High Incidence of Decision-Making Incapacity in Hospitalized Psychiatric Patients

The right to involuntarily hold patients who are a danger to themselves or to others does not automatically impart the right to treat them. To assess decision-making capacity among patients in psychiatric hospitals, researchers performed a cross-sectional study of 338 consecutive adult patients who were admitted to one of three psychiatry wards in London during a 16-month period. Mental capacity was assessed within 8 days after admission (median, 2 days) by administration of the MacArthur Competence Assessment Tool for Treatment (a semistructured interview) or by clinical interview.

Prevalence of incapacity to make decisions was 60% for all patients and ranged from highs of 97% in patients with mania and 81% in patients with schizophrenia to…