"CAPACITY AND CONSENT
The patient has capacity to engage in the agreed care plan because they are: Able to understand, retain, repeat, weigh up on balance, use the information given The patient gives informed consent to treatment without coercion. Yes"
This was written by one worker after discharge. I assume the patient isn’t lacking capacity as they have apparently got the patient’s ‘informed consent’ to treat them?
There is one comment from the RC at the time where they write ‘Capacity and consent They were not sure why they were taking the depot though was willing to continue to take this and was aware that this was being prescribed for mental illness.
The RC is saying the patient has no idea why they have been prescribed this drug, but are agreeing to it and they are aware what the medication is for - still here, that does not sound to me that the patient has been informed about what this is medication is about in relation to them considering they are not sure of it. That again contradicts what informed consent is. Because the patient has not been informed otherwise there would be no lack of certainty from them? Surely you can not prescribe medication if the person you are prescribing to has not been informed properly of what they are made to take?
The quote is from a review months after discharge - but these reviews about the patient’s capacity and consent has not been followed through with those legal steps required in the files e.g. ability to retain info etc. They just write they ‘agree’.
In the patient’s records there are comments made by them - that the patient does not agree to therapy or any other psychological treatment - the patient denies any disorder - it’s been recorded even throughout their sectioned detention on both 2 and 3 and after discharge from each nurse or professional that they do not exhibit any symptoms of a disorder - towards the end where the patient is trying to get them off the medication - they fabricate some comments saying the patient was requesting for a ‘reduction’ (rather than ‘stopping’) this reduction was mentioned repeatedly in the notes - instead, even this request of a reduction was delayed and ignored by the RC - the patient recalls that in the end the RC over the phone still ignored what the patient said to come off the medication and decided to tell the patient to hand the phone call to a relative for their decision. Then steps were made to stop.
To add - there are comments written down by them saying the patient 'continues to say the reasons they take medication is because it was prescribed by the doctor. They do wish to stop the medication at some point. No other concerns expressed.’ or ’ Informed they would need to attend the centre for their depot which they was reluctant to do but eventually agreed’ and ‘P was happy that this was the last injection as they stated they were stopping following this one.’ With the last comment - it was several months before they got their last injection.
Within the records they have falsely put down the patient agrees to medication. However, as written above - the notes have this contradiction of comments from them e.g. No evidential disorder observed, refusing alternative forms of therapy, denying themselves they need the medication or have any disorder; RC wants them to take anti-depressants based on assumption - it is noted down the patient declines anti-depressants as they feel they do not have depression etc. Also after medication is stopped - the RC mentions a few times that they want the patient to recommence medication - but the patient does not want to. Which in itself is bizarre - when there is no reason to recommence.
Yet, considering the records noting down all of this - why would then this person agree to taking medication? Then, agree to taking high strength medication? Lastly, be given high strength medication from the RC?
Towards the end of their care plan - it is noted by one new care coordinator of what the patient thought about the whole process. They write along the lines that the patient ‘felt they had no choice in the matter and had to comply in taking medication even though they did not’.
I understand if the patient signed off on a care plan - that the community teams can administer legally some support services for a specific time frame. But even then with medication - that is a completely different area. If the patient declines at any stage - they should have stopped. It was always under the impression they had to take it or they risk detention. They were completely dismissed. It’s also a very long time to continually to make someone see them without any choice - two years. In those two years they felt they could not do anything because of their visits and monitoring - when in reality the patient always had the right to say ‘no’ to them and continue with their life.
It doesn’t make any sense that this can only come a care plan - the document signed says the patient is discharged fully from any restrictions - so what on earth has happened here? Was the law different back in 2018/2019 over Crisis resolution home treatment team care plans?
Apologise if my comment is not clear - kept finding parts within the records that were unclear that I kept adding on - which is why it might not be cohesive to read. Again anyone who can make sense of all of this or try to make sense of it - would be better than nothing. Thanks.