title: Reliability of mental capacity assessments in psychiatric in-patients.
abstract: BACKGROUND
  Previous work on the reliability of mental capacity assessments in patients with psychiatric illness has been limited.
  
  
  OBJECTIVE
  To describe the interrater reliability of two independent assessments of capacity to consent to treatment, as well as assessments made by a panel of clinicians based on the same interview.
  
  
  METHODS
  Fifty-five patients were interviewed by two interviewers 1-7 days apart and a binary (yes/no) capacity judgement was made, guided by the MacArthur Competence Assessment Tool for Treatment (MacCAT-T). Four senior clinicians used transcripts of the interviews to judge capacity.
  
  
  RESULTS
  There was excellent agreement between the two interviewers for capacity judgements made at separate interviews (kappa=0.82). A high level of agreement was seen between senior clinicians for capacity judgements of the same interview (mean kappa=0.84).
  
  
  CONCLUSIONS
  In combination with a clinical interview, the MacCAT-T can be used to produce highly reliable judgements of capacity.
authors.affiliation: Academic Department of Psychological Medicine, Institute of Psychiatry, Weston Education Centre, 10 Cutcombe Road, London SE5 9RJ, UK.
authors.forename: Ruth
authors.initials: R
authors.lastname: Cairns
authors.forename: Clementine
authors.initials: C
authors.lastname: Maddock
authors.forename: Alec
authors.initials: A
authors.lastname: Buchanan
authors.forename: Anthony S
authors.initials: AS
authors.lastname: David
authors.forename: Peter
authors.initials: P
authors.lastname: Hayward
authors.forename: Genevra
authors.initials: G
authors.lastname: Richardson
authors.forename: George
authors.initials: G
authors.lastname: Szmukler
authors.forename: Matthew
authors.initials: M
authors.lastname: Hotopf
mesh_terms: D000328:Adult; D003657:Decision Making; D005260:Female; D006760:Hospitalization; D006801:Humans; D007258:Informed Consent / Q000523:psychology*; D007406:Interview, Psychological; D008297:Male; D016743:Mental Competency / Q000523:psychology*; D001523:Mental Disorders / Q000523:psychology*; D015588:Observer Variation; D010348:Patient Care Team; D011569:Psychiatric Status Rating Scales; D015203:Reproducibility of Results