- Chapter 4 Deprivation of Liberty Safeguards: Past, Present and Future
- Chapter 5A Mental Capacity Act Application: Hospital Settings
- Chapter 5B Mental Capacity Act Application: Social Care Settings
- Chapter 6 Mental Capacity and End of Life Decision-Making
- Chapter 7 Clinical Ambiguities in the Assessment of Capacity
- Index
- References
Chapter 2 - The Assessment of Mental Capacity
Published online by Cambridge University Press: 17 June 2019
Book contents
- Mental Capacity Legislation
- Mental Capacity Legislation
- Copyright page
- Contents
- Contributors
- Foreword
- Preface
- Editors’ Note
- Chapter 1 Introduction
- Chapter 2 The Assessment of Mental Capacity
- Chapter 3 Best Interests
- Chapter 4 Deprivation of Liberty Safeguards: Past, Present and Future
- Chapter 5A Mental Capacity Act Application: Hospital Settings
- Chapter 5B Mental Capacity Act Application: Social Care Settings
- Chapter 6 Mental Capacity and End of Life Decision-Making
- Chapter 7 Clinical Ambiguities in the Assessment of Capacity
- Index
- References
Summary
The Mental Capacity Act (MCA) 2005 (Mental Capacity Act 2005) has had an unprecedented impact on psychiatric practice in England and Wales. The MCA originally arose out of the need to protect individuals lacking capacity in settings aside from mainstream mental health services, where the Mental Health Act 1983 (MHA) (Mental Health Act 1983) provided the dominant legal framework. However the Acts interact in complex ways (Brown et al., 2013; Owen et al., 2009), and increasingly it is expected that mental capacity will be assessed in the context of a decision around admission and treatment in a psychiatric hospital, even if the MHA is ultimately to be used and lack of mental capacity often may act as a gateway into the use of the MHA. Patients who are undergoing inpatient psychiatric treatment must have their authorisation of treatment carefully characterised (Care Quality Commission, 2015/2016), and the new MHA Code of Practice (Mental Health Act 2015) stresses the importance of supporting mental capacity and responding to patients’ ‘wishes and feelings’.
Information
- Type
- Chapter
- Information
- Mental Capacity LegislationPrinciples and Practice, pp. 13 - 33Publisher: Cambridge University PressPrint publication year: 2019
References
References
Bean, G., Nishisat, S., Rector, N. A. & Glancy, G. (1994) The psychometric properties of the Competency Interview Schedule. Canadian Journal of Psychiatry, 39(8), 368–376.Google Scholar
Beckett, J. & Chaplin, R. (2006) Capacity to consent to treatment in patients with acute mania. Psychiatric Bulletin, 30, 419–422.CrossRefGoogle Scholar
Bellhouse, J., Holland, A. J., Clare, I. C. H., Gunn, M. & Watson, P. (2003) Capacity-based mental health legislation and its impact on clinical practice: 1) admission to hospital. Journal of Mental Health Law, 9–23.Google Scholar
Berghmans, R., Dickenson, D. & Meulen, R. T. (2004) Mental capacity: In search of alternative perspectives. Health Care Anal, 12(4), 251–263; discussion 65–72.Google Scholar
Breden, T. M. & Vollmann, J. (2004) The cognitive based approach of capacity assessment in psychiatry: A philosophical critique of the MacCAT-T. Health Care Anal, 12(4), 273–283; discussion 65–72.Google Scholar
Brown, P. F., Tulloch, A. D., Mackenzie, C., Owen, G. S., Szmukler, G. & Hotopf, M. (2013) Assessments of mental capacity in psychiatric inpatients: A retrospective cohort study. BMC Psychiatry, 13, 115.Google Scholar
Buchanan, A. E. (2004) Mental capacity, legal competence and consent to treatment. Journal of the Royal Society of Medicine, 97(9), 415–420.Google Scholar
Buchanan, A. E. & Brock, D. W. (1989) Deciding for Others: The Ethics of Surrogate Decision Making. Cambridge University Press, 422 pp.Google Scholar
Buller, T. (2001) Competence and risk-relativity. Bioethics, 15(2), 93–109.CrossRefGoogle ScholarPubMed
