{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,2]],"date-time":"2026-05-02T18:18:10Z","timestamp":1777745890092,"version":"3.51.4"},"reference-count":26,"publisher":"F1000 Research Ltd","license":[{"start":{"date-parts":[[2021,6,10]],"date-time":"2021-06-10T00:00:00Z","timestamp":1623283200000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100012317","name":"UCLH Biomedical Research Centre","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100012317","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100010269","name":"Wellcome Trust","doi-asserted-by":"crossref","award":["203376"],"award-info":[{"award-number":["203376"]}],"id":[{"id":"10.13039\/100010269","id-type":"DOI","asserted-by":"crossref"}]}],"content-domain":{"domain":["wellcomeopenresearch.org"],"crossmark-restriction":false},"short-container-title":["Wellcome Open Res"],"abstract":"<ns3:p>\n                    <ns3:bold>Background:\u00a0<\/ns3:bold>\n                    The Mental Capacity Act (2005) of England and Wales described in statute a test to determine whether a person lacked the \u201cmental capacity\u201d to make a particular decision. No large-scale survey has explored experiences of capacity assessment across professional groups.\n                  <\/ns3:p>\n                  <ns3:p>\n                    <ns3:bold>Methods:<\/ns3:bold>\n                    We administered an opportunistic self-report questionnaire survey of professionals who undertake capacity assessments in England and Wales (n= 611). Topics of interest included; how often and where capacity assessment took place, self-ratings of competency and challenges experienced in assessment, use of psychological testing and concerns about undue influence. We analysed the quantitative responses using a mixed-methods approach using regression methods for the quantitative ratings and a thematic analysis for qualitative data.\n                  <\/ns3:p>\n                  <ns3:p>\n                    <ns3:bold>Results:\u00a0<\/ns3:bold>\n                    Our sample included 307\/611 (50.2%), social workers, 89\/611 (14.6%) psychiatrists, 62\/611 (10.1%) nurses, 46\/611 (7.5%) clinical psychologists, 30\/611 (4.9%) doctors from other medical specialties, 12\/611 (2.0%) speech and language therapists and 8\/611 (1.3%) solicitors. 53% of these professionals undertook more than 25 capacity assessments per year, with psychiatrists, social workers and nurses undertaking them the most frequently. Most professionals reported high self-ratings of confidence in their assessment skills, although non-psychiatrist doctors rated themselves significantly lower than other groups (p&lt; .005). Most professionals (77.1%) were at least moderately concerned about undue influence, with people with dementia and learning disabilities and older adults considered to be the most at risk. Qualitative themes for challenges in capacity assessment included inter-disciplinary working, complicated presentations and relational issues such as interpersonal influence. Requests for support mainly focused on practical issues.\n                  <\/ns3:p>\n                  <ns3:p>\n                    <ns3:bold>Conclusions:<\/ns3:bold>\n                    Most professionals feel confident in their ability to assess capacity but note substantial challenges around practical and relational issues. Undue influence is a particularly common concern amongst professionals when working with service users with dementia and learning disabilities which public services and policy makers need to be mindful of.\n                  <\/ns3:p>","DOI":"10.12688\/wellcomeopenres.16823.1","type":"journal-article","created":{"date-parts":[[2021,6,10]],"date-time":"2021-06-10T10:33:22Z","timestamp":1623321202000},"page":"144","update-policy":"https:\/\/doi.org\/10.12688\/wellcomeopenres.crossmark-policy","source":"Crossref","is-referenced-by-count":10,"title":["Experiences of assessing mental capacity in England and Wales: A large-scale survey of professionals"],"prefix":"10.12688","volume":"6","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-0565-2502","authenticated-orcid":false,"given":"Kevin","family":"Ariyo","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2742-5178","authenticated-orcid":false,"given":"Andrew","family":"McWilliams","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Anthony S.","family":"David","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5166-9332","authenticated-orcid":false,"given":"Gareth S.","family":"Owen","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"2560","published-online":{"date-parts":[[2021,6,10]]},"reference":[{"key":"ref-1","article-title":"Capacity Survey Anonymised Data and Questionnaire.","author":"K Ariyo","year":"2021","journal-title":"figshare."