Serious Mental Illness
by Sharon Bronner
Competency is a legal term and is decided by the court of law (Schouten & Brendel, 2004).
Capacity suggests the ability to comprehend the problem and to make a decision. Capacity is an assessment of a psychiatric/medical provider.
Applebaum and Grisso (1988) outlined four criteria used to determine capacity to consent to treatment:
- Patient expression of a preference.
- Ability to understand the illness, the prognosis with and without treatment, and the risks and benefits of the treatment (accurate understanding).
- An appreciation of the significance of the facts (significance of the facts).
- Ability to use the information in a rational way to reach a decision in a logical manner (rationality of the thought processes).
Incompetence can be caused by intense pain, depression, delirium, dementia, and psychosis (Schouten & Brendel, 2004).
Collaboration with the team and communication is a key component to providing quality of care for the serious mental illness population.
Sharon Bronner, DNP, MSN, APRN, GNP, BC Hct
- Applebaum, P.S., & Grisso, T. (1988). Assessing patient’s capacities to consent to treatment. New England Journal of Medicine, 319(25), 1635-1638.
- Schouten, R., & Brendel, R.W. (2004). Legal aspects of consultation. In T.A. Stern, G.L. Fricchione, H.N.H. Cassem, M.S. Jellinek, & J.F. Rosenbaum (Eds.), Massachusetts General Hospital handbook of general hospital psychiatry (5th ed.) (p. 356). Philadelphia, PA: Mosby.