Cairns, R., Maddock, C., Buchanan, A., David, A. S., Hayward, P., Richardson, G., Szmukler, G. & Hotopf, M. (2005a) Reliability of mental capacity assessments in psychiatric in-patients. British Journal of Psychiatry, 187, 372–378.Google Scholar
Cairns, R., Maddock, C., Buchanan, A., David, A. S., Hayward, P., Richardson, G., Szmukler, G. & Hotopf, M. (2005b) Prevalence and predictors of mental incapacity in psychiatric in-patients. British Journal of Psychiatry, 187(4), 379–385.Google Scholar
Cale, G. S. (1999) Risk-related standards of competence: Continuing the debate over risk-related standards of competence. Bioethics, 13(2),131–148.Google Scholar
Charland, L. C. (1998) Is Mr Spock mentally competent? Competence to consent and emotion. Philosophy, Psychiatry, and Psychology, 5(1), 67–81.Google Scholar
Charland, L. C. (2001) Mental competence and value: The problem of normativity in the assessment of decision‐making capacity. Psychiatry, Psychology and Law, 8(2), 135–145.CrossRefGoogle Scholar
David, A. S., Hotopf, M., Moran, P., Owen, G., Szmukler, G. & Richardson, G. (2010) Mentally disordered or lacking capacity? Lessons for management of serious deliberate self harm. British Medical Journal, 341, c4489.Google Scholar
Edelstein, B. (2000) Challenges in the assessment of decision making capacity. Journal of Aging Studies, 14, 423–437.Google Scholar
Folstein, M. F., Folstein, S. E. & McHugh, P. R. (1975) ‘Mini-mental state’: A practical method for grading the cognitive state of patients for the clinician. Journal of Psychiatric Research, 12(3), 189–198.Google Scholar
Freyenhagen, F. & O’Shea, T. (2013) Hidden substance: Mental disorder as a challenge to normatively neutral accounts of autonomy. International Journal of Law in Context, 9(1), 53–70.Google Scholar
Grisso, T. & Appelbaum, P. S. (1995) MacArthur Treatment Competence Study. Journal of the American Psychiatric Nurses Association, 1(4), 125–127.Google Scholar
Grisso, T. & Appelbaum, P. S. (1998) Assessing Competence to Consent to Treatment: A Guide for Physicians and Other Health Professionals. Oxford University Press, pp. xi, 211.Google Scholar
Grisso, T., Appelbaum, P. S. & Hill-Fotouhi, C. (1997) The MacCAT-T: A clinical tool to assess patients’ capacities to make treatment decisions. Psychiatric Services, 48(11), 1415–1419.Google Scholar
Hindmarch, T., Hotopf, M. & Owen, G. S. (2013) Depression and decision-making capacity for treatment or research: A systematic review. BMC Medical Ethics, 14, 54.Google Scholar
Hotopf, M. (2006) Mental health law and mental capacity: Dogma and evidence. Journal of Mental Health, 15(1), 1–16.Google Scholar
Jacob, R., Clare, I. C., Holland, A., Watson, P. C., Maimaris, C. & Gunn, M. (2005) Self-harm, capacity, and refusal of treatment: Implications for emergency medical practice – prospective observational study. Emergency Medicine Journal, 22(11), 799–802.Google Scholar
Janofsky, J. S., McCarthy, R. J. & Folstein, M. F. (1992) The Hopkins Competency Assessment Test: A brief method for evaluating patients’ capacity to give informed consent. Hospital and Community Psychiatry, 43(2), 132–136.Google Scholar
Kim, S. Y., Caine, E. D., Swan, J. G. & Appelbaum, P. S. (2006) Do clinicians follow a risk-sensitive model of capacity-determination? An experimental video survey. Psychosomatics, 47(4), 325–329.Google Scholar
Marson, D. C. (2001) Loss of competency in Alzheimer’s disease: Conceptual and psychometric approaches. International Journal of Law and Psychiatry, 24(2–3), 267–283.CrossRefGoogle ScholarPubMed
Mental Health Act (MHA) (2015) Code of Practice, published pursuant to Section 118 of the Mental Health Act 1983. London: HMSO.Google Scholar
Okai, D., Owen, G., McGuire, H., Singh, S., Churchill, R. & Hotopf, M. (2007) Mental capacity in psychiatric patients: Systematic review. British Journal of Psychiatry, 191, 291–297.Google Scholar
Owen, G. S., Richardson, G., David, A. S., Szmukler, G., Hayward, P. & Hotopf, M. (2008) Mental capacity to make decisions on treatment in people admitted to psychiatric hospitals: Cross sectional study. British Medical Journal, 337, 448.Google Scholar
