OBJECTIVE: To estimate the prevalence of mental capacity to make decisions on treatment in people from different diagnostic and legal groups admitted to psychiatric hospital. DESIGN: Cross sectional study. SETTING: General adult acute psychiatric inpatient units. PARTICIPANTS: 350 consecutive people admitted to psychiatric wards from the community over 16 months. MAIN OUTCOME MEASURE: Mental capacity assessed by clinical interview and the MacArthur competence assessment tool for treatment. RESULTS: Estimates of mental capacity were obtained on 97% (n=338) of the 350 people admitted. Of those an estimated 60% (95% confidence interval 55% to 65%) lacked mental capacity to make decisions on treatment. This proportion varied according to diagnosis, ranging from 97% (n=36) in people with mania to 4% (n=24) in people with personality disorder. Mental incapacity was common in patients admitted informally to the psychiatric wards (n=188; 39%, 32% to 46%). Incapacity and detention are closely associated under non-capacity based mental health law. CONCLUSIONS: Mental incapacity to make decisions on treatment is common in people admitted to psychiatric wards from the community but cannot be presumed. It is usual in those detained under the Mental Health Act and common in those admitted voluntarily.
OBJECTIVE: To estimate the prevalence of mental capacity to make decisions on treatment in people from different diagnostic and legal groups admitted to psychiatric hospital. DESIGN: Cross sectional study. SETTING: General adult acute psychiatric inpatient units. PARTICIPANTS: 350 consecutive people admitted to psychiatric wards from the community over 16 months. MAIN OUTCOME MEASURE: Mental capacity assessed by clinical interview and the MacArthur competence assessment tool for treatment. RESULTS: Estimates of mental capacity were obtained on 97% (n=338) of the 350 people admitted. Of those an estimated 60% (95% confidence interval 55% to 65%) lacked mental capacity to make decisions on treatment. This proportion varied according to diagnosis, ranging from 97% (n=36) in people with mania to 4% (n=24) in people with personality disorder. Mental incapacity was common in patients admitted informally to the psychiatric wards (n=188; 39%, 32% to 46%). Incapacity and detention are closely associated under non-capacity based mental health law. CONCLUSIONS: Mental incapacity to make decisions on treatment is common in people admitted to psychiatric wards from the community but cannot be presumed. It is usual in those detained under the Mental Health Act and common in those admitted voluntarily.
Authors: Vanessa Raymont; William Bingley; Alec Buchanan; Anthony S David; Peter Hayward; Simon Wessely; Matthew Hotopf Journal: Lancet Date: 2004 Oct 16-22 Impact factor: 79.321
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Authors: Gareth S Owen; Anthony S David; Peter Hayward; Genevra Richardson; George Szmukler; Matthew Hotopf Journal: Br J Psychiatry Date: 2009-11 Impact factor: 9.319
Authors: Gareth S Owen; George Szmukler; Genevra Richardson; Anthony S David; Peter Hayward; James Rucker; Duncan Harding; Matthew Hotopf Journal: Br J Psychiatry Date: 2009-09 Impact factor: 9.319