Mental Health and Mental Capacity assessments: Social Workers making Best Interest Decisions

This paper presents the results of a comparative study of social work practice between community and inpatient settings in mental health services. UK legislation makes provision for social workers to assess a person’s mental... [ view full abstract ]

This paper presents the results of a comparative study of social work practice between community and inpatient settings in mental health services. UK legislation makes provision for social workers to assess a person’s mental health needs, including admission to psychiatric hospital. However, different laws apply depending on whether the person being assessed has capacity to make informed decisions about their care and treatment. The social workers’ task is to manage the interface between the Mental Health Act (1983) and the Mental Capacity Act (2005) both of which have implications for the human rights of people using mental health services. Where a person is assessed as not having capacity, the social worker can make a Best Interest Decision, on their behalf.

The methodological framework for the study is documentary analysis of social work reports and case notes, followed up by focus groups with the social workers in the community as Approved Mental Health Practitioners and social workers who work in an inpatient setting (Neuro-psychiatry). It considers the process of decision-making, what the decision is that needs to be made, how a decision was made, recorded and what the outcomes are for service users, their carers and families.

The paper concludes with a discussion of the concept of social workers making decisions about safeguarding the rights of service users at the interface of different legislative frameworks and the associated challenges and opportunities for social work education and professional practice.