MC4 Assessing mental capacity

There are a number of steps involved in a mental capacity assessment. These are shown below.

• The starting point
  • the principles of the presumption of capacity and respecting a person’s entitlement to make unwise decisions with capacity are the starting point for any capacity assessment.
• Capacity is decision and time specific
  • saying that someone lacks capacity is meaningless. You must ask yourself: “what is the specific decision that needs to be made at this point in time?” If you don’t define this question before you start undertaking the assessment, the exercise will be pointless and may lead to the wrong outcome.
• Preparation
  • for capacity assessments – remember that a crucial step of assessing capacity is to prepare yourself for the assessment. Don’t go in with a blank canvas.
• Take all practicable steps
  • you have to ask yourself if there is something that you can do which might mean that an individual would be able to make the decision for themselves.
• Applying the test
  • the MCA test for capacity has two aspects:
    • the diagnostic element (that is, is there an impairment of, or a disturbance in the functioning of, the mind or brain?)
    • the functional element (is the person unable to make a decision because of the impairment?).
  • Being unable to make a decision means being unable to understand, retain or “use or weigh” information relevant to the decision, or to communicate their decision.

Let’s now look at the fifth step in this list, which is the two-stage test for assessing mental capacity.