Prevalence and predictors of mental incapacity in psychiatric in-patients
Open Access
- 1 October 2005
- journal article
- Published by Royal College of Psychiatrists in The British Journal of Psychiatry
- Vol. 187 (4), 379-385
- https://doi.org/10.1192/bjp.187.4.379
Abstract
Background: Little is known about the proportion of psychiatric in-patients who lack capacity to make treatment decisions, or the associations of lack of capacity.Aims: To determine the prevalence of psychiatric in-patients who lack capacity to make decisions about current treatment and to identify demographic and clinical associations with lack of mental capacity.Method: Patients (n=112) were interviewed soon after admission to hospital and a binary judgement of capacity was made, guided by the MacArthur Competence Tool for Treatment. Demographic and clinical information was collected from an interview and case notes.Results: Of the 112 participants, 49 (43.8%) lacked treatment-related decisional capacity Mania and psychosis, poor insight, delusions and Black and minority ethnic group were associated with mental incapacity. Of the 49 patients lacking capacity, 30 (61%) were detained under the Mental Health Act 1983. Of the 63 with capacity, 6 (9.5%) were detained.Conclusions: Lack of treatment-related decisional capacity is a common but by no means inevitable correlate of admission to a psychiatric in-patient unit.Keywords
This publication has 22 references indexed in Scilit:
- Reliability of mental capacity assessments in psychiatric in-patientsThe British Journal of Psychiatry, 2005
- Coercion and treatment pressuresPsychiatry: Interpersonal & Biological Processes, 2004
- Neurocognitive Deficits and Functional Outcome in Schizophrenia: Are We Measuring the "Right Stuff"?Schizophrenia Bulletin, 2000
- Mental health legislation is now a harmful anachronismPsychiatric Bulletin, 1998
- The MacArthur Treatment Competence Study. III: Abilities of patients to consent to psychiatric and medical treatments.Law and Human Behavior, 1995
- Two scales for measuring patients' perceptions for coercion during mental hospital admissionBehavioral Sciences & the Law, 1993
- The Assessment of Insight in PsychosisThe British Journal of Psychiatry, 1992
- Insight and PsychosisThe British Journal of Psychiatry, 1990
- Why must some schizophrenic patients be involuntarily committed? The role of insightComprehensive Psychiatry, 1989
- “Mini-mental state”: A practical method for grading the cognitive state of patients for the clinicianJournal of Psychiatric Research, 1975