Adults who self-neglect will often have complex needs however in most instances the adult is assessed as having the mental capacity to make relevant decisions in relation to their self-neglect. However, their behaviour may include not wishing to engage with services to make any changes to their situation increasing risk of social isolation and risks to their health and wellbeing.

In cases of self-neglect the adult must be assumed to have capacity, however if concerns are raised about an adult the practitioner must be clear about the adults mental capacity in regard to the key decisions that may require intervention. If there are uncertainties about the adult’s capacity a mental capacity assessment should be undertaken. Practitioners and social care professionals should ensure that the views and wishes of the adult are respected including their right to make what others might consider to be an “unwise decision”.

If the adult is assessed as not having capacity to make decisions in relation to their self-neglect, then the best interest process should be followed this must take into account the adults views and the least restrictive approach. Consideration should be given as to whether an Independent Mental Capacity Advocate (IMCA) should be instructed. IMCAs may be instructed in Safeguarding regardless of the level of involvement of family or friends.