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Mental Capacity Assessment - What Is It?
"A mental capacity assessment is a process used to determine whether an individual can safely make specific decisions about their welfare. The evaluation may be carried out by using a structured interview or a series of structured interviews with the individual who is to be assessed. There would also be interviews and consultations with other individuals, including family members and professionals who know the individual who is to be assessed well."
The MCA assessment may require an evaluation of social work records . It may be necessary also to use psychometric tests in a capacity assessment. Assessing capacity can be more complex where the individual’s capacity fluctuates or where there are major disputes between the family or professional and the individual involved about whether or not they lack capacity.
Assessment of mental capacity may be carried out using the Wechsler Memory Scale and Wechsler Adult Intelligence Test for adults with learning disabilities, dementia, neuropsychological impairments, brain injury and chronic alcohol abuse.
In addition to using IQ and memory tests in the assessment of capacity, the expert psychologist might also use the Kaplan-Baycrest Neuropsychological Assessment or other capacity tests for individuals with neuropsychological impairments, including dementia.
When carrying out an assessment of mental capacity for individuals who have mental health problems, our expert psychologists may use a range of instruments, including the Personality Assessment Inventory and the Minnesota Multiphasic Personality Inventory.
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What is Meant by Mental Capacity?
What is meant by mental capacity? What does mental capacity mean? The term mental capacity is most frequently used to describe someone lacking capacity. Mental Capacity Definition:
“A person has capacity if the person being assessed can interpret and apply information necessary to make decisions that impact on their welfare.”
The law that sets out the framework for evaluating a person’s mental capacity is the Mental Capacity Act 2005 (MCA). The Mental Capacity Act definition of mental health capacity is used here to consider how capacity should be assessed.
Who does the Mental Capacity Act apply to? The MCA applies to everyone who is aged 16 or older.
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When Should An Individual's Capacity To Make A Decision Be Assessed?
There are several situations in which an individual’s capacity may need to be evaluated. These can include conditions where an individual might be managing substantial amounts of wealth, and an assessment of capacity and appointment of a deputy to manage their affairs might stop others from taking advantage of them. Additionally, an individual may require an evaluation of capacity when there are concerns that the individual is a risk to themselves or that they cannot take care of themselves and have little insight into the risk posed by making or not making specific decisions.
The situations include whether a vulnerable individual has the capacity to enter into contracts or indeed the capacity to consent to sexual activity.
Who Can Carry Out A Mental Capacity Assessment?
Who can carry out a mental capacity assessment? The law does not restrict who can complete a mental capacity assessment. The benefit of this is that there are a wide variety of healthcare professionals who can carry out a mental capacity assessment. Some professionals are, by virtue of their training, likely to have the skills to more effectively carry out mental capacity assessments than other professionals, including psychologists, psychiatrists, social workers, and general medical practitioners.
Excellent mental capacity assessments can be carried out in partnership with family members and other people that know the individual who is subject to the mental capacity assessment well.
How to Complete A Mental Capacity Assessment
How to do a mental capacity assessment? There are five important principles which our expert psychologists follow when carrying out a Mental Capacity Act 2005 assessment:
- The starting point of the capacity assessment is that the person being assessed is able to make their own decision.
- Provide the support necessary for the person to make their own decision, making all necessary reasonable adjustments.
- Do not conclude that the individual cannot make a decision simply because it is an unwise decision or because somebody else disagrees with it.
- If it is found that an individual is unable to make a decision for themselves, another person will have to make a decision for them in the best way for the person fully taking into account their best interests.
- If a decision is made by a relative or another professional, that person must always select the least restrictive course of action that does not confine the individual or interfere with their rights more than is necessary.
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When carrying out a Mental Capacity Act Assessment, one must consider the 2 stage capacity test.
What is the Test for Mental Capacity
The Two Stage Test – Decision Making Capacity
The two-stage test set out in the MCA is an integral part of the mental capacity assessment. This aspect of the mental capacity assessment focuses on decision-making. The first aspect of the two-stage test of capacity is:
1. “Is there an impairment or disturbance causing their brain or mind not to function efficiently? The impairment can be caused by a learning disability, brain injury, mental illness, dementia, a stroke, drug or alcohol use or concussion.
2. When the person needs to make a specific decision, does the impairment or disturbance prevent the person from making one? The individual must be provided with all appropriate support to make the decision. A person’s ability to make a specific decision may get better or worse over time so they should be given enough time to make the decision themselves."
The specific criteria for being unable to make a decision as defined by the MCA is that:
The individual cannot understand the information relevant to the decision.
