King's College London

The Unit has published a scoping paper examining the mental capacity assessment of people experiencing multiple exclusion homelessness in England. Funded by the NIHR School for Social Care Research, the paper reports findings from interviews with 10 experts that were conducted by Stephen Martineau in 2023, with a view to informing the subsequent 30-month research study (2023-26) on the topic.

Participants were: two third sector workers, a social worker, a GP, a nurse, a psychiatrist, a psychologist, a lawyer, an expert in brain injury, and an academic.* As well as speaking about the rudiments and practicalities of capacity assessment with this population, participants reflected critically about current practice.

10 minute 'walkthrough'

Huge thanks to Alex Ruck Keene KC (Hon) who has recorded a short walkthrough of the paper on his channel. Alex is a co-investigator on the 2023-26 study.

More about this topic

Multiple exclusion homelessness is a term used to capture the phenomenon of homelessness where it occurs along with other experiences associated with social exclusion – for example, adverse childhood experiences, institutional care (such as detention under the Mental Health Act 1983), and substance dependency. Use of the term directs attention toward the health and social care needs of this population. Core questions for the associated workforce include those around consent and whether individuals have capacity to make decisions, particularly around their care and treatment. The focus of both the new paper and the larger study, which is ongoing until March 2026, is mental capacity assessment practice in this area.

This strand of work forms part of the Homelessness Research Programme at King's College London.

This publication

Martineau, S. (2025) Approaches to the mental capacity assessment of people experiencing multiple exclusion homelessness in England: A scoping paper, London: NIHR Policy Research Unit in Health and Social Care Workforce, The Policy Institute, King's College London. https://doi.org/10.18742/pub01-205

The author, Stephen Martineau, would welcome any comments on this paper: stephen.martineau@kcl.ac.uk

• Project page for this study
• Project page for the 2023-26 study

See also

• Homelessness Research Programme at King's
• Our Homelessness webinar series (run by Jess Harris; all welcome)

* The small scale of this study precluded the inclusion of people with experience of multiple exclusion homelessness in the interview cohort, since this would have entailed a more involved ethical approvals process than resources allowed. The 2023-26 study involves people with lived experience of multiple exclusion homelessness in an advisory and oversight capacity, and in its fieldwork.