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People admitted to psychiatric hospitals commonly lack the mental capacity to make treatment decisions

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QUESTION

Question:

What proportion of people admitted to psychiatric hospitals have the mental capacity to make decisions on treatment?

Population:

350 people consecutively admitted for psychiatric care. Exclusions: no written informed consent; change in choice or resistance to assessment; residence outside catchment area or transferred from other inpatient facilities.

Setting:

Three general adult psychiatric wards serving an inner city area, Maudsley Hospital, London, UK; February 2006–June 2007.

Assessment:

Information on patient’s presenting problems, diagnosis and treatment plan were obtained from medical records. The clinical researcher ascertained whether the main decision about treatment was stabilisation with drugs, admission to a place of safety or further assessment. Decision about a patient’s mental capacity was based on a clinical assessment and the McArthur competence assessment tool for treatment. The McArthur tool consists of an …

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