Capacity Assessment and Information Provision for Voluntary Psychiatric Patients: a service evaluation in a UK NHS Trust

Abstract

Since the Cheshire West judgement, yearly applications for the Mental Health Act (MHA) and Deprivation of Liberty Safeguards (DoLS) have increased, though many patients are still admitted informally. To ensure lawfulness, informal admissions must be capacitous, informed, and without coercion. If fully capacitous consent is not obtained, then there is a risk of “de facto” detention and deprivation of liberty.  Deprivation of liberty is only lawful through appropriate legal frameworks (DoLS for incapacitous, non-objecting hospital inpatients, or MHA otherwise).  Use of such legal frameworks might be hampered by the perceived stigma associated with them, though this may not be in the best interests of the patient.

We aimed to examine the assessment of capacity and provision of adequate information required for an informed voluntary psychiatric admission, and any evidence of possible coercion into informal admission. We postulate variable use of legal frameworks designed to empower patients and prevent illegal deprivation of liberty.