Mental Capacity Act

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Mental Capacity Act Mental Health
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• Objectives
• Mental Capacity Act 2005
• Principles of the Act
• Assessing Capacity
• Best Interest
• Advanced Decisions

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Introduction
Every day we make decisions about our lives, be
it simple things such as what to wear or major
things like our health or finances etc.
The Mental Capacity Act 2005 is a new law which
comes into force on 1st April 2007, covering
people aged 16 and over who may lack capacity to
make their own decisions. It also allows people
to plan ahead if they think they may lack
capacity in the future.
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Statistics
Up to 2 million people are affected by incapacity
Over 700,000 suffer from Dementia
145,000 have severe profound learning
disabilities
10- 15 people per 100,000 will suffer a severe
head injury each year
120,000 suffering long term effects of severe
brain injury
1 in 4 people will suffer a serious mental health
illness in their lifetime
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Introduction
Mental Capacity Act PRINCIPLES
Code of Practice, Section 1
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Mental Capacity
Having capacity means that a person is able to
make their own decisions
Brain / Head Injury
The MCA is designed to cover situations where
someone is unable to make a decision because
their mind or brain is affected
Stroke
Dementia
Confusion, drowsiness or unconsciousness due to
an illness
Substance Misuse
Severe Mental Illness
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Mental Capacity

• Is
• the ability to make decisions
• the ability to take actions affecting daily life

Is there an impairment of, or disturbance in, the
functioning of the persons mind or brain ?
(permanent or temporary)
Code of Practice, Section 2
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Mental Capacity Principles of the MCA 2005
The act sets out a single clear test for
assessing whether a person lacks capacity to take
particular decisions at a particular time
No one can be labelled incapable as a result of
a particular medical condition or diagnosis
A lack of capacity cannot be established merely
by reference to a persons age, appearance, or any
condition or aspects of a persons behaviour
which might lead others to make unjustified
assumptions about capacity
Code of Practice, Section 2
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Assessing Capacity Principles of the MCA 2005
Principle 1
Is there an impairment of, or disturbance in, the
functioning of the persons mind or brain either
permanent or temporary?
Does the impairment or disturbance make the
person unable to make the particular decision?
Principle 2
Refer to Handout
Code of Practice, Section 3
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Inability to make Decisions
A Person is unable to make decisions for himself
if he is unable to
To use or weigh that information as part of the
process of making the decision
To communicate his decision (whether by talking,
using sign language or any other means
To retain that Information
Understand the information relevant to the
decision
Code of Practice, Section 3
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Best Interest
If a person has been assessed as lacking capacity
then any action taken, or decision made for, or
on behalf of that person, must be made in his or
her best interests
Decision making or carrying out an Act must be
considered against the checklist of factors and a
full record made on the PRF
Refer to Handout
Code of Practice, Section 4
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Advanced Decisions
The act allows anybody with capacity at that
time, who is over 18 yrs to make an advanced
decision to refuse specified treatment should
they lose capacity in the future.
An advance decision is not applicable to
life-sustaining treatment unless the decision is
verified by a statement to the effect that it is
to apply to that treatment even if life is at
risk, and is in writing (signed witnessed)
An Advanced Decision can be withdrawn or altered
at any time when there is capacity to do so
Is it Valid Applicable ?
Code of Practice, Section 24
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Scenario Exercise
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Protection of Vulnerable People
The Act also includes three further key
provisions to protect vulnerable people

• Independent Mental Capacity Advocate (IMCA) An
  IMCA will be someone appointed to support a
  person who lacks capacity but has no one to speak
  for them, such as family or friends. (s.35)

• Advance decisions to refuse treatment The Act
  creates statutory rules with clear safeguards so
  that people may make a decision in advance to
  refuse treatment if they should lack capacity in
  the future.

• A criminal offence The Act introduces a new
  criminal offence of ill treatment or neglect of a
  person who lacks capacity. A person found guilty
  of such an offence may be liable to imprisonment
  for a term of up to five years. The new criminal
  offence will be effective from April 2007.

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Code of Practice
There will be a statutory Code of Practice to
accompany the Act. The Code will provide guidance
to all those working with and/or caring for
adults who lack capacity, including family
members, professionals and carers. It describes
their responsibilities when acting or making
decisions with, or on behalf of, individuals who
lack the capacity to do these things themselves.
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Everyone working with and/or caring for people
who lack capacity must comply with the ACT
Summary
Always work within the principles of the MCA
You are under a legal duty to have regard
Summary
Use the Mental Capacity test consider the
checklist of factors
Always document your actions decisions
Assess whether the act or decision is in the
Best Interest of the patient
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Any questions ?