The individual cannot retain that information.
The individual is unable to weigh up or use that information as part of the decision-making process.
Mental Capacity Assessment Questions
Mental Capacity Assessment Example Questions:
Think through questions before you ask them.
Put questions in plain English, avoiding jargon and over-complex words.
Ask questions which the respondent can build on. Avoid asking closed questions.
Ask none-leading questions so that the respondent is not overly influenced to respond in a specific way.
The aim of the objective of questioning is to engage the person in a discussion about the options for their future. It is therefore vital that rapport and a good relationship is developed before asking critical questions.
For some individuals with limited communication, a support person may be critical. This is because the support person may be able to put them at ease and also may understand how to communicate or know specific words that the individual who is assessed uses. Remember that the objective of the mental capacity assessment is to give the individual who is being assessed as much support as necessary. This support can sometimes be from a third party.
Questions are typically going to be asked on the issue that the person undergoing a mental capacity assessment is asked to decide.
Mental Capacity Test Questions
With an individual who is felt to be at risk living alone, one might ask:
“Do you have any difficulty making contact with the emergency service’s?”
- “How would you get help in an emergency?”
- “Are you able to turn on and off the gas?”
“What days it today?”
“What year is it?”
“Do you have any food at home?”
“What things did you consider when you decided to live alone?”
“How did you balance the risks and benefits of deciding to live alone?
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Mental Capacity Assessment Training
Our mental capacity act assessment training provides a framework to give the individual the ability to make their own decisions. Ultimately this needs procedures and frameworks that are easy to follow. Our training programme takes people through the process. We consider five top principles stemming from the Mental Capacity Act. Within the training course, we also teach participants about the two-stage test involved in making a capacity assessment. The programme also looks at what additional assistance is required in making a mental capacity assessment.
An essential element of the training is to highlight the critical role that the individual at the heart of the decision has in the decision-making process. There is a need to respond appropriately to their needs.
The Mental Capacity Act 2005 training programme also includes an option for senior staff, managers, Clinical Commissioning Groups (CCGs), social workers and the police. The programme can be fully accredited so that it forms part of your continuous professional development (CPD). There is an online training programme, an open-access course and an in-house Mental Capacity Act training programme available.
It is crucial that when assessing someone’s mental capacity, you can come to a decision about whether, on the balance of probabilities, that someone does not have the capacity to make a decision about their welfare.
The course will help practitioners understand the difference between lacking capacity and making unwise decisions. The Mental Capacity Act training will also address the issue of fluctuating mental capacity through the assessment of dementia cases. Mental health capacity will also be considered in the context of the Deprivation of Liberty Safeguards.
The mental capacity assessment training will provide practitioners with the skills to apply best interests decision-making.
Mental capacity and the law will be addressed in detail, the implications for mental capacity assessments arising from the European Convention of Human Rights (Articles 5 and 8) will be considered in the context of the evolving case law. The interplay between the Mental Health Act 1983 and the Mental Capacity Act 2005 will be considered. The mental capacity assessment training provides training and guidance in writing reports for the Court of Protection and how to be an effective 3A representative.
Advanced Assessments’ mental capacity assessment training will also develop practitioner skills in mental capacity assessment of the capacity to consent to sexual relationships, contraception, restricting contact and marriage. The theme of safeguarding runs throughout the mental capacity assessment training programme.
Our assessment of capacity training also considers issues which are particular to specific demographic groups such as people with learning disabilities, young people and those with protected characteristics under the Equality Act 2010, when assessing capacity to consent.
Advanced Assessments’ mental capacity training programme also includes advice on developing a robust complaints process so that if the individual does not agree with the mental capacity assessment, they can complain.
What is A Mental Capacity Assessment Test?
In reality, there are various different tests of mental capacity. Each test is designed to assess a particular aspect of ability relevant to the individual who is being evaluated.
The first part of any mental capacity assessment is for our expert psychologists to determine whether the person who is to be assessed has a disturbance or impairment in their brain or psychological functioning, the second stage of a mental capacity assessment is to determine, by following the four indicators, whether the person who is being assessed is unable because of their illness or impairment to decide on a specific issue at the point in time when a decision needs to be made. It is essential to identify why the individual does not want to make a particular decision or is rejecting a specific decision.
What Are The Four Steps in The Mental Capacity Test?
- Does the person understand the information that relates to the decision, and do they appreciate what might happen if they do not make a decision?
- Can the person retain the information for long enough to make the decision?
- Can the individual evaluate, weigh or assess the information and use it to reach the decision?
- Can the individual express or communicate their decision to others in a way that others understand?
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