When it comes to the assessment of mental capacity, I often see people referring to the ‘2 stage test’ as the process they follow. In this blog I explore why the 2 stage test is not an assessment process, rather it’s a target list that we should use to inform our process. What is the 2- stage test? The 2 stage test (which, incidentally, I believe is really 3 stages) is the term that is commonly given to the framework that appears in Sections 2 and 3 of the Mental Capacity Act

It’s a question that crops up regularly in both clinical and legal settings: if a person has never done something before, do they have the mental capacity to decide to do it now? Whether the decision relates to managing finances, making a Will, choosing where to live, or consenting to treatment, lack of experience is often mistaken for lack of capacity. Capacity is decision-specific and time-specific, not experience-dependent. The MCA requires us to assess whether a person ca

In the context of mental capacity, ‘engagement’ refers to a person’s active participation and cooperation in the assessment or decision-making process. This might include answering questions, attending meetings, or otherwise communicating with professionals. A lack of engagement, therefore, is when a person is unwilling to take part in the assessment. Crucially, we must distinguish between someone choosing not to engage versus someone who is unable to engage due to an impairm