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Matthew Hotopf - One of the best experts on this subject based on the ideXlab platform.
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assessments of Mental Capacity in psychiatric inpatients a retrospective cohort study
BMC Psychiatry, 2013Co-Authors: Penelope Brown, Gareth Owen, Alexander Tulloch, Charlotte Mackenzie, George Szmukler, Matthew HotopfAbstract:The Mental Capacity Act 2005 (MCA) was introduced in 2007 to protect vulnerable individuals who lack Capacity to make decisions for themselves and to provide a legal framework for professionals to assess inCapacity. The impact of the MCA on clinical practice is not known. This study aims to evaluate how frequently Mental Capacity is assessed in psychiatric inpatients, whether the criteria for determining Capacity set out in the MCA are used in practice, and whether this has increased with the introduction of the MCA. A retrospective cohort study was carried out using a case register of South East London Mental health service users. The Case Register Interactive Search (CRIS) system enabled searching and retrieval of anonymised information on patients admitted to the South London and Maudsley NHS Foundation Trust since 2006. The presence and outcomes of documented Mental Capacity assessments in psychiatric admissions between May 2006 and February 2010 were identified and demographic information on all admissions was retrieved. Capacity assessments were documented in 1,732/17,744 admissions (9.8%). There was a significant increase in the frequency of Capacity assessments carried out over the study period of 0.3 percentage points per month (95% CI 0.26-0.36, p < 0.00001). In only 14.7% of Capacity assessments were the MCA criteria for assessing Capacity explicitly used. Over the period of the introduction of the MCA there has been a significant increase in the number of Mental Capacity assessments carried out on psychiatric inpatients. Although Mental health services are considering the issue of Capacity more frequently, Mental Capacity assessments are inconsistently applied and do not make adequate use of MCA criteria.
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Assessments of Mental Capacity in psychiatric inpatients: a retrospective cohort study
BMC Psychiatry, 2013Co-Authors: Penelope Brown, Gareth Owen, Alexander Tulloch, Charlotte Mackenzie, George Szmukler, Matthew HotopfAbstract:The Mental Capacity Act 2005 (MCA) was introduced in 2007 to protect vulnerable individuals who lack Capacity to make decisions for themselves and to provide a legal framework for professionals to assess inCapacity. The impact of the MCA on clinical practice is not known. This study aims to evaluate how frequently Mental Capacity is assessed in psychiatric inpatients, whether the criteria for determining Capacity set out in the MCA are used in practice, and whether this has increased with the introduction of the MCA. A retrospective cohort study was carried out using a case register of South East London Mental health service users. The Case Register Interactive Search (CRIS) system enabled searching and retrieval of anonymised information on patients admitted to the South London and Maudsley NHS Foundation Trust since 2006. The presence and outcomes of documented Mental Capacity assessments in psychiatric admissions between May 2006 and February 2010 were identified and demographic information on all admissions was retrieved. Capacity assessments were documented in 1,732/17,744 admissions (9.8%). There was a significant increase in the frequency of Capacity assessments carried out over the study period of 0.3 percentage points per month (95% CI 0.26-0.36, p
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Mental Capacity and psychiatric in patients implications for the new Mental health law in england and wales
British Journal of Psychiatry, 2009Co-Authors: Gareth Owen, Genevra Richardson, Anthony S. David, Peter Hayward, George Szmukler, James Rucker, Duncan Harding, Matthew HotopfAbstract:Background In England and Wales Mental health services need to take account of the Mental Capacity Act 2005 and the Mental Health Act 1983. The overlap between these two causes dilemmas for clinicians. Aims To describe the frequency and characteristics of patients who fall into two potentially anomalous groups: those who are not detained but lack Mental Capacity; and those who are detained but have Mental Capacity. Method Cross-sectional study of 200 patients admitted to psychiatric wards. We assessed Mental Capacity using a semi-structured interview, the MacArthur Competence Assessment Tool for Treatment (MacCAT–T). Results Of the in-patient sample, 24% were informal but lacked Capacity: these patients felt more coerced and had greater levels of treatment refusal than informal participants with Capacity. People detained under the Mental Health Act with Capacity comprised a small group (6%) that was hard to characterise. Conclusions Our data suggest that psychiatrists in England and Wales need to take account of the Mental Capacity Act, and in particular best interests judgments and deprivation of liberty safeguards, more explicitly than is perhaps currently the case.
