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The early experience of Old Age Psychiatrists in the application of the Mental Capacity Act 2005: a pilot study

Published online by Cambridge University Press:  25 June 2009

Ajit Shah ,
Natalie Banner ,
Chris Heginbotham  and
Bill Fulford
Ajit Shah*
Affiliation:
Institute for Philosophy, Diversity and Mental Health, International School for Communities, Rights and Inclusion, University of Central Lancashire, Preston and West London Mental Health NHS Trust, London, U.K.
Natalie Banner
Affiliation:
Institute for Philosophy, Diversity and Mental Health, International School for Communities, Rights and Inclusion, University of Central Lancashire, Preston, U.K.
Chris Heginbotham
Affiliation:
Institute for Philosophy, Diversity and Mental Health, International School for Communities, Rights and Inclusion, University of Central Lancashire, Preston, U.K.
Bill Fulford
Affiliation:
Institute for Philosophy, Diversity and Mental Health, International School for Communities, Rights and Inclusion, University of Central Lancashire, Preston, U.K.
*
Correspondence should be addressed to: Professor Ajit Shah, West London Mental Health NHS Trust, Uxbridge Road, Southall, Middlesex UB1 3EU, U.K. Phone: +44 (0)208 354 8191; Fax: +44 (0)208 354 8307. Email: ajit.shah@wlmht.nhs.uk.
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Abstract

Background: The Mental Capacity Act 2005 (MCA) was fully implemented in October 2007 in England and Wales.

Methods: A pilot questionnaire study examined the experience of consultants in Old Age Psychiatry in the early implementation of the MCA pertaining to local policy and training in the application of the MCA, the assessment of decision-making capacity, the determination of best interests, and the use of the least restrictive option and restraint.

Results: Fifty-two (27%) of the 196 consultants in Old Age Psychiatry returned useable questionnaires. Seventy-five percent of them reported that local training on the application of the MCA was available, but less than 50% reported that training was mandatory. The vast majority of assessments of decision-making capacity were conducted by consultants in Old Age Psychiatry. Almost all of them reported using the four-fold specific test of decision-making capacity (DMC) described in the MCA. Restraint was reported to be rarely used.

Conclusions: Consultants in Old Age Psychiatry generally reported using the criteria for the assessment of DMC, the determination of best interests and restraint described in the MCA. The findings highlight concern about the workload of clinicians in implementing the MCA and this requires careful monitoring. Consideration should be given to statutory provision of training in the application of the MCA by all healthcare and social care providers for all their healthcare and social care staff.

Keywords

Mental Capacity Actcapacity to make decisionspsychiatry
Type
Research Article
Information
International Psychogeriatrics , Volume 22 , Issue 1 , February 2010 , pp. 147 - 157
Copyright
Copyright © International Psychogeriatric Association 2009

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