Dr. Lorcan Martin:

Capacity is time specific. That is important. Depending on when that study was done, a person may have been involuntarily detained but thereafter developed capacity over a period of time. At the point of admission, the vast majority of people who are involuntarily detained lack capacity because they lack insight. The vast majority of patients who are admitted under the current legislation are not the ones who are at serious and immediate risk of harm to themselves or others. The bulk are those who require treatment under Part 3B of the current Act. Those people require treatment that is otherwise unavailable in the community and admitting them under the Act would benefit them to a material extent. The bulk of patients coming in would lack insight and capacity but would not necessarily be at immediate serious risk. As they are treated, their capacity improves. Best practice would be that when somebody reaches that threshold, the whole issue of whether they should be involuntarily detained anymore comes into play. That is why we have the option of regrading somebody from an involuntary patient to a voluntary patient. My understanding is that psychiatrists do that. I know psychiatrists who at the first available opportunity it is reasonable and safe to do so would convert someone from involuntary to voluntary. As patients get treatment, their capacity, hopefully, improves. That does not happen in every case but in the vast majority of cases, as people improve, their capacity returns.