Capacity Assessment and Information Provision for Voluntary Psychiatric Patients: a service evaluation in a UK NHS Trust

Benjamin Ian Perry,Swaran Preet Singh,David Hedley White

doi:10.19164/ijmhcl.v2016i22.575

Benjamin Ian Perry, Swaran Preet Singh + Show 1 more

Open Access

https://doi.org/10.19164/ijmhcl.v2016i22.575

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Abstract

Since the Cheshire West judgement, yearly applications for the Mental Health Act (MHA) and Deprivation of Liberty Safeguards (DoLS) have increased, though many patients are still admitted informally. To ensure lawfulness, informal admissions must be capacitous, informed, and without coercion. If fully capacitous consent is not obtained, then there is a risk of “de facto” detention and deprivation of liberty. Deprivation of liberty is only lawful through appropriate legal frameworks (DoLS for incapacitous, non-objecting hospital inpatients, or MHA otherwise). Use of such legal frameworks might be hampered by the perceived stigma associated with them, though this may not be in the best interests of the patient.We aimed to examine the assessment of capacity and provision of adequate information required for an informed voluntary psychiatric admission, and any evidence of possible coercion into informal admission. We postulate variable use of legal frameworks designed to empower patients and prevent illegal deprivation of liberty.

Highlights

Those with severe mental illness may be vulnerable, and are at risk of coercive hospital admission (Hoge et al, 1997)
The Convention for the Protection of Human Rights and Fundamental Freedoms, Article 5 states that all human beings have the right to liberty and security of person (Art 5(1), Council of Europe, 1950), save in certain circumstances, which include a mental disorder (Art 5(1)(e), Council of Europe, 1950) meeting the Winterwerp criteria
In England and Wales, there are three ways in which a mentally disordered patient can be lawfully detained in hospital should this be deemed necessary; via the Mental Health Act (MHA) (1983, as amended 2007), via the Deprivation of Liberty Safeguards (Mental Capacity Act 2005 as amended 2007, Schedule A1) (DoLS) or by order of the Court of Protection (CoP), as outlined in table 1

Summary

Introduction

Those with severe mental illness may be vulnerable, and are at risk of coercive hospital admission (Hoge et al, 1997). In England and Wales, there are three ways in which a mentally disordered patient can be lawfully detained in hospital should this be deemed necessary; via the Mental Health Act (MHA) (1983, as amended 2007), via the Deprivation of Liberty Safeguards (Mental Capacity Act 2005 as amended 2007, Schedule A1) (DoLS) or by order of the Court of Protection (CoP), as outlined in table 1. Each of these is a due legal process, with the necessary patientorientated safeguards such as the right to appeal or second opinion

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