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The impact of context on assessments of Mental Capacity by psychiatrists
Journal of Mental Health, 2009Co-Authors: Olumuyiwa John Olumoroti, Akim Kassim, Matthew HotopfAbstract:Background: The assessment of Mental Capacity in patients who have self harmed is often difficult. Contextual factors may influence judgements on Mental Capacity.Aims: To determine the proportion of consultant psychiatrists who judge a self harming patient described in a vignette likely to have Mental Capacity, and to test the hypothesis that judgements are influenced by contextual factors which should not necessarily influence Mental Capacity.Method: Four hundred and four consultant psychiatrists were randomized to receive one of four vignettes describing a woman who took a serious paracetamol overdose and required liver transplantation.Results: Seventy percent of questionnaires were returned. Forty-nine percent of participants thought that the patient lacked Mental Capacity. There was no statistically significant effect of vignette on judgement of Mental Capacity (p = .4). Psychiatric speciality of the participants influenced Capacity judgements (p = .06), with old age psychiatrists being least likely t...
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Legal Aspects of Mental Capacity
British Journal of Psychiatry, 2009Co-Authors: Matthew HotopfAbstract:[⇓][1] ![Figure][2] Pity the authors of books on Mental Capacity legislation! Not long after the Mental Capacity Act 2005 – an act which codified the previously confused English common law – was implemented in October 2007, it suddenly ballooned with the amendments added to it by the
Gareth Owen - One of the best experts on this subject based on the ideXlab platform.
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Mental Capacity in Colombia: a comparison with the UK.
BJPsych international, 2018Co-Authors: Juan P. Borda, Ricardo Tamayo, Gareth OwenAbstract:: Several international proclamations in the last decades have advocated for the dignity and autonomy of persons with Mental disorders. Few discussions have been generated regarding the implication of this transition in low- and middle-income countries. The objective of this publication is to review how the concept of Mental Capacity has been defined in Colombian law. We then briefly compare the Colombian and UK situations and propose a few points of discussion, addressing some difficulties and challenges of both countries. Finally, we propose that the first steps in the Colombian context would be to strengthen understanding about Mental Capacity in medical schools, postgraduate and other health related programmes, the adoption of standardized tools to improve its assessment in everyday clinical settings and the establishment of community care services from collaborative efforts between governMental and civil organizations.
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Mental Capacity and borderline personality disorder
BJPsych bulletin, 2017Co-Authors: Karyn Ayre, Gareth Owen, Paul MoranAbstract:The use of the Mental Capacity Act 2005 in assessing decision-making Capacity in patients with borderline personality disorder (BPD) is inconsistent. We believe this may stem from persisting confusion regarding the nosological status of personality disorder and also a failure to recognise the fact that emotional dysregulation and characteristic psychodynamic abnormalities may cause substantial difficulties in using and weighing information. Clearer consensus on these issues is required in order to provide consistent patient care and reduce uncertainty for clinicians in what are often emergency and high-stakes clinical scenarios.
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assessments of Mental Capacity in psychiatric inpatients a retrospective cohort study
BMC Psychiatry, 2013Co-Authors: Penelope Brown, Gareth Owen, Alexander Tulloch, Charlotte Mackenzie, George Szmukler, Matthew HotopfAbstract:The Mental Capacity Act 2005 (MCA) was introduced in 2007 to protect vulnerable individuals who lack Capacity to make decisions for themselves and to provide a legal framework for professionals to assess inCapacity. The impact of the MCA on clinical practice is not known. This study aims to evaluate how frequently Mental Capacity is assessed in psychiatric inpatients, whether the criteria for determining Capacity set out in the MCA are used in practice, and whether this has increased with the introduction of the MCA. A retrospective cohort study was carried out using a case register of South East London Mental health service users. The Case Register Interactive Search (CRIS) system enabled searching and retrieval of anonymised information on patients admitted to the South London and Maudsley NHS Foundation Trust since 2006. The presence and outcomes of documented Mental Capacity assessments in psychiatric admissions between May 2006 and February 2010 were identified and demographic information on all admissions was retrieved. Capacity assessments were documented in 1,732/17,744 admissions (9.8%). There was a significant increase in the frequency of Capacity assessments carried out over the study period of 0.3 percentage points per month (95% CI 0.26-0.36, p < 0.00001). In only 14.7% of Capacity assessments were the MCA criteria for assessing Capacity explicitly used. Over the period of the introduction of the MCA there has been a significant increase in the number of Mental Capacity assessments carried out on psychiatric inpatients. Although Mental health services are considering the issue of Capacity more frequently, Mental Capacity assessments are inconsistently applied and do not make adequate use of MCA criteria.
