The circular problems of mental capacity

There are some infinite loops in how someone suffering from a mental health crisis receives treatment in hospital that makes the situation more difficult for everyone involved than it should be. The scenario plays out like this:

Infinite loop 1: physical and mental health

Someone who requires medical attention for physical health concerns is seen by paramedics. The person refuses treatment but because the paramedics judge that they don’t have mental capacity, they are told that the decision is being taken from them and they have to go to hospital. Once in hospital they continue to refuse treatment. The doctors and nurses are powerless to treat them because even though its obvious that they lack the mental capacity to make decisions about treatment they haven’t yet been seen by a mental health professional. But the mental health professional won’t see them until they are medically fit.

This is the first infinite loop the person finds themselves in. They can’t receive treatment for their mental health until they are physically healthy, but their mental health prevents them from becoming physically healthy.

Infinite loop 2: decision making and mental capacity

If they do speak to a mental health professional at some point whilst in hospital, they are told their options and given a choice about whether to accept treatment, but that mental health professional knows that they don’t have the mental capacity to understand the choice because that’s why they are there, but because they haven’t had a mental capacity act assessment yet and deemed officially to still have mental capacity.

This is the second infinite loop the person finds themselves in. The lack of mental capacity gets them into a situation where they have to make difficult decisions that they don’t have the mental capacity to understand, but because they are still considered to have sufficient capacity they are expected to make decisions as a person with capacity would.

So, as with so many things, these infinite loop problems are characteristics of a systems problem where no policies and procedures can encompass the complexities of human behaviour and real life, but the people in those situations are bound to follow the policies and procedures.