Decision making (DOLs and MCA)

When mental health affects the ability to make decisions

Every day, people make decisions about lots of things in their lives. The ability to make decisions is called mental capacity. People may have difficulties making some decisions either all or some of the time. This could be because they have a learning disability, dementia, a mental health problem, or could be the result of a head injury or a stroke or a temporary condition such as an illness, accident or the influence of alcohol or drugs.

The Mental Capacity Act 2005 sets out the legal rights for supporting and protecting vulnerable people who are not able to make their own decisions. It makes clear who can take decisions, in which situations, and how they should go about this. It also allows people to plan ahead for a time when they may lose capacity. It affects families, carers, health and social care staff, and other people who have contact with people who lack capacity. It could cover decisions about financial matters, social care, medical treatment and research arrangements, as well as everyday decisions about personal care.

The Deprivation of Liberty safeguards (DOLS) have been introduced into the Mental Capacity Act 2005 by the Mental Health Act 2007. The safeguards apply to people who have a mental disorder and lack capacity to consent to the arrangements made for their care or treatment, but for whom receiving care or treatment in circumstances that amount to a deprivation of liberty may be necessary to protect them from harm and appears to be in their best interests. This may apply to people who are living in a care home or a supported living arrangement.

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