Owen, G. S., Szmukler, G., Richardson, G., David, A. S., Hayward, P., Rucker, J., et al. (2009) Mental capacity and psychiatric in-patients: Implications for the new mental health law in England and Wales. British Journal of Psychiatry, 195(3), 257–263.Google Scholar
Owen, G. S., Ster, I. C., David, A. S., Szmukler, G., Hayward, P., Richardson, G., et al. (2011) Regaining mental capacity for treatment decisions following psychiatric admission: A clinico-ethical study. Psychological Medicine, 41(1), 119–128.Google Scholar
Owen, G. S., Freyenhagen, F., Hotopf, M. & Martin, W. (2013) Temporal inabilities and decision-making capacity in depression. Phenomenology and the Cognitive Sciences, 14(1), 163–182.CrossRefGoogle Scholar
Ranjith, G. & Hotopf, M. (2004) ‘Refusing treatment – please see’: An analysis of capacity assessments carried out by a liaison psychiatry service. Journal of the Royal Society of Medicine, 97(10), 480–482.Google Scholar
Raymont, V., Bingley, W., Buchanan, A., David, A. S., Hayward, P., Wessely, S., et al. (2004) Prevalence of mental incapacity in medical inpatients and associated risk factors: Cross-sectional study. Lancet, 364(9443), 1421–1427.Google Scholar
Raymont, V., Buchanan, A., David, A. S., Hayward, P., Wessely, S. & Hotopf, M. (2007) The inter-rater reliability of mental capacity assessments. International Journal of Law and Psychiatry, 30(2), 112–117.Google Scholar
Roth, L. H., Lidz, C. W., Meisel, A., Soloff, P. H., Kaufman, K. & Spiker, D. G., et al. (1982) Competency to decide about treatment or research: An overview of some empirical data. International Journal of Law and Psychiatry, 5(1), 29–50.Google Scholar
Spencer, B. W. J., Gergel, T., Hotopf, M. & Owen, G. (2018c) Unwell in hospital but not incapable: Dissociation of decision-making capacity for treatment and research in inpatients with schizophrenia and related psychoses. A cross sectional study. British Journal of Psychiatry, 213(2), 484–489.Google Scholar
Spencer, B. W. J., Wilson, G., Okon-Rocha, E., Owen, G. S. & Wilson, J. C. (2017a) Capacity in vacuo: An audit of decision-making capacity assessments in a liaison psychiatry service. BJPsych Bulletin, 41(1), 7–11.Google Scholar
Spencer, B. W. J., Shields, G., Gergel, T., Hotopf, M. & Owen, G. S. (2017b) Diversity or disarray? A systematic review of decision-making capacity for treatment and research in schizophrenia and other non-affective psychoses. Psychological Medicine, 47(11), 1906–1922.Google Scholar
Szmukler, G. & Holloway, F. G. (1998) Mental health legislation is now a harmful anachronism. Psychiatric Bulletin, 22, 662–665.Google Scholar
Tan, J., Hope, T. & Stewart, A. (2003) Competence to refuse treatment in anorexia nervosa. International Journal of Law and Psychiatry, 26(6), 697–707.Google Scholar
Vollmann, J., Bauer, A., Danker-Hopfe, H. & Helmchen, H. (2003) Competence of mentally ill patients: A comparative empirical study. Psychological Medicine, 33(8), 1463–1471.Google Scholar
Wicclair, M. R. (1991) Patient decision-making capacity and risk. Bioethics, 5(2), 91–104.Google Scholar
Wong, J. G., Clare, I. C. H., Holland, A. J., et al. (2000) The capacity of people with a ‘mental disability’ to make a health care decision. Psychological Medicine, 30, 295–306.Google Scholar
Case law
Banks v. Goodfellow 1870 LR 5QB 549.Google Scholar
Re C (Adult: Refusal of Medical Treatment) 1994 1 All ER 819.Google Scholar
‘Sparkly’ Kings College Hospital NHS Foundation Trust v. C [2015] 2015 EWCOP 80.Google Scholar
Accessibility standard: Unknown
Why this information is here
This section outlines the accessibility features of this content - including support for screen readers, full keyboard navigation and high-contrast display options. This may not be relevant for you.Accessibility Information
Accessibility compliance for the HTML of this chapter is currently unknown
and may be updated in the future.