Page 18 - Adult C Overview Report - FINAL

This document was classified as: OFFICIAL

7.27. Section 5 indicates how spasmodic Adult C’s engagement with agencies was. On many

occasions she was deemed and assessed as required by the Mental Capacity Act (2005), to
have the Mental Capacity to make decisions, despite the fact that on many of those occasions
she was under the influence of alcohol or intoxicated.

7.28. Professionals did not show a general understanding of the impact of alcohol on decision
making. More specifically, whether Adult C had the ability to use and weigh information
regarding her decisions regarding ability to keep herself safe or if she was able to display
executive capacity to actually carry out the decisions that she had previously agreed to. Not
only does recent consumption of alcohol affect decision making and leads to fluctuating
capacity, but it is also known that alcohol dependency leads to changes in the brain that can

lead to issues and affect mental capacity. Many neuropsychological studies have repeatedly
highlighted that alcohol dependence is associated with impaired executive functioning,
15
including working memory, planning, and flexibility . Whilst that may have an impact on
attending appointments and the ability to engage effectively with services, when that is
combined with domestic abuse impacts, it can be seen that mental capacity is possibly
severely impacted.

7.29. Professionals have a general understanding of application of the Mental Capacity Act,
however, when it is being assessed as part of such complex circumstances, there is very little
guidance available. Use of legal advice and the Court of Protection were not considered or
discussed in the case of Adult C.

7.30. Adult C was also associating with, not only her partner who was a problem drinker, but with
other people who were also drinkers. They engaged in drinking parties and there appeared to

be an expectation that income/benefits that funded drinking were shared. It is not known
how exploited Adult C was in this regard. Professionals did not appear to explore this further.
This was likely to mean that breaking away and changing that drinking pattern would be even
more difficult than for an individual drinker.

7.31. When Adult 1 met with the author he had a very different view of Adult C’s drinking. His
belief was that she was not dependant on alcohol although he stated that he was. Adult 1
said that Adult C only drank when he did and did not appear to have a need to drink in the
way that he did. This review acknowledges that the medical evidence indicated otherwise.
Adult 1 is now trying to address his alcohol issues and has distanced himself from the group

that he and Adult C used to associate with.

15 Brevers, Damien et al. “Impaired decision-making under risk in individuals with alcohol dependence.” Alcoholism, clinical and experimental
research vol. 38,7 (2014): 1924-31. doi:10.1111/acer.12447
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4115290/pdf/nihms587887.pdf

18