},{"key":"ref-2","doi-asserted-by":"publisher","first-page":"464-469","DOI":"10.1111\/j.1467-842X.2001.tb00294.x","article-title":"How can I deal with missing data in my study?","volume":"25","author":"D Bennett","year":"2001","journal-title":"Aust N Z J Public Health."},{"key":"ref-3","doi-asserted-by":"publisher","first-page":"77-101","DOI":"10.1191\/1478088706qp063oa","article-title":"Using thematic analysis in psychology.","volume":"3","author":"V Braun","year":"2006","journal-title":"Qual Res Psychol."},{"key":"ref-4","doi-asserted-by":"publisher","first-page":"26152","DOI":"10.3402\/qhw.v9.26152","article-title":"What can \u201cthematic analysis\u201d offer health and wellbeing researchers?","volume":"9","author":"V Braun","year":"2014","journal-title":"Int J Qual Stud Health Well-being."},{"key":"ref-5","article-title":"The Mental Capacity Act 2005: A Guide for Practice.","author":"R Brown","year":"2015"},{"key":"ref-6","first-page":"120-123","article-title":"Teaching thematic analysis: Overcoming challenges and developing strategies for effective learning.","volume":"26","author":"V Clarke","year":"2013","journal-title":"psychologist."},{"key":"ref-7","doi-asserted-by":"publisher","first-page":"107-112","DOI":"10.1177\/001316447303300111","article-title":"Eta-squared and partial eta-squared in fixed factor ANOVA designs.","volume":"33","author":"J Cohen","year":"1973","journal-title":"Educ Psychol Meas."},{"key":"ref-8","article-title":"Undue Influence in decision-making support for people with mental disabilities: A scoping paper.","author":"J Craigie","year":"2020"},{"key":"ref-10","doi-asserted-by":"publisher","first-page":"189-198","DOI":"10.1016\/0022-3956(75)90026-6","article-title":"\u201cMini-mental state\u201d. a practical method for grading the cognitive state of patients for the clinician.","volume":"12","author":"M Folstein","year":"1975","journal-title":"J Psychiatr Res."},{"key":"ref-12","doi-asserted-by":"publisher","first-page":"128-135","DOI":"10.1111\/j.1471-6712.2007.00561.x","article-title":"Relational autonomy or undue pressure? 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status","group":{"name":"current-referee-status","label":"Current Referee Status"}},{"value":"10.21956\/wellcomeopenres.18558.r44444, John Dawson, Faculty of Law, University of Otago, Dunedin, New Zealand, 29 Jun 2021, version 1, indexed","URL":"https:\/\/wellcomeopenresearch.org\/articles\/6-144\/v1#referee-response-44444","order":0,"name":"referee-response-44444","label":"Referee Report","group":{"name":"article-reports","label":"Article Reports"}},{"value":"10.21956\/wellcomeopenres.18558.r44466, Peter Bartlett, School of Law and Institute of Mental Health, University of Nottingham, Nottingham, UK, 30 Jun 2021, version 1, indexed","URL":"https:\/\/wellcomeopenresearch.org\/articles\/6-144\/v1#referee-response-44466","order":1,"name":"referee-response-44466","label":"Referee Report","group":{"name":"article-reports","label":"Article Reports"}},{"value":"This research is funded by the Wellcome Trust Collaborative Award in Humanities & Social Science [203376], made to G.O. as Principal Investigator in the Mental Health and Justice Project, and paying the research costs for K.A. and salary of A.McW. Additional support for A.S.D. is provided by the UCLH National Institute of Health Research Biomedical Research Centre. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.","order":2,"name":"grant-information","label":"Grant Information"},{"value":"This is an open access article distributed under the terms of the Creative Commons Attribution Licence, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.","order":0,"name":"copyright-info","label":"Copyright"}]}}