The Mental Capacity Act (Northern Ireland) is a pivotal piece of legislation designed to promote rights and safeguard vulnerable people who are not able to make decisions for themselves. It also includes rules around the Deprivation of Liberty Safeguards (DoLS).
In this three-part blog series, we explore the basics of the Act and how it applies in everyday practice in Northern Ireland.
The Act in context
In 2002, a detailed review of provisions, law and policy for those with mental health and/or learning disabilities in Northern Ireland took place – known as the Bamford Review. The review produced numerous reports and also proposed a series of reforms, including the need for a consistent approach to safeguarding and protecting those who are unable to make decisions for themselves.
Building on this report, the Department of Health, Social Services and Public Safety released a three year action plan for Delivering the Bamford Vision, which included an action plan to prepare a new mental capacity bill that would bring together mental capacity and mental health law for those aged 16 years old and over.
This bill was enacted in 2016 as the Mental Capacity Act (Northern Ireland).
Principles of the Mental Capacity Act (Northern Ireland)
The Mental Capacity Act (NI) is designed to support decision making and promote autonomy and inclusion. To support this focus, there are five statutory Principles that are to be upheld at all times when working under this legislation. These are:
- No-one should be treated as lacking capacity unless proven they do
- No assumptions can be made (based on any condition the person may have, or any characteristics of the person)
- Help and support must be provided
- No assumptions can be made because of unwise decisions
- All acts and decisions must be made in the person’s best interests
The focus here is very much on the need to presume capacity unless someone is proven to lack capacity. The Act also places strong emphasis on the need to uphold an individual’s rights. As such, no presumptions should be made about an individual based on their actions, diagnosis or defining characteristics. Meanwhile, all reasonable adjustments should be made to support capacity and allow the person to make their own decision.
The fifth and final Principle of the MCA (NI) draws focus on those supporting a person under the Act who is proven to lack capacity for a particular decision – requiring that tall decisions be made in the person’s best interest.
Northern Ireland’s Department of Health publishes a regular newsletter update which includes information on DoLS statistics, training, contact details and other useful information. Within which, it is evident that cases across the UK are taken account of around mental capacity and this constantly evolving domain.
For further reading around Northern Ireland’s Mental Capacity Act (2016), I would recommend:
- BJPsych Bulletin, ‘Mental Capacity Act (Northern Ireland) 2016’, by G Lynch, C Taggart and P Campbell
- Mental Health Today, ‘Ending “substituted decision making” in crisis care: Lessons from Northern Ireland’ (2018), by C Caughey
- International Journal of Mental Health and Capacity Law, ‘No longer “Anomalous, Confusing and Unjust”: The Mental Capacity Act (Northern Ireland) 2016’, by C Harper, G Davidson and R McClelland
- Royal College of Psychiatrists, ‘A brave new (fused) world? The draft Irish Mental Capacity Bill’ (2014), by A Keene and C Taggart