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The Mental Capacity Act 2005 (MCA) was fully implemented in October 2007 in England and Wales. This article reports on two similar, but separate, pilot questionnaire…
The Mental Capacity Act 2005 (MCA) was fully implemented in October 2007 in England and Wales. This article reports on two similar, but separate, pilot questionnaire studies that examined the experience of consultants in old age psychiatry and consultants in other psychiatric specialities in the early implementation of the MCA pertaining to issues relevant to black and minority ethnic (BME) groups. Fifty‐two (27%) of the 196 consultants in old age psychiatry and 113 (12%) of the 955 consultants in other psychiatric specialities returned useable questionnaires. Eighty per cent or more of the consultants in old age psychiatry and consultants in other psychiatric specialities gave consideration to religion and culture and ethnicity in the assessment of decision‐making capacity (DMC). Almost 50% of the consultants in old age psychiatry reported that half or more of the patients lacking fluency in English or where English was not their first language received an assessment of DMC with the aid of an interpreter and 40% of the consultants in other psychiatric specialities reported that no such patients received an assessment of DMC with the aid of an interpreter.The low rate of using interpreters is of concern. The nature of the consideration and implementation of factors relevant to culture, ethnicity and religion in the application of the MCA and the precise reasons for the low rate of using interpreters in patients lacking fluency in English or English not being their first language require clarification in further studies.
This article considers the effectiveness of two one‐day events designed to raise awareness of The Mental Capacity Act 2005 (MCA) in BME communities. The events were held…
This article considers the effectiveness of two one‐day events designed to raise awareness of The Mental Capacity Act 2005 (MCA) in BME communities. The events were held using specially developed materials and were evaluated with the help of a 12‐item questionnaire. The results of the evaluation showed that there was an increase in the proportion of correct responses for 10 of the 12 questions after attending awareness‐raising events. The total score for all correct responses on the 12‐item questionnaire significantly increased after attending the awareness‐raising events. Collectively, the findings suggest that the awareness‐raising events were able to improve awareness of the MCA among representatives of BME communities. Such awareness‐raising events should be encouraged by health and social care providers
The Mental Capacity Act 2005 (MCA) was fully implemented in October 2007 within England and Wales as a framework for making decisions about incapacitated persons' care and…
The Mental Capacity Act 2005 (MCA) was fully implemented in October 2007 within England and Wales as a framework for making decisions about incapacitated persons' care and treatment generally not amounting to a deprivation of their liberty (although such could be authorised under its powers by the new Court of Protection). From a planned date of April 2009, the MCA is to be enlarged by the provisions of the Mental Health Act 2007 (MHA 2007) to encompass deprivation of liberty, with the addition of a new framework of Deprivation of Liberty Safeguards (DOLS). The MHA 2007 also revised significant aspects of the Mental Health Act 1983 (MHA), which were implemented in November 2008. The interface between the MCA, as amended to include DOLS, and the revised MHA is complex and potentially ambiguous. This paper describes in detail some issues that may arise at the interface of the two acts, and seeks to inform professionals involved in the use of these legal frameworks of the resulting complexity.
As a healthcare professional caring for people who lack capacity, the author has noted a wide variation in knowledge and awareness by staff of the Deprivation of Liberty…
As a healthcare professional caring for people who lack capacity, the author has noted a wide variation in knowledge and awareness by staff of the Deprivation of Liberty Safeguards (DoLS). The purpose of this paper is to examine the DoLS and the background to their coming into being, describes their operation and qualifying requirements, and the continuing problems with their application nationwide.
Utilising a literature search of government papers, official reports of statutory bodies, and critical studies, it examines the central criticisms of DoLS, particularly the lack of a clear statutory definition of deprivation of liberty, and reports on the wide variation in knowledge of the legislation by staff in health and social care, and uneven application of the safeguards nationwide.
It cites evidence from studies showing that even professionals with high levels of expertise in the field find the legislation confusing, and presents testimony from legal experts that case law has failed to clarify the issues for professionals.
Finally, it argues that the legislation is now too complex to successfully amend, and tentatively suggests that, pending a government review to make the process more understandable, health care professionals make ‘precautionary’ applications for DoLS. The author argues that, notwithstanding its faults, the process is a worthwhile exercise in care planning and ensuring that people's care is in their best interests and the least restrictive available.
In the last four years, since Volume I of this Bibliography first appeared, there has been an explosion of literature in all the main functional areas of business. This…
In the last four years, since Volume I of this Bibliography first appeared, there has been an explosion of literature in all the main functional areas of business. This wealth of material poses problems for the researcher in management studies — and, of course, for the librarian: uncovering what has been written in any one area is not an easy task. This volume aims to help the librarian and the researcher overcome some of the immediate problems of identification of material. It is an annotated bibliography of management, drawing on the wide variety of literature produced by MCB University Press. Over the last four years, MCB University Press has produced an extensive range of books and serial publications covering most of the established and many of the developing areas of management. This volume, in conjunction with Volume I, provides a guide to all the material published so far.
The purpose of this paper is to give a brief background to the Deprivation of Liberty Safeguards (DoLS), and studies which factors Best Interests Assessors consider when…
The purpose of this paper is to give a brief background to the Deprivation of Liberty Safeguards (DoLS), and studies which factors Best Interests Assessors consider when making a judgement on Deprivation of Liberty. It examines some of the reasons why professionals may be under-using DoLS, including lack of knowledge, complex processes and paperwork, and the pejorative nature of the word “deprivation”, and looks at a possible way forward.
The paper looks at the evidence to the House of Commons and House of Lords Committees on the Mental Health Act and Mental Capacity Act, as well as previous and current research papers. It examines the nuances of difference between restriction and deprivation, and the cumulative impact of several restrictions, which may, in fact, amount to a deprivation, illustrated by case studies from the author's own practice.
It makes the case that health and social care professionals should err on the side of caution, by making precautionary DoLS applications, arguing that MCA DoLS is a forerunner of good practice, and that good care planning allied to judicious application of the MCA leads to better, more robust and more defensible decision making.
And it points the way to a possible future, citing the recommendations of the Select Committee on the MCA for a clearer link between DoLS and the principles underpinning the MCA, and for simplifying and clarifying the legislative provisions and the associated paperwork.