Assessing Mental Capacity : A Handbook to Guide Professionals from Basic to Advanced Practice book cover
1st Edition

Assessing Mental Capacity
A Handbook to Guide Professionals from Basic to Advanced Practice

ISBN 9781138102774
Published May 18, 2020 by Routledge
444 Pages 4 B/W Illustrations

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Book Description

This practical, how-to handbook provides essential resources to help clinicians and other professionals assess mental capacity in key decisions. The book illustrates the basics of capacity assessments before discussing a variety of complex issues of which professionals will need to be aware. Offering expertise from a multi-disciplinary perspective, the book provides hands-on coverage of mental capacity law (concentrating on England and Wales).

This book is accompanied by online resources including semi-structured interviews and a multi-disciplinary team (MDT) questionnaire which can be downloaded and used for clinical cases, as well as further examples, information and tips. Please visit

Chapters are written by a variety of different professionals with extensive experience in the assessment of mental capacity. Coverage includes:

  • Explanations of mental capacity law and how to put it into practice across a range of settings, services and populations
  • A "how to" approach for administering assessments of mental capacity both for professionals who are new to the area and for more experienced professionals
  • Information on practical aspects of assessing mental capacity for commonly occurring decisions and for more specialist and complex decisions
  • Consideration of the best interests process and Liberty Protection Safeguards (LPS).

With easily accessible information, case studies, examples from case law and internationally relevant discussions on ethical issues, this is the perfect companion to help busy professionals understand complex concepts relating to mental capacity.

Table of Contents


Part 1. Getting Started

Chapter 1. Mental Capacity Past, Present and Future: An Overview

Chapter 2. Some Basic Concepts of the Mental Capacity Act (2005): What You Need to Know

Chapter 3. Legal Perspectives on Practical Capacity Concerns

Chapter 4. International Perspectives on Mental Capacity Law

Part 2. Factors to Consider

Chapter 5. Psychosocial Aspects of Decision-Making and the Assessment of Mental Capacity

Chapter 6. A Functional Perspective to Information Gathering, Risk Assessment and Insight-Building

Chapter 7. Information Relevant to the Decision: Deciding What the Person Needs to Know, and to What Extent, in Order to be Able to Make a Decision

Chapter 8. Introducing a Capacity Assessment to the Person, Family and Carers

Chapter 9. How to Provide Relevant Information and Enhance Mental Capacity

Chapter 10. Capacity Assessment and Cognitive Impairment

Chapter 11. Communication in the Context of Assessing Mental Capacity

Chapter 12. Using a Semi-Structured Interview to Assess Capacity

Part 3. Specific Decisions and Conditions

Chapter 13. Capacity to Consent to Medical Procedures

Chapter 14. Advance Care Planning

Chapter 15. Capacity Assessment for Swallowing Disorders and Feeding Management

Chapter 16. Assessing Capacity in Relation to a Change of Residence or Accommodation and Care Needs

Chapter 17. Assessing Capacity to Consent to Sexual Relations

Chapter 18. Assessing Capacity to Manage Financial Affairs

Chapter 19. Assessing Capacity in Relation to Signing a Tenancy Agreement

Chapter 20. The Courtroom: Capacity to Litigate, Fitness to Plead and Fitness to be a Witness

Chapter 21. Assessing the Mental Capacity of People Living with Dementia: Getting Practice Right

Part 4. Complex Situations

Chapter 22. What to do When Someone Says One Thing, but Does Another: Capacity to Make a Decision and Put it Into Practice

Chapter 23. Assessment of Mental Capacity to Make High-Risk Decisions

Chapter 24. Assessing Mental Capacity When the Decision Needs to be Made Urgently

Chapter 25. Mental Capacity Assessment: What to do When Someone is Refusing to Engage or is Ambivalent

Chapter 26. Changes in Capacity Over Time and in Different Situations

Chapter 27. Involving Friends, Family and Other Professionals in the Assessment of Mental Capacity and the Best Interests Process and Dealing with Any Potential Conflict

Part 5. Issues related to the Mental Capacity Act (2005)

Chapter 28. Capacity Assessment, Deprivation of Liberty and the Liberty Protection Safeguards

Chapter 29. Best Interests Decisions

Chapter 30. The Mental Capacity Act’s Interaction with Other Legislation

Part 6. Additional Considerations

Chapter 31. Ethical Issues in Capacity Assessments and their Outcomes

Chapter 32. Assessing Capacity for the Court or as an Independent Practitioner

Chapter 33. Teaching and Training Capacity Assessors


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Dr. Janice A. Mackenzie is a consultant clinical neuropsychologist who has a specialist interest in mental capacity dating back to 2002. She has published research, presented at conferences and provided training on mental capacity to numerous professionals. She developed a semi-structured interview which has been adapted for various different mental capacity assessments.


Dr. Kate E. Wilkinson is a consultant clinical neuropsychologist who has been carrying out complex capacity assessments since 2010 and has developed a particular interest in the complex ethical and sociopolitical aspects of such work. She routinely provides formal teaching, supervision and consultation on mental capacity to professionals from other disciplines.


"A really useful summary of the relevant information and legal guidance coupled with practical tips, cautionary notes and points to remember when assessing mental capacity. It provides illustrative examples of common decisions in clinical practice and discusses complex situations such as high risk decisions, the ‘frontal lobe paradox’, and refusals to engage with the assessment of mental capacity. This book will be a helpful resource for practitioners both for those new to assessments of mental capacity and for those with more experience." Dr Camilla Herbert, Consultant Clinical Neuropsychologist