Decision making and mental capacity - Transition Guide

In law, young people aged 16 or over are presumed to have the ability to make their own decisions. This includes certain decisions relating to their education or medical treatment.

Once you turn 16, services will normally speak to you direct, rather than with your parents.

Your parents can continue to support you by:

  • continuing to be involved in talking about your future
  • attending meetings
  • filling in forms
  • dealing with any mail on your behalf

This is if you are happy for them to do this. Your parents are still responsible for you until you get to the age of 18.

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The Mental Capacity Act is a law that protects vulnerable people over the age of 16 about the decisions they make.

This could be