The Mental Capacity Act

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The Mental Capacity Act

Post by nettyb » Sat Apr 21, 2007 3:55 pm

The Mental Capacity Act 2005 came into force in April 2007. Clinical Psychologists will play a key role in the assessment of capacity alongside other professionals including doctors and Psychiatrists. It is suggested that Psychologists in Learning Disability and Older Adult services are likely to conduct more capacity assessments than Clinical Psychologists working in other specialties, however all applied psychologists working in health and social care may be required to assess an individuals capacity at some point . Capacity assessments may be requested when an individual has difficulty in managing their finances, wants to sell or buy a house, decline medical treatment, or engage in a sexual relationship, for example.

The BPS published its Assessment of Capacity in Adults: Interim Guidance for Psychologists in 2006, and it can be found here.

The following is a summary of the BPS guidance:

The Assessment of Capacity

In our daily lives mental capacity means the ability to make decisions about some aspect of our lives. Some people may need help and support to be able to make a decision and some others may not be able to make a decision. In that case others may make a decision for the person based on a judgement of their best interests.

The Mental Capacity Act 2005 states that a person lacks capacity in relation to a matter if at the material time he is unable to make a decision for himself because of an impairment of, or a disturbance in the functioning of, the mind or brain (whether permanent or temporary).

Currently, good practice in assessing capacity takes a decision specific and functional approach. The Mental Capacity Act states that a person should be considered unable to make a decision should he be unable to complete any of the following steps in decision making:
(a) Understand the information relevant to the decision;
(b) Retain that information;
(c) Use or weigh that information as part of the process of making the decision;
(d) Communicate his decision (whether by talking, sign language or other means).

In the Mental Capacity Act information relevant to the decision is defined as being information about the reasonably foreseeable consequences of (a) deciding one way or another; or (b) failing to make the decision.

The act qualifies the meaning of “retain the information” by stating that the fact that a person is able to retain information relevant to a decision for a short period only does not prevent him from being regarded as able to make the decision.

Within the functional approach to the assessment of capacity, a person’s learning disability, level of memory impairment in dementia, cognitive deficits after TBI/ABI/severe mental illness (no matter how severe), does not of itself indicate a lack of capacity. Nonetheless, the severity of an individuals learning disability, level of memory impairment, and cognitive deficits, is particularly relevant to the criteria involving understanding and using the relevant information, memory and to a lesser extent communication. Consequently, formal psychometric assessment of the individuals intellectual and cognitive functioning may be undertaken as part of the assessment.

Capacity assessments usually involve some formal psychometric assessments and interviews with the individual being assessed. During the assessment the individual should be provided with information to assist them in making a decision and this information ought to be presented to them in such a way that helps them to understand and retain the information presented. If is is determined that the individual does not have capacity then a best interest decision ought to be made on the individual's behalf.

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