Psychiatric evaluation of mental capacity in the general hospital: a significant teaching opportunity. 2009

Donald S Kornfeld, and Philip R Muskin, and Fatimah A Tahil
Columbia University College of Physicians and Surgeons, New York, NY, USA. dsk3@columbia.edu

BACKGROUND Requests for evaluation of mental capacity in general hospitals have increased in frequency. OBJECTIVE The authors sought to determine the interventions required to respond adequately and assess the initiating circumstances. METHODS Questionnaires completed by psychiatric consultants were analyzed, and chart reviews were completed. RESULTS Capacity evaluation alone resolved 32% of the requests; 31% required an evaluation plus additional interventions; 37% did not require a capacity evaluation. Patients threatening to leave against advice, and/or refusing treatments or procedures represented 64% of requests. Consultants successfully resolved 88% of such cases. CONCLUSIONS A mental capacity evaluation alone was insufficient to resolve two-thirds of problems eliciting requests. Consultation-liaison psychiatrists can use these evaluations as teaching opportunities.

UI MeSH Term Description Entries
D008297 Male Males
D008875 Middle Aged An adult aged 45 - 64 years. Middle Age
D011569 Psychiatric Status Rating Scales Standardized procedures utilizing rating scales or interview schedules carried out by health personnel for evaluating the degree of mental illness. Factor Construct Rating Scales (FCRS),Katz Adjustment Scales,Lorr's Inpatient Multidimensional Psychiatric Rating Scale,Wittenborn Scales,Edinburgh Postnatal Depression Scale,Mini International Neuropsychiatric Interview
D012017 Referral and Consultation The practice of sending a patient to another program or practitioner for services or advice which the referring source is not prepared to provide. Consultation,Gatekeepers, Health Service,Hospital Referral,Second Opinion,Consultation and Referral,Health Service Gatekeepers,Hospital Referrals,Referral,Referral, Hospital,Referrals, Hospital,Consultations,Gatekeeper, Health Service,Health Service Gatekeeper,Opinion, Second,Opinions, Second,Referrals,Second Opinions
D005260 Female Females
D006769 Hospitals, General Large hospitals with a resident medical staff which provides continuous care to maternity, surgical and medical patients. General Hospital,General Hospitals,Hospital, General
D006801 Humans Members of the species Homo sapiens. Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man
D000328 Adult A person having attained full growth or maturity. Adults are of 19 through 44 years of age. For a person between 19 and 24 years of age, YOUNG ADULT is available. Adults
D000368 Aged A person 65 years of age or older. For a person older than 79 years, AGED, 80 AND OVER is available. Elderly
D000369 Aged, 80 and over Persons 80 years of age and older. Oldest Old

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