How Do, and How Should, Risk Considerations Influence Approved Mental Health Professionals’ Assessments of Mental Capacity? : A Literature Review

Brown, Clare (2025) How Do, and How Should, Risk Considerations Influence Approved Mental Health Professionals’ Assessments of Mental Capacity? : A Literature Review. Practice. ISSN 0950-3153

Abstract

The role of the Approved Mental Health Professional (AMHP) involves assessing people’s mental capacity to make decisions about their care and treatment. This article has relevance for AMHPS and other mental health staff. It asks questions about the way in which risk considerations inform assessment. Findings are that while identified risk factors may be relevant to the decision to assess and may also form part of the relevant information about options, they should not be determinative of the outcome of assessments. Although a lack of research focussing exclusively on AMHP interventions makes it difficult to draw firm conclusions, literature suggests that perceived risk remains key to the outcome of many capacity assessments. There is, moreover, a sharp differentiation between the way in which risk is considered in assessments of people from different social groups and with different diagnoses: Both risk and capacity are raced, classed and gendered concepts, and some professionals continue to perpetuate ‘hermeneutic injustice’ by making assumptions about people on the basis of their belonging to a group perceived as ‘vulnerable’. AMHPs are, however, well placed to address injustice by embracing both risk and mental capacity as socially constructed concepts to be negotiated as part of assessment.