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Assessments of Mental Capacity in psychiatric inpatients: a retrospective cohort study
BMC Psychiatry, 2013Co-Authors: Penelope Brown, Gareth Owen, Alexander Tulloch, Charlotte Mackenzie, George Szmukler, Matthew HotopfAbstract:The Mental Capacity Act 2005 (MCA) was introduced in 2007 to protect vulnerable individuals who lack Capacity to make decisions for themselves and to provide a legal framework for professionals to assess inCapacity. The impact of the MCA on clinical practice is not known. This study aims to evaluate how frequently Mental Capacity is assessed in psychiatric inpatients, whether the criteria for determining Capacity set out in the MCA are used in practice, and whether this has increased with the introduction of the MCA. A retrospective cohort study was carried out using a case register of South East London Mental health service users. The Case Register Interactive Search (CRIS) system enabled searching and retrieval of anonymised information on patients admitted to the South London and Maudsley NHS Foundation Trust since 2006. The presence and outcomes of documented Mental Capacity assessments in psychiatric admissions between May 2006 and February 2010 were identified and demographic information on all admissions was retrieved. Capacity assessments were documented in 1,732/17,744 admissions (9.8%). There was a significant increase in the frequency of Capacity assessments carried out over the study period of 0.3 percentage points per month (95% CI 0.26-0.36, p
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Mental Capacity and psychiatric in patients implications for the new Mental health law in england and wales
British Journal of Psychiatry, 2009Co-Authors: Gareth Owen, Genevra Richardson, Anthony S. David, Peter Hayward, George Szmukler, James Rucker, Duncan Harding, Matthew HotopfAbstract:Background In England and Wales Mental health services need to take account of the Mental Capacity Act 2005 and the Mental Health Act 1983. The overlap between these two causes dilemmas for clinicians. Aims To describe the frequency and characteristics of patients who fall into two potentially anomalous groups: those who are not detained but lack Mental Capacity; and those who are detained but have Mental Capacity. Method Cross-sectional study of 200 patients admitted to psychiatric wards. We assessed Mental Capacity using a semi-structured interview, the MacArthur Competence Assessment Tool for Treatment (MacCAT–T). Results Of the in-patient sample, 24% were informal but lacked Capacity: these patients felt more coerced and had greater levels of treatment refusal than informal participants with Capacity. People detained under the Mental Health Act with Capacity comprised a small group (6%) that was hard to characterise. Conclusions Our data suggest that psychiatrists in England and Wales need to take account of the Mental Capacity Act, and in particular best interests judgments and deprivation of liberty safeguards, more explicitly than is perhaps currently the case.
George Szmukler - One of the best experts on this subject based on the ideXlab platform.
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assessments of Mental Capacity in psychiatric inpatients a retrospective cohort study
BMC Psychiatry, 2013Co-Authors: Penelope Brown, Gareth Owen, Alexander Tulloch, Charlotte Mackenzie, George Szmukler, Matthew HotopfAbstract:The Mental Capacity Act 2005 (MCA) was introduced in 2007 to protect vulnerable individuals who lack Capacity to make decisions for themselves and to provide a legal framework for professionals to assess inCapacity. The impact of the MCA on clinical practice is not known. This study aims to evaluate how frequently Mental Capacity is assessed in psychiatric inpatients, whether the criteria for determining Capacity set out in the MCA are used in practice, and whether this has increased with the introduction of the MCA. A retrospective cohort study was carried out using a case register of South East London Mental health service users. The Case Register Interactive Search (CRIS) system enabled searching and retrieval of anonymised information on patients admitted to the South London and Maudsley NHS Foundation Trust since 2006. The presence and outcomes of documented Mental Capacity assessments in psychiatric admissions between May 2006 and February 2010 were identified and demographic information on all admissions was retrieved. Capacity assessments were documented in 1,732/17,744 admissions (9.8%). There was a significant increase in the frequency of Capacity assessments carried out over the study period of 0.3 percentage points per month (95% CI 0.26-0.36, p < 0.00001). In only 14.7% of Capacity assessments were the MCA criteria for assessing Capacity explicitly used. Over the period of the introduction of the MCA there has been a significant increase in the number of Mental Capacity assessments carried out on psychiatric inpatients. Although Mental health services are considering the issue of Capacity more frequently, Mental Capacity assessments are inconsistently applied and do not make adequate use of MCA criteria.
