title: Assessment of decision-making capacity: views and experiences of consultation psychiatrists.
abstract: BACKGROUND
  Decision-making capacity (DMC) assessments can have profound consequences for patients. With an aging population, an increasing emphasis on shared decision-making, and a rising number of potential medical interventions, the need for such assessments will continue to grow.
  
  
  OBJECTIVE
  To assess psychosomatic medicine clinicians' training, experiences, and views about DMC assessments.
  
  
  METHODS
  Online survey of members of the Academy of Psychosomatic Medicine (APM). Of 780 eligible members, 288 responded to the survey (36.9% response rate).
  
  
  RESULTS
  Approximately 1 in 6 psychiatric consultations are DMC assessments. Ninety percent of respondents reported that at least half of their capacity assessments involve patients older than 60 years. DMC assessments were seen as more challenging and time-consuming than other types of consultations; yet training in capacity evaluations was seen as suboptimal and half of respondents felt the evidence-base guiding DMC assessment is somewhat or much weaker than for other types of psychiatric consultations. In addition, the practice of capacity assessment seems to vary widely with no consistent approach among respondents. Respondents strongly endorsed multiple areas and topics for potential future research, indicating a desire for a stronger evidence-base.
  
  
  CONCLUSIONS
  Members of the APM perceive capacity assessments as common and challenging. Yet they perceive having received subpar training with relatively weak evidence to guide their current practice. Future research should address these potential deficiencies, given the likelihood that DMC assessments will only become more common.
authors.affiliation: Department of Psychiatry, University of Michigan, Ann Arbor, MI 48109-2800, USA.
authors.forename: Lisa
authors.initials: L
authors.lastname: Seyfried
authors.forename: Kerry A
authors.initials: KA
authors.lastname: Ryan
authors.forename: Scott Y H
authors.initials: SY
authors.lastname: Kim
mesh_terms: D000368:Aged; D001291:Attitude of Health Personnel; D002170:Canada; D002983:Clinical Competence / Q000592:standards; D003625:Data Collection; D003657:Decision Making; D019317:Evidence-Based Medicine / Q000592:standards; D005260:Female; D006801:Humans; D007258:Informed Consent / Q000523:psychology*; D008297:Male; D016743:Mental Competency / Q000523:psychology*; D008875:Middle Aged; D011611:Psychosomatic Medicine / Q000592:standards*; D012017:Referral and Consultation / Q000592:standards; D012044:Regression Analysis; D012955:Societies, Medical; D014481:United States