An innovative framework for psychosocial assessment in complex mental capacity evaluations

This study describes an innovative tool developed by the Regional Capacity Assessment Team (RCAT) to assess unique psychosocial factors related to capacity evaluations. Capacity is a socio-legal construct entailing the ability to understand choices, appreciate consequences and follow through (or direct a surrogate) with chosen options. RCAT's targeted psychosocial assessment includes medico-legal factors, social history and supports, coping skills, religious/cultural factors and risk of abuse. RCAT completes the psychosocial assessment to determine whether a full capacity assessment is required (referral disposition) and to determine the impact of an adult's social functioning on their decision-making capacity (capacity determination). RCAT's psychosocial assessment protocol was developed after a comprehensive literature review of capacity assessment and incorporates recommended practices in geriatric social work and psychology. This study will synthesise the pertinent literature, discuss cultural interviewing processes significant to capacity, caregiver assessment and describe the tool itself. Suggestions for future research and appropriate implementation of this tool are provided.