Assessment of mental capacity

We read with interest the article by Church & Watts on the assessment of mental capacity (Psychiatric Bulletin, August 2007, 31, ). The Mental Capacity Act 2005 came into effect in April 2007. However, are clinicians and other health professionals prepared and equipped to implement the Act? Any attempt to clarify capacity assessment as in the flow chart described by Church & Watts is helpful. In a survey earlier this year we found that many medical professionals outside the field of mental health are unaware of the Act and have had no training in assessing mental capacity. This is highly relevant as the Act states that ‘the person who is required to assess an individual's capacity will be the person contemplating making a decision on behalf of the person who is to be assessed’. Most old age psychiatrists are familiar with requests from general wards to assess ‘ this patient's capacity’, especially when a discharge placement is in question. The Act is clear that having a psychiatric diagnosis (e.g. dementia) does not imply lack of capacity as long as the person passes the components of the capacity test. However, the Code of Practice also lists instances when an ‘opinion from a professional may be required’. In the coming months will non-psychiatric clinicians stop sending their referrals or will liaison and old age psychiatrists be flooded with requests for assessment? What is now required is clear guidance drawn up jointly by primary care, acute and mental health trusts, and training to be widely available to all professionals.