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There's been some discussion on #MHTwitter about assessing capacity in regard to people being suicidal. I will try and explain the issues and my opinion in a short thread
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"Capacity to decide whether to kill oneself" is by and large irrelevant, a red herring, a cop-out
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Of course the Adults with Incapacity Act, Mental Capacity Act etc. allow for people making unwise decisions - but they don't say that you must stand by and allow people to act on unwise decisions. You can question, persuade, negotiate, help
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So if your reaction to someone feeling so desperate or hopeless, in so much pain that being dead is preferable, is "Oh I'd better assess their capacity", you're doing it all wrong. Offer some help, talk, listen, figure out what's going on
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And some observations about the reality of capacity assessment
"Presumption of capacity" doesn't mean "If I don't bother to do a capacity assessment, they have capacity" - it means the opposite:
You mustn't assume incapacity without assessment, not you can assume capacity
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"Presumption of capacity" doesn't mean "If I don't bother to do a capacity assessment, they have capacity" - it means the opposite:
You mustn't assume incapacity without assessment, not you can assume capacity
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So if you refer to mental health staff and they say "Oh that person has capacity" without seeing them, they are wrong. Very wrong. Don't try and persuade that person to help - go up the chain
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Similarly, a 'care plan' which says "This person has full capacity" without further details is a red flag for problems in a mental health service needing urgent review. Don't accept something like that without challenge
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One should read the AWIA/MCA codes of practice to understand how to apply
My opinion is that the legislation is fit for purpose, provided the expertise exists. It is difficult, and one should ask for help if stuck - but if the goal is to help it's not a good place to start
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My opinion is that the legislation is fit for purpose, provided the expertise exists. It is difficult, and one should ask for help if stuck - but if the goal is to help it's not a good place to start
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