Use of the Mental Capacity Act 2005 with people experiencing multiple exclusion homelessness in England

Society

Use of the Mental Capacity Act 2005 with people experiencing multiple exclusion homelessness in England

The study Guidance & Tool and Animation will be launched 17.12.26
Stephen Martineau introduces the study on the Unit blog (2023), reports on presentation of early emerging findings (2024) and summarises contributions at a national roundtable (2025).

About this study

This mixed methods study has focused on the assessment of the mental capacity of people experiencing multiple exclusion homelessness (MEH), a term that captures overlapping experiences associated with profound social exclusion, including institutional care, substance misuse and ‘street culture’ activities. Factors such as poor mental health, addiction, brain injury, and the effects of adverse childhood experiences in this population mean that capacity assessments under the Mental Capacity Act 2005 (MCA) can be particularly challenging. This study has examined practitioner thinking and approaches and lived experience perspectives on the practice and implications of these assessments and their impact on supporting people, or further embedding them within multiple exclusion homelessness. The main academic output is in preparation.

Methods

Scoping review of evidence; Interviews with national experts; National survey of practitioners; Fieldwork in three contrasting study sites: interviews with practitioners and people with lived experience.

Funding

NIHR Health and Social Care Delivery Research (HSDR) Programme: NIHR154668. NIHR project page.

Timescale

October 2023 - March 2026

Research team

Main study researchers: Jess Harris Senior Research Fellow, HSCWRU, KCL (contact for enquiries) and Stephen Martineau (Research Fellow, HSCWRU, KCL).

Kritika Samsi (co-PI), Senior Research Fellow, HSCWRU, KCL.
Michelle Cornes (co-PI), Professor of Health and Social Policy Inequalities, University of Salford.
Stan Burridge, Director, Expert Focus.
Alex Ruck Keene KC (Hon), Barrister, 39 Essex Chambers; Professor of Practice, Dickson Poon School of Law, KCL.
Bruno Ornelas, Senior Programme Adviser, Ministry for Housing, Communities and Local Government.
Samantha Dorney-Smith, (previously Pathway); Clinical Research Associate, University College London.
Alex Bax, Chief Executive / Sophie Koehne, Mental Health and OT Lead, Pathway.
Nathan Davies, Professor of Ageing and Applied Health and Care Research, Queen Mary University of London.

Lived experience Advisory Group (PPIE)

Led by Stan Burridge.

Greta Gillett
Katie Ibrahim
Aisha Lewis
Charlie
Rachel
Jack
Vincent

Collaborators

Barney Wells & Helen Kelsall, Enabling Assessment Service London (EASL).
Ezra Furber, Approved Mental Health Professional, Islington.
Fiona Bateman, Safeguarding Adults Board Independent Chair.

Study Steering Committee

Adi Cooper OBE (Chair), Care and Health Improvement Advisor, LGA
Carla Ecola, The Outside Project
Ed Addison, The People’s Recovery Project
Ellie Atkins, Manager, Entrenched Rough Sleepers Social Work
Gareth Owen, Psychiatrist, IOPPN, KCL
Jo Prestidge / Alex Smith, Homeless Link
Karl Mason, Social Work Course Lead / Researcher
Katie Pavoni, Royal College of Paramedics
Leigh Andrews, Change Communication
Michael Preston-Shoot, Professor Emeritus in Social Work
Michele Lawrence, OHID, DHSC
Mike Dilley, Neuropsychiatrist / Royal College of Psychiatrists
Penny Rapaport, Professor of Psychological interventions, UCL
Rosemary Amran, Occupational Therapist
Simon Young, Public Health Systems Coordinator, Substance Misuse
Steph Grant, Lived Experience Advisor / Head Injury & Homelessness Research Group
Viki Teggart, Clinical Neuropsychologist, Addictions & Homelessness