Purpose – This review of the decision‐making literature aims to challenge the rational model of decision‐making upon which the Mental Capacity Act (MCA) 2005 is premised. Design/methodology/approach – The paper forms part of a larger study commissioned by the Office of the Public Guardian looking into complex cases. Findings – The literature supported the study findings that decisions are not made in a linear way and identified the importance of history and memory, motivation and drive, mood and stability, and openness to influence when assessing the mental capacity of vulnerable people, especially in the context of self‐neglect. Practical implications – This paper will inform workers in health and social care about the emotional factors that influence decision‐making and increase their ability to make nuanced assessments. Social implications – Taken together, with other publications from this project, this paper alerts practitioners to situations where vulnerable people are out of their depth; when the role of depression and anxiety may be at least as salient as their understanding of possible consequences and when the past may exert more control over their actions than their understanding of future options. Originality/value – The paper's added value is that it uses ideas that are current within academic psychology to make explicit some of the factors that lead to complexity when assessing mental capacity under the MCA, especially in the context of self‐neglect.
The Journal of Adult Protection – Emerald Publishing
Published: Aug 15, 2011
Keywords: Mental capacity; Decision making; Vulnerable adult; Neglect; Self‐neglect; Service‐refusal; Psychology; Depression
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