King's College London

Final report from this study

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 | King's news item | 10 minute walkthrough by Alex Ruck Keene KC (Hon)

This report presents findings from interviews with 10 experts conducted in 2023, which focused on the assessment of the mental capacity of people with experience of multiple exclusion homelessness (MEH) in England. Funded by the NIHR School for Social Care Research, the study’s purpose was to scope this topic in advance of a larger 30-month research study (2023-26). 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.

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

Background

Our three-year SSCR-funded study ‘Strengthening Adult Safeguarding responses to homelessness and self-neglect’ (2019–2022) has generated rich data on attitudes and approaches to safeguarding people experiencing multiple exclusion homelessness (MEH).

One (emerging) finding from the study is professionals’ concern about attitudes and approaches to mental capacity among practitioners working with MEH. These professionals report that assessments may fail to be carried out because of the default assumption of capacity; because substance use may be dismissed as a ‘choice’ without professional inquiry; or because it is (mistakenly) believed that assessments cannot be carried out on the street.

We hope that findings from this study will inform our research project: Use of the Mental Capacity Act 2005 with people experiencing multiple exclusion homelessness in England (2023-2026)

Methods

This short project (2022-23) involves further analysis and write-up of the SSCR study findings relating specifically to mental capacity, with additional discussion with a small number of experts in the field, with a view to conducting more research on this topic.

Ethical clearance

Ethical clearance for this project was granted by King's College London on 30-11-22. Minimal Risk Registration Number: MRA-22/23-34816  

Related work in homelessness

• Strengthening Adult Safeguarding responses to homelessness and self-neglect
• Evidencing the social work role within responses to multiple exclusion homelessness
• Just another form of exclusion? Carrying out research with people experiencing multiple exclusion homelessness
• Addressing multiple exclusion homelessness in social work education
• Use of the Mental Capacity Act 2005 with people experiencing multiple exclusion homelessness in England