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9. Capacity, consent, confidentiality and legislation

Lesson 9/10 | Study Time: 60 Min
9. Capacity, consent, confidentiality and legislation

There are a number of different legislations relating to people who have mental health needs that we need to be aware of. These are the main ones…

The Mental Health Act 1983 (updated 2007) is the law in England and Wales which tells people with mental health problems what their rights are regarding:

  • Pathways into hospital
  • Assessment and treatment in hospital
  • Treatment in the community.

Many people who receive inpatient treatment on psychiatric wards have agreed to go into hospital as informal patients (also known as voluntary patients).

However, over half are in hospital without their agreement as formal patients. This is because they have been detained under the Mental Health Act. This is often called being sectioned. People can be sectioned for the following reasons:

The Mental Capacity Act (MCA) 2005 is about assessing capacity and seeking consent. It protects people if they are not able to make decisions.

Someone may lack mental capacity if they are unable to:

  • Understand information about a decision
  • Remember this information
  • Use this information to make a decision, or
  • Communicate their decision.

Someone may only lack mental capacity for a short period of time. Being unwell or having a mental illness does not mean someone automatically lacks mental capacity. Most people with a mental illness do not lack mental capacity. Being held under the MCA does not mean that someone lacks mental capacity. Making a bad decision does not mean that someone lacks mental capacity.

The MCA sets out who can make decisions for someone if they lack capacity.

Any decisions need to be in the person’s ‘best interests’ and a full record of the capacity assessment and best interests decision kept.

It is important to encourage family members, carers and care workers to be actively involved throughout the assessment, care and treatment of the person’s mental health problem, apart from in exceptional circumstances when an adult or young person with decision-making capacity has said that they do not want them involved.

You may find our Mental Capacity Act Essentials course useful.

In this course we talk about people, their rights and making sure that if they are unable to make choices for themselves that they are appropriately protected and supported. 

Anyone can lose capacity for a short period of time and knowing their rights in these situations is essential. This course will help you to understand this important area of care and support work.

Human Rights Act 1998 – rights regarding discrimination and right to respect 

The Human Rights Act gives people legal protection of their human rights, such as the right to liberty and security.

People detained in hospital are protected by this act. For example, if someone is is sectioned, the hospital must make sure that the Mental Health Act is followed, the person is given reasons why they have been detained and an opportunity to challenge it. People must be looked after and treated in a way which complies with human rights.

Everyone has the right to respect for his private and family life, his home and his correspondence.

– Source: Human Rights Act

Every year, more and more people are detained under the Mental Health Act.

More than half of respondents to a 2017 survey who had been detained in hospital said they felt they had received degrading treatment. All public authorities or bodies exercising public functions, must follow the Human Rights Act including:

The police
NHS employees
Local authorities and their employees
Nursing and personal care accommodation providers

Data Protection Act 2018 – storage of records and disclosure of information

The Data Protection Act was developed to control how personal and customer information is used by organisations and government bodies.

It protects people and sets out rules for how data about people can be used. This means that conversations with doctors, nurses, solicitors, advisers and other professionals are confidential. Usually if a professional needs to share information, they must ask the person’s permission first. Professionals can share information without consent if:

  • There is a risk of serious harm to the person  or to others
  • There is a risk of a serious crime
  • The person does not have the capacity to make the decision.

The information an organisation holds on people should be up-to-date, accurate and relevant.

An organisation should not hold more information about someone than they need or for longer than they need it. They should also make sure that people only have access to personal information if they really need access to it. We must ensure that we do not share information unnecessarily and that if we need to share it, then we do so with the right people and confidentially. We must also ensure that all records are stored confidentially including electronic ones.

Privacy is one of the most debated topics in recent memory.

It often seems like everyone wants to know our business. Our Handling Information course provides information on current data protection legislation for people working in health and social care work environments.