A short BLOG on something which I think provides a very useful tool for police officers – for that matter, many other professionals – to consider how to approach the issue of ‘capacity’ when vulnerable people are making decisions. This was originally drawn to my attention by @meditude on Twitter and I’m very grateful for that.
It has since been slightly added to after feedback from MCA trainer @mattgrahamdrum.
It is simple to consider and easy to remember.
The “ID A CURE” Test means –
- Impairment – is there an impairment (temporary or premanent) which prevents the person from being able to ‘CURE’, as below; OR
- Disturbance – is there an disturbance of the mind (temporary or premanent) which prevents the person from being able to ‘CURE’, as below; OR
AND – only one of the follow factors need be satisfied for the person to lack capacity
- Communicate – can the person communicate their decision to you (even if not verbally)?
- Understand – can the person understand the information that would enable them to make the decision?
- Retain – can the patient retain the information in order to make the decision?
- Employ – can the patient employ the information to make the decision effectively?
The Mental Capacity Act invites consideration of whether someone, in fact, has capacity to take certain decisions for themselves and as a precussor to decisions about whether / what may be in someone’s best interests, if it is believed that they lack capacity. The Code of Practice to the Act does make clear that such considerations do not require a ‘scientific’ level of reasoning or evidence – but it does require evidence of a thoughful (enough) approach against presumption of capacity.
It should be remembered: the fact that someone’s decision may be considered ‘unwise’ is not in itself sufficient to assume that they lack capacity. People may take decisions to self-harm, decline medical treatment and so on.
Reminder – police officers, wherever they possibly can, should defer decision-making around mental capacity to healthcare professionals. The ambulance service – from whom this mnemonic is “borrowed with pride” – have better training than police officers around this business and the CoP MCA requires it. It may also be possible or necessary to contact mental health crisis services or out of hours GPs, depending on circumstances.
For more information, read my main blog on The Police and the Mental Capacity Act.
Police intervention should be restricted to the circumstances outlined in s4B MCA – only where intervention is necessary to mitigate an immiment, life-threatening risk where delay would leave the incapacitated person exposed to the risks officers have identified.
The Mental Health Cop blog
– won the ConnectedCOPS ‘Top Cop’ Award for leveraging social media in policing.
– won the Digital Media Award from the UK’s leading mental health charity, Mind
– won a World of Mentalists #TWIMAward for the best in mental health blogs
– was highlighted by the Independent Commission on Policing & Mental Health
– was referenced in the UK Parliamentary debate on Policing & Mental Health
– was commended by the Home Affairs Select Committee of the UK Parliament.