This guide is for people detained under section 2 and 3 of the Mental Health Act or if you are staying in hospital as a voluntary patient. A voluntary patient (also called an informal patient) is someone who is in hospital but is not detained under the Mental Health Act. They can leave hospital at any time. However, if health professionals are concerned about their safety or the safety of others, they can stop them from leaving for up to 72 hours. The guide explains what rights individuals have and what should happen to them at different stages through their journey in hospital. There are six parts to this guide. The first four parts (A-D) relate to the different stages of stay in hospital in time order, covering: the decision to detain; being detained in hospital; staying in hospital; and leaving hospital. Part E explains how to make a complaint at any stage of one’s stay in hospital; and Part F explains some of the key terms used in this document.

This document sets out to inform and support psychologists to make informed, sound clinical judgements and decisions across a range of sometimes very different situations where a client’s capacity to make their own decisions is being questioned. The document is the culmination of a consensus which has developed since the implementation of the MCA 2005 in England and Wales, itself drawing on Scottish experiences, including clinical practice and experience, research studies and case law. The document’s structure follows the chronological flow of a considered approach to assessment. It starts with an overview of the current legal context, followed by necessary preparatory steps and aspects of completing a best practice assessment (including consideration of the use of psychometric inventories) before drawing together the threads of information collected and forming defensible, balanced, well evidenced opinions, conclusions and recommendations.

This document sets out to define the process that professionals should follow when making judgements about a person’s capacity to consent to medical treatment.

Annual report on the use of the Mental Health Act (MHA), looking at how providers are caring for patients, and whether patients’ rights are being protected. The report sets out CQC’s activity and findings from our engagement with people subject to the MHA and review of services registered to assess, treat and care for people detained using the MHA during 2020/21. It is largely based on feedback letters on the 620 remote monitoring letters following reviews of 682 wards carried out during 2020/21. These involved private conversations with 1,895 patients and 1,111 carers. The report highlights three key findings. Firstly, the workforce is under extreme pressure; the pandemic has placed additional stresses on staff, patients and carers; staff are now exhausted, with high levels of anxiety, stress and burnout, and the workforce is experiencing high levels of vacancies. The negative impact of working under this sustained pressure poses a challenge to the safe, effective and caring management of inpatient services and to the delivery of care in a way that maintains people’s human rights. Secondly, community services are key to reducing levels of detention in hospital. Not getting the right help at the right time can lead to symptoms worsening and people needing inpatient care. During the pandemic this has been a particular concern for children and young people. We have seen an increase in the numbers of children and young people being cared for in inappropriate settings while they wait for an inpatient bed. Thirdly, urgent action is needed to address longstanding inequalities in mental health care. We remain concerned that Black or Black British people are more likely to be detained under the MHA, spend longer in hospital and have more subsequent readmissions than White people.

This factsheet explains what mental capacity is, outlines the key principles or rules of the Mental Capacity Act, and looks at how it can be applied when planning for the future. Topics covered include decision-making and mental capacity; the principles of the Mental Capacity Act; assessing capacity; making decisions; planning ahead; and when someone hasn’t planned ahead – deputyship.

This factsheet outlines the responsibilities of a deputy, how to apply to become
one, and factors to consider before deciding to do so.

This guidance explains how a person can manage a bank or building society account on another person’s behalf, including on behalf of a person who does not have mental capacity. It describes the circumstances in which this is possible and how it can be done. It also sets out the documents that need to be shown the bank or building society to be able to manage the account. This guidance applies to England and Wales.

Findings from a study to gather information from people who have experienced Do Not Attempt Resuscitation (DNAR) decision making, both since and prior to the Coronavirus pandemic. The report shows a worrying picture around the rights of involvement in care and treatment decisions, including DNARs. The evidence depicts serious issues of discrimination related to disability and age, and the intersection between the two, as well as other factors. Coronavirus has shone a spotlight on this, and some reported an increase in worrying DNAR decisions; but none of this is new, these problems are ongoing. The report’s key findings are: 100% of people involved said there needs to be more easily accessible information about human rights; almost 60% of people involved said they had received no information about their right to life during Coronavirus; 65% of people involved said that they (or a person they care for/about) had a DNAR order put on your medical file. 21% said they didn’t know; of those who had seen a DNAR order put in place almost half (47%) were not related to end-of-life care; less than a third of people (29%) who were involved in DNAR decision-making felt fully listened to, most felt listened to a bit (46%), and 25% felt not listened to; 91% of people involved felt that discrimination was an issue in the DNAR decisions they’d experienced.

This toolkit provides practical guidance to assist doctors in making decisions in the best interests of adults who lack capacity in England and Wales. It sets out an overview of the law; outlines a clear decision-making process to follow; and provides detailed practical advice as to who doctors should consult and the information they need in reaching a decision.

This toolkit acts as a prompt to doctors when they are providing care and treatment for people who lack, or who may lack, the mental capacity to make decisions on their own behalf.

This factsheet explains how advance decisions and advance statements work,
and what they can and cannot do. It also provides practical advice to help
draft an advance decision.

A dementia-friendly financial services charter designed to enable the sector to work towards becoming dementia-friendly. In addition to the charter, the document sets out the expectations for a dementia-friendly financial services sector and provides guidance on the commitments in the charter.