Capacity to consent to admission of patients detained under Section 5(2) of the Mental Health Act

Background: Little is known regarding capacity to agree to admission of informal patients later detained under Section 5(2) of the UK Mental Health Act.
Aim: To evaluate how frequently such capacity is assessed and to discover associations related to length of time from admission until imposition of Section 5(2).
Method: Patients detained under Section 5(2) on acute inpatient general adult and old age psychiatric wards in one UK location between June 2016 and March 2018 were identified. Their admission records were scrutinized.
Results: Capacity was assessed in 97 of 124 patients. Fewer assessments were performed immediately prior to admission, especially upon patients admitted from residential settings. On admission, medical staff assessed for capacity less than non-medics, but found an individual lacked capacity more frequently. Time until detention was less upon a first admission, in absence of pre-admission capacity assessment, when medical staff assessed, or when any inpatient clinician detected incapacity.
Conclusion: Routine capacity assessment immediately prior to and at psychiatric admission should be formalized and offers potential to reduce use of Section 5(2), unlawful detention and negative sequalae.