A pilot study of the early implementation of the Mental Capacity Act 2005 in England and Wales: the experience of consultants in old age psychiatry

Abstract

Background The Mental Capacity Act 2005 (MCA) was fully implemented in October 2007 in England and Wales. Methods A pilot qualitative study using thematic analysis examined the experience of consultants in old age psychiatry in the early implementation of the MCA using a questionnaire designed to ascertain the experienced difficulties and the positive experiences of implementing the MCA, and its impact on their workload and associated changes in staffing levels. Results Fifty-two (27%) of the 196 consultants in old age psychiatry returned usable questionnaires. Eleven categories of difficulties and nine categories of positive experiences in the implementation of the MCA were reported. Two-thirds of respondents reported an increase in their workload, but over 90% reported no associated changes in staffing levels. Conclusions The factors contributing to the experienced difficulties and positive experiences in the implementation of the MCA require careful identification because strategies to lessen the difficulties and to maintain positive experiences need to be developed. The definitions of restraint and deprivation of liberty used in clinical practice and the overlap between these definitions requires careful study. The workload of clinicians in the context of implementing the MCA requires ongoing monitoring.