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

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


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.


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


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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  • Source of funding: The Wellcome Trust, UK.


  • Competing interests: None.