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Assessments of Mental Capacity in psychiatric inpatients: a retrospective cohort study
BMC Psychiatry, 2013Co-Authors: Penelope Brown, Gareth Owen, Alexander Tulloch, Charlotte Mackenzie, George Szmukler, Matthew HotopfAbstract:The Mental Capacity Act 2005 (MCA) was introduced in 2007 to protect vulnerable individuals who lack Capacity to make decisions for themselves and to provide a legal framework for professionals to assess inCapacity. The impact of the MCA on clinical practice is not known. This study aims to evaluate how frequently Mental Capacity is assessed in psychiatric inpatients, whether the criteria for determining Capacity set out in the MCA are used in practice, and whether this has increased with the introduction of the MCA. A retrospective cohort study was carried out using a case register of South East London Mental health service users. The Case Register Interactive Search (CRIS) system enabled searching and retrieval of anonymised information on patients admitted to the South London and Maudsley NHS Foundation Trust since 2006. The presence and outcomes of documented Mental Capacity assessments in psychiatric admissions between May 2006 and February 2010 were identified and demographic information on all admissions was retrieved. Capacity assessments were documented in 1,732/17,744 admissions (9.8%). There was a significant increase in the frequency of Capacity assessments carried out over the study period of 0.3 percentage points per month (95% CI 0.26-0.36, p
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Mental Capacity and psychiatric in patients implications for the new Mental health law in england and wales
British Journal of Psychiatry, 2009Co-Authors: Gareth Owen, Genevra Richardson, Anthony S. David, Peter Hayward, George Szmukler, James Rucker, Duncan Harding, Matthew HotopfAbstract:Background In England and Wales Mental health services need to take account of the Mental Capacity Act 2005 and the Mental Health Act 1983. The overlap between these two causes dilemmas for clinicians. Aims To describe the frequency and characteristics of patients who fall into two potentially anomalous groups: those who are not detained but lack Mental Capacity; and those who are detained but have Mental Capacity. Method Cross-sectional study of 200 patients admitted to psychiatric wards. We assessed Mental Capacity using a semi-structured interview, the MacArthur Competence Assessment Tool for Treatment (MacCAT–T). Results Of the in-patient sample, 24% were informal but lacked Capacity: these patients felt more coerced and had greater levels of treatment refusal than informal participants with Capacity. People detained under the Mental Health Act with Capacity comprised a small group (6%) that was hard to characterise. Conclusions Our data suggest that psychiatrists in England and Wales need to take account of the Mental Capacity Act, and in particular best interests judgments and deprivation of liberty safeguards, more explicitly than is perhaps currently the case.
Bridgit Dimond - One of the best experts on this subject based on the ideXlab platform.
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The Mental Capacity Act 2005 and decision-making: advocacy
British journal of nursing, 2020Co-Authors: Bridgit DimondAbstract:This article continues the series into the content and implications of the Mental Capacity Act 2005, which looks at the requirement to provide an independent Mental Capacity advocacy service in specified situations. The Act requires NHS organizations and local authorities to arrange for the appointment of an independent Mental Capacity advocate in the following situations: where serious medical treatment is being considered for a person who is incapable of making his or her own decisions, and where accommodation is being arranged by an NHS organization, or by a local authority, for a person who lacks the requisite Mental Capacity to give consent. Additional situations have been added by regulations and these include where there is a review of the accommodation arrangements (Reg. 3) or where an NHS body or local authority propose to take protective measures in relation to a person who lacks the requisite Mental Capacity (Reg. 4). The statutory duty does not apply if there is a person whom it would be appro...
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The long-awaited Mental Capacity Bill has arrived.
British journal of nursing, 2020Co-Authors: Bridgit DimondAbstract:After a long journey, the Mental Capacity Bill has reached its final stages in Parliament with the discussion of the report stage having taken place in the House of Commons on 14 December 2004. The Law Commission (1995) published recommendations for legislation on Mental Capacity following consultation on all aspects of decision making on behalf of the Mentally incapacitated adult. The report was followed by a new consultation in 1997 (Lord Chancellor's Office, 1997) and a White Paper in 1999 (Lord Chancellor's Office, 1999). The present Bill received scrutiny by the House of Lords and House of Commons Joint Committee (2002–2003) which made significant recommendations including the change of title from Mental InCapacity to Mental Capacity.
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The Mental Capacity Act 2005: Mental Capacity and Mental illness.
