I am part of a research project that aims to improve the way resident psychiatry trainees are taught how to do financial capacity assessments. I’m going to be blogging a bit about this as I dig through the literature, and think more about what financial capacity is and the related legal terrain in Ontario, how to assess capacity, and teach and train others to do it.
The basic rationale for the study is this. Financial capacity is, broadly, the capacity of a person to manage their assets (money, belongings, and all property) in ways that allow them to live and function adequately in society. Mental disorders may affect this capacity, temporarily or maybe even permanently, depending on the disorder. Therefore, in many jurisdictions (and in particular, in Ontario where I am based), assessing a person’s capacity is a requirement for psychiatrists under certain conditions (e.g. when a patient is admitted to the hospital).
However, and this is a bit disconcerting to me, financial capacity assessment is not a first-class citizen in the Canadian Royal College’s psychiatry training requirements (see here). That is, there is no required checkbox or assessment of a trainee to verify they have reached competency in doing financial capacity assessments as there are for most other aspects of training. It has been my experience that financial capacity assessment is also not particularly well taught during residency: the opportunities for conducting assessments are rare (but shouldn’t be!), the task is complex and different enough from other skills we learn that it’s not a simple transfer, and there are picky legal/procedural aspects that need to be considered along the way. I suspect it’s also not a skill that many psychiatrists are very familiar.
In our study, the plan to improve this situation is to use a combination of pre-reading, formal teaching, and simulated patient encounters where residents can practice their assessments and get directed feedback. We’ve recently conducted a pilot with two residents and plan a larger run later this year.
Stay tuned.