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Mental capacity and psychiatric admission

BMJ 2008; 337 doi: (Published 30 June 2008) Cite this as: BMJ 2008;337:a116
  1. John Dawson, professor
  1. 1University of Otago, PO Box 56, Dunedin, New Zealand
  1. john.dawson{at}

    Many patients lack capacity to consent to treatment on admission, but not all qualify for treatment under the Mental Capacity Act

    When the Mental Capacity Act 2005 and the Mental Health Act 2007 are fully implemented in England and Wales over the next year, both will be available to authorise a person’s psychiatric treatment without consent. The two acts are based, however, on different legal standards.1 The Mental Capacity Act may be used only when a person lacks the capacity to consent. The Mental Health Act, in contrast, can be used regardless of a person’s capacity to consent, if the act’s different criteria of mental disorder, risk of harm, availability of treatment, and so on, apply. Nevertheless, a person can be covered by both acts at the same time, in which case clinicians would have to choose which one to apply.2

    In their linked study, Owen and colleagues throw some light on the frequency with which this choice between legal options will arise.3 In a study of 350 consecutive admissions to psychiatric care …

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