Mental Capacity Event Notes

Judith Cross Age NI
Capacity assessments- will they be done by social workers?
Which sector will they be from- statutory or voluntary? What about capacity and statutory sector?
Funding-will services be there when required?
Position of carers- where do they fit into the process?
Training-will adequate training be provided for staff who are affected by provisions of bill?
Compliance-how to ensure provisions of Bill will be met?
Age NI Perspective- Serious decisions are very relevant re nursing/ residential move
Culture change required- Ageism
Concerns ;
1. Composition of panel?
Specific to topic of discussion?
Open and transparent?
Regional variations?
2. Ageing populations in prison- provision of treatment + moves to health care provision
3. In palliative care setting- query over next of kin and access to advocacy (when financial
implications could be manipulated)
4. How to communicate this to the public
Need a better advocacy service, earlier point
Interpretation of capacity is varied
Family members being consulted
Capacity changes over time- issue specific
How is capacity to make day to day decisions
Who asks the person to decide the older person has capacity? Social worker? Nurse?
Problematic issue: if an older person states ‘I don’t want to be here’
What does the best interest check list look like?
What are the safeguards to support decision making?
What about RQIA? Where is the improvement element?
L.P.A- costs for some
- complex documentation
-denying access to save older people
Cost-people living older
(EPOA) discrimination- legal aid
Lasting power of attorney
Older people caring for people without capacity-implications
Parents planning future of their children- there are risks with this
Older people- ageing population- dementia and other issues
Safeguards-presumption of capacity
Opportunity to hold professionals to account
Subordinate legislation and codes of practice need to be worked out
Finances tp back up training, advocacy and legislation
Presumption of capacity important
Advocacy stressed as important at early stage of legislation
Funding for advocacy
Resource issue important
Discrimination and stigma creates barriers to care
Risk assessments and dignity and choices e.g. restraint
Eamonn McNally- Children’s law centre
Age appropriate and provision of same codes of practice
Timescales-can it be done- committee stages
Consultation over summer
Transitions 16/17
Access to education clause-hurdles to advocacy
Independence of the advocate
Education of the public- bill in general and what it means
Lack of info to service users and parents
Weight attached to consultation responses
Pat Conway- NIACRO
3 key points
1. Disproportionate representation in criminal justice system
2. 2. Pathways to resettlement (address main issues to reduce returners and victims)
3. Joint up provision- capacity can fluctuate- does the capacity bill have the capacity to bring
about change
Bamford recommendations-when?
Benchmarking-concerns that no local
Advocacy- what shape will that take?
Is it crucial?
Nominated person-measures in place are biased and affected on personal autonomy
Serious concerns about lack of therapeutic services for those in crisis at serious risk
DOJ resistance to new types of interventions
Resources are a big concern. How can we ensure this is funded?
Misunderstanding in practical terms
Code of practice that is easy to follow and understand and that relates to all people involved
2 departments- already seems to be a disjoint-DOJ have only provided policy proposals so difficult to
Divergence between statutory and voluntary sector
Capacity of statutory sector to carry out assessment function
Benchmarking- was comparison with Scotland sufficient?
NIACRO-Mental health diagnosis high prevalence in prison
Timeline concerns- Concern about limited choices leading to potentially unwise decisions. Services
need investment
Concern about limited choices leading to potentially unwise decisions. Services need investment
Capacity to deliver quality advocacy in a timely, clear, fashion
Would improve delivery of ideal operation of the bill
Cultural shift required to address mental health inequalities in CJS
Custody- limited choices available vs com
Capacity inhibited by detention
Focus on one aspect of person- what about dual diagnosis?
Lack of awareness of dementia in prison
Unfit to plead but retains capacity challenge
Low educational attainment= need for advocacy- need to resource appropriately
Risk as a dominant discourse- will over power capacity in practice
1. People in CJS-95% mental health issue/substance abuse
2. Re-settlements pathways. Programme in place- reduce offending- 6k in prison each year-30k
3. Capacity fluctuations- tied to resources exist outside of bill
4. Closed mental health units- e.g. Windsor
5. Who is going to fund advocacy?
6. Point of transfer to hospital
7. Criminal record stigmatism
8. Codification could make system worse