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The Mental Health Act 2007 makes significant amendments to the Mental Health Act 2003, and also amends the Mental Capacity Act 2005 with the introduction of ‘deprivation of liberty safeguards’.

Following a case in the 1990s when a learning‐disabled man was admitted to hospital unlawfully, the UK government has introduced the Deprivation of Liberty Safeguards into the Mental Capacity Act 2005. This article discusses the case that was the background to the legislation, explores the safeguards, and discusses the impact on services and individuals in the UK.

What is the difference between a deprivation of liberty and a restriction upon liberty? This sounds like a question for a lawyer, but it is a one to which staff in health and social care institutions will need to know the answer when the new Deprivation of Liberty Safeguards are implemented in April 2009.

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.

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.

Psychiatrists are among the front‐line professionals involved in the implementation of Deprivation of Liberty Safeguards (DOLS). This paper aims to explore how the safeguards are perceived and practised amongst psychiatrists.

The authors carried out a postal survey among 519 psychiatrists on their views and experiences on DOLS.

A total of 171 psychiatrists (36 per cent) responded to the survey. Nearly three‐quarters of the participants had received DOLS training and 81 per cent of individuals who had training believed that DOLS would protect the rights of vulnerable people. Almost half of both groups agreed that DOLS make a valuable contribution to the provision of necessary care in the least restrictive way possible. The most common concern raised was possible increase in bureaucratic process. Interface between the existing legislations continues to be a grey area for many practitioners with difficulties in interpreting the relevant Code of Practice. In total, 50 per cent of the participants felt DOLS should extend to community placement provisions.

The views and concerns expressed by psychiatrists in this paper are relevant to all professionals working with adults who lack capacity to consent to their care or treatment in any setting. As the process continues to widen, it is important to recognise the issues, encourage use of DOLS process to protect human rights, and to address key gaps in training.

On the 1st April 2009 all local authorities and primary care trusts were legally obliged to implement procedures to conform with the new Mental Capacity Act Deprivation of Liberty Safeguards (MCADOLS). This article looks at practical issues in implementation.

The purpose of this paper is to introduce the readership to the consultation being held by the Law Commission concerning proposed revisions to the Deprivation of Liberty Safeguards (DoLS).

Discussion of the consultation being held by the Law Commission concerning proposed revisions to the DoLS.

These are as yet unknown as the consultation period is ongoing – it is planned that a future paper will examine the findings and recommendations from the consultation process.

There has been criticism of the DoLS since their introduction in 2009. A new scheme provides the opportunity to respond to some of the criticisms and to develop more appropriate processes. The paper invites readers to take part in the consultation process and to respond to the proposals that have been developed.

A new and more appropriate scheme would be beneficial for service users and families/caregivers.

This is the first opportunity for a revision to the DoLS scheme and introduction of the proposed scheme and the consultation process to the readership is highly appropriate and valuable to the Journal.

Deprivation of Liberty Safeguards (DoLS), as part of the Mental Capacity Act 2005 (DoLS, 2007), was established to provide a legal framework for decision-making in respect of adults who lack capacity to make decisions in relation to their care and residence in England and Wales. The purpose of this study was to explore the DoLS decision-making process from the perspectives of health and social care practitioners when working with individuals with an acquired brain injury (ABI).

A total of 12 health and social care practitioners were interviewed in 2019–2020 about their experiences of using and making or supporting decisions in the DoLS framework with ABI survivors. Data were analysed, and a tentative explanation of variations in DoLS decision-making was developed.

Three distinct approaches emerged capturing different decision-making styles (risk-averse, risk-balancing and risk-simplifying) which appeared to influence the outcome of DoLS assessments. A range of mediating factors seemed to account for the variability in these styles. The wider contextual challenges that impact upon practitioners’ overall experiences and use of DoLS processes in their ABI practice were noted.

The findings highlight a need for changes in practice and policy in relation to how DoLS or similar processes are used in decision-making practice with ABI survivors and may be relevant to the implementation of the Liberty Protection Safeguards that are replacing the DoLS system.

To the best of the authors’ knowledge, this is the first study to explore accounts of DoLS decision-making practices in ABI service.

A recent case in the Court of Protection has focused attention on the legal position of supported living arrangements for people with learning disabilities. As well as the question of whether there had been a deprivation of liberty, the court also considered the validity of the tenancy and whether the arrangements constituted a ‘care home’, such that registration under the Care Standards Act would be required.