The Mental Health Act 1983 and incapacity: what general hospital doctors know

Abstract

Aims and MethodA questionnaire survey of general hospital doctors was conducted before and after a 1h training intervention. Baseline levels of knowledge and confidence regarding the use of section 5(2) of the Mental Health Act 1983 and assessment and management of incapacitated patients were determined. Following a training intervention, improvements in these areas were established.ResultsEighteen doctors participated. Confidence in assessing capacity and the knowledge of treatment under common law and section 5(2) were low at baseline. Improvements were seen following the training intervention, with four knowledge items relating to section 5(2) achieving statistically significant improvements.Clinical ImplicationsSimple training interventions delivered by psychiatrists may be an effective way of improving the knowledge and confidence of general hospital doctors.

What do NHS staff learn from training on the Mental Capacity Act (2005)?

“…Consequently, implementation of the MCA presents a challenge to services (Hardy & Joyce, 2009; Johnston & Liddle, 2007). Many studies have reported a generally poor state of knowledge regarding consent to treatment, and other mental capacity issues, among doctors and other National Health Service (NHS) staff (Evans, Warner, & Jackson, 2007; Fisher‐Jeffes, Barton, & Finlay, 2007; Guvver, Hindle, Harrison, Jain, & Brinsden, 2010; Jackson & Warner, 2002; McCullough, 2009; Richards & Dale, 2009; Sawhney, Mukhopadhyay, & Karki, 2009; Schofield, 2008; Willner, Jenkins, Rees, John, & Griffiths, 2011), though two recent studies of specialist staff were more encouraging (Shah, Banner, Heginbotham, & Fulford, 2010; Wilson, Seymour, & Perkins, 2010). While some mental capacity issues may need a specialist assessment, any health care worker could be faced with a patient whose capacity is uncertain, so it is essential that mental capacity issues are understood generally, not simply in specialist services.…”

Knowledge of Mental Capacity Issues in Community Teams for Adults with Learning Disabilities

“…2007; Fisher‐Jeffes et al. 2007; Richards & Dale 2009). A recent survey of learning‐disability psychiatrists reported a similarly poor understanding of situations requiring an IMCA referral and the legal situation regarding people who lack capacity to consent to be detained (Sawhney et al.…”

Knowledge and confidence of the mental health act in Scotland: a survey of general practitioners

“…The overwhelming majority were keen to explore further teaching and training in this area and this is something that is in keeping with the limited previous research in this area. 6,7,10 The majority of respondents felt their knowledge of the mental health act was fair or better, with a third of respondents identifying their knowledge of this legislation as poor. Some previous studies have found a lack of knowledge amongst psychiatrists and general hospital doctors with regard to the assessment of mental capacity, however there is limited literature on knowledge of GPs, particularly in Scotland.…”

“…Some previous studies have found a lack of knowledge amongst psychiatrists and general hospital doctors with regard to the assessment of mental capacity, however there is limited literature on knowledge of GPs, particularly in Scotland. 10,11 More than half of respondents rated their confidence in using the act is poor or worse. NICE guidelines on service user experience set out that those performing assessments under the mental health act should do so ''in a calm and considered way'' and this is something that would likely be affected by the confidence of the medical practitioner involved.…”