No CrossRef data available.
Article contents
The Mental Capacity Act (Northern Ireland) 2016 – progress so far
Published online by Cambridge University Press: 06 October 2025
Abstract
The Northern Ireland Mental Capacity Act (MCA) fuses mental health and capacity legislation into a single legislative framework for involuntary treatment for all those aged 16 years and over. Impairment of decision-making capacity is a mandatory prerequisite for any interference in a person’s autonomy without their consent. Such ‘fusion’ legislation, as described by Dawson and Szmukler (2008), has the potential to reduce discrimination in the law against psychiatric patients and would apply consistent ethical principles across medical law. This approach was recommended by the Bamford Review in 2007 and the MCA was passed by the Stormont Assembly in 2016. The legislation has not as yet been fully introduced and a phased implementation is being undertaken. This article describes progress so far and discusses measures that are required if the anticipated benefits of fusion legislation are to be realised.
Information
- Type
- Perspective Piece
- Information
- Copyright
- © The Author(s), 2025. Published by Cambridge University Press on behalf of College of Psychiatrists of Ireland
References
Anderson, P, Davidson, G, Doherty, F, Hanna, H, Harper, C, Lynch, G, McClelland, RJ, McKenna, C (2023). Legal capacity, developmental capacity, and impaired mental capacity in children under 16: neurodevelopment and the law in Northern Ireland. International Journal of Law and Psychiatry 87, 101872. https://doi.org/10.1016/j.ijlp.2023.101872.CrossRefGoogle Scholar
Ayre, K., Owen, G. S., Moran, P. (2017). Mental capacity and borderline personality disorder. BJPsych Bulletin, 41(1), 33–36. https://doi.org/10.1192/pb.bp.115.052753
CrossRefGoogle Scholar
Cairns, R, Maddock, C, Buchanan, A, David, AS, Hayward, P, Richardson, G, Szmukler, G (2005). Reliability of mental capacity assessments in psychiatric in-patients. British Journal of Psychiatry 187, 372–378. doi:10.1192/bjp.187.4.372.CrossRefGoogle ScholarPubMed
Campbell, P, Rix, K (2018). Fusion legislation and forensic psychiatry: the criminal justice provisions of the Mental Capacity Act (Northern Ireland) 2016. British Journal of Psychiatry Advances 24, 195–203. doi:10.1192/bja.2017.9.Google Scholar
Davidson, G, McClelland, RJ, Harper, C, Lynch, G, McKenna, C (2023). Mental capacity and mental health law in Northern Ireland: navigating the fusion approach. International Journal of Law and Psychiatry 86, 101861. doi:10.1016/j.ijlp.2022.101861.Google Scholar
Davidson, G, Daly, M, Harper, M, McIlroy, D, Montgomery, L. (2023). ‘The Fusion Approach to Mental Capacity Law in Northern Ireland: Possibilities and Challenges.’ In: Kong, C, Coggon, J, Cooper, P, Dunn, M, Ruck Keene, A, eds. Capacity, Participation and Values in Comparative Legal Perspective, pp. 46–64. Bristol: Bristol University Press. https://doi.org/10.2307/jj.3485527.9
Google Scholar
Dawson, J, Szmukler, G (2006). Fusion of mental health and incapacity legislation. British Journal of Psychiatry 188, 504–509.10.1192/bjp.188.6.504CrossRefGoogle ScholarPubMed
Department of Health (2007). The Bamford review of mental health and learning disability: a comprehensive legislative framework. https://www.health-ni.gov.uk/articles/bamford-review-mental-health-and-learning-disability.Google Scholar
Department of Health (2021). Mental health strategy 2021–2031. https://www.health-ni.gov.uk.Google Scholar
Department of Health (2022). For now and for the future- an advance care policy for adults in Northern Ireland. Advance Care Planning: For Now and For the Future | Department of HealthGoogle Scholar
Farrell, AM, Hann, P (2020). Mental health and capacity laws in Northern Ireland and the COVID-19 pandemic: examining powers, procedures and protections under emergency legislation. International Journal of Law and Psychiatry 71, 101602. doi:10.1016/j.ijlp.2020.101602.CrossRefGoogle ScholarPubMed
Farrell, AM, Agnew, E, Hann, P (2025). Mental health and capacity laws in Northern Ireland: examining the position of children and young people. Medical Law Review 33. doi:10.1093/medlaw/fwae038.CrossRefGoogle ScholarPubMed
Harper, C, Davidson, G, McClelland, RJ (2016). No longer “anomalous, confusing and unjust”: the Mental Capacity Act (Northern Ireland) Act 2016. International Journal of Mental Health and Capacity Law 22, 57–70. https://pureadmin.qub.ac.uk/ws/portalfiles/portal/121459381/NoLonger552_1726_3_PB.pdf.10.19164/ijmhcl.v2016i22.552CrossRefGoogle Scholar
HM Government (2018). Modernising the mental health act- increasing choice, reducing compulsion. https://www.gov.uk/government/publications.Google Scholar
Law Commission (2017). Report No. 372 Mental Capacity and Deprivation of Liberty. Law Commission Mental Capacity and Deprivation of LibertyGoogle Scholar
Lynch, G, Taggart, C, Campbell, P (2016). Mental Capacity Act (Northern Ireland). British Journal of Psychiatry Bulletin 41, 353–357. doi:10.1192/pb.bp.117.056945.Google Scholar
Owen, GS, Szmukler, G, Richardson, G, David, AS, Hayward, P, Hotopf, M (2009). Mental capacity and psychiatric inpatients: implications for the new mental capacity act. Psychological Medicine 39, 1389–1398. doi: 10.1192/bjp.bp.108.059782
Google Scholar
Szmukler, G, Kelly, BD (2018). We should replace conventional mental health law with capacity-based law. British Journal of Psychiatry 209, 449–453. https://doi.org/10.1192/bjp.bp.116.191080.CrossRefGoogle Scholar