Mental Capacity: A Policy Brief

In this post I report on a recently launched brief, prepared by Sophie Stammers for policy makers and mental health and social care professionals, entitled "Mitigating the risk of assumptions and biases in assessments of mental capacity". The work on the brief was funded by the University of Birmingham and the actual brief was launched with a Webinar hosted by the Mental Elf on 26th March 2020.

Mark Brown introduced the presentations and moderated the discussion. I summarised the main findings of project PERFECT relevant to the brief, and Sophie explained our recommendations, based on her research but also on extensive consultations conducted in January to March 2020.

Sophie Stammers

The conversation continued on Twitter where people made comments and asked questions using the #MentalCapacity2020 hashtag. Alex Ruck Keene wrote a post on the brief which appeared on the Mental Elf blog. Alex is a barrister specialising in mental capacity and mental health law. He is also a Wellcome Research Fellow at King’s College London, and created a website on mental health capacity law and policy.

Alex Ruck Green

What was the rationale for consulting mental health providers, service users, organisations, and policy makers on mental capacity? Mental health and social care professionals routinely assess the capacity of people to make decisions about their lives, in accordance with the Mental Capacity Act 2005 (MCA). 

The briefing note outlines how the functional approach to testing capacity in the MCA underdetermines decisions, describing the risks for stereotypes and assumptions to affect outcomes. It advocates for the need for specific training for professionals using the MCA to enable them to recognise the role of value judgements in capacity decisions, to mitigate the effects of stereotyping and assumptions, and to improve decision making.

If you want to know more, you can watch the Webinar on YouTube, or read the full brief on the Project PERFECT website, easy to download in an accessible PDF. On the website, you also find some quotes with stakeholders' reactions to our recommendations.

For instance, Anneliese Dodds, Labour (Co-op) MP for Oxford East said:

"There is now quite widespread recognition of the biases which affect decision-making, such as negativity bias in our retention of information from the media. Yet our awareness of these biases does not seem to feed in to our understanding of mental health, which often categorises people as ‘irrational’ in an unspecified way. This can be a political issue; I’ve been urged previously not to engage with people with mental ill-health on the grounds that they ‘would not be interested’, yet people suffering from mental ill-health are often not only interested in politics but have a great deal of importance to say and are not less ‘rational’, depending on the type of illness they are suffering from. These issues surely need more consideration, which is why I was pleased to see the progress of the PERFECT research project."