Assessment of medical decision-making capacity: impact on rates of consultation and involuntary commitment at a safety net hospital

One of the most common questions posed to hospital behavioral health consultants is whether a patient has the capacity to make medical decisions. Such consultations are typically requested in complex clinical situations when the physician is unsure whether a patient has this capacity. At a safety net hospital where many patients have comorbid medical, cognitive, and psychiatric disorders that increase their risk of having impaired medical decisionmaking, such evaluations are frequent. Our behavioral health consult-liaison team created an instrument to assist physicians in more rapidly and accurately performing assessments of medical decision-making. This program evaluation study was undertaken to determine whether use of the instrument achieved its goals.