British journal of nursing, 2008Co-Authors: Bridgit DimondAbstract:In this series of articles on the Mental Capacity Act 2005 (MCA) the author now turns to the interrelation between Mental Capacity and Mental disorder and between the Mental Health Act 1983 (MHA) (as amended by the Mental Health Act 2007 [MHA, 2007]) and the Bournewood safeguards. The article explains how the MCA and the MHA are designed to cover distinct situations: the one Mental Capacity; the other Mental disorder and the different definitions are considered. The article also looks at the different principles which apply and the different powers available under each Act. The different forms of protection under each Act are contrasted. Because of criticism of the UK by the European Court of Human Rights in the Bournewood case, amendments have been made by the MHA 2007 to the MCA to provide protection for those incapable of making decisions who suffer from Mental disorder and whose best interests require a loss of liberty.
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Mental Capacity and decision aking definining Capacity
British journal of nursing, 2007Co-Authors: Bridgit DimondAbstract:The Mental Capacity Act 2005 came fully into force on 1st October 2007 (some sections came into force on 1 April 2007). This series of articles considers some of the key features of the Act, including the concepts of best interests, the lasting power of attorney, the role of the new Court of Protection, the Office of Public Guardian and the deputies of the Court, to name but a few. This first article looks at the central feature of the Act: how Mental Capacity is determined.
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Mental Capacity requirements and a patient's right to die.
British journal of nursing, 2006Co-Authors: Bridgit DimondAbstract:This article reviews the situation of a patient who has suffered a severe stroke whose daughter knows would not wish to continue in that situation. It explores the law relating to the refusal of life-saving treatment by a patient with Mental Capacity compared with a person who lacked Mental Capacity. It also considers the implications of the failure of the Assisted Suicide Bill to be passed into law.
Penelope Brown - One of the best experts on this subject based on the ideXlab platform.
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assessments of Mental Capacity in psychiatric inpatients a retrospective cohort study
BMC Psychiatry, 2013Co-Authors: Penelope Brown, Gareth Owen, Alexander Tulloch, Charlotte Mackenzie, George Szmukler, Matthew HotopfAbstract:The Mental Capacity Act 2005 (MCA) was introduced in 2007 to protect vulnerable individuals who lack Capacity to make decisions for themselves and to provide a legal framework for professionals to assess inCapacity. The impact of the MCA on clinical practice is not known. This study aims to evaluate how frequently Mental Capacity is assessed in psychiatric inpatients, whether the criteria for determining Capacity set out in the MCA are used in practice, and whether this has increased with the introduction of the MCA. A retrospective cohort study was carried out using a case register of South East London Mental health service users. The Case Register Interactive Search (CRIS) system enabled searching and retrieval of anonymised information on patients admitted to the South London and Maudsley NHS Foundation Trust since 2006. The presence and outcomes of documented Mental Capacity assessments in psychiatric admissions between May 2006 and February 2010 were identified and demographic information on all admissions was retrieved. Capacity assessments were documented in 1,732/17,744 admissions (9.8%). There was a significant increase in the frequency of Capacity assessments carried out over the study period of 0.3 percentage points per month (95% CI 0.26-0.36, p < 0.00001). In only 14.7% of Capacity assessments were the MCA criteria for assessing Capacity explicitly used. Over the period of the introduction of the MCA there has been a significant increase in the number of Mental Capacity assessments carried out on psychiatric inpatients. Although Mental health services are considering the issue of Capacity more frequently, Mental Capacity assessments are inconsistently applied and do not make adequate use of MCA criteria.
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Assessments of Mental Capacity in psychiatric inpatients: a retrospective cohort study
BMC Psychiatry, 2013Co-Authors: Penelope Brown, Gareth Owen, Alexander Tulloch, Charlotte Mackenzie, George Szmukler, Matthew HotopfAbstract:The Mental Capacity Act 2005 (MCA) was introduced in 2007 to protect vulnerable individuals who lack Capacity to make decisions for themselves and to provide a legal framework for professionals to assess inCapacity. The impact of the MCA on clinical practice is not known. This study aims to evaluate how frequently Mental Capacity is assessed in psychiatric inpatients, whether the criteria for determining Capacity set out in the MCA are used in practice, and whether this has increased with the introduction of the MCA. A retrospective cohort study was carried out using a case register of South East London Mental health service users. The Case Register Interactive Search (CRIS) system enabled searching and retrieval of anonymised information on patients admitted to the South London and Maudsley NHS Foundation Trust since 2006. The presence and outcomes of documented Mental Capacity assessments in psychiatric admissions between May 2006 and February 2010 were identified and demographic information on all admissions was retrieved. Capacity assessments were documented in 1,732/17,744 admissions (9.8%). There was a significant increase in the frequency of Capacity assessments carried out over the study period of 0.3 percentage points per month (95% CI 0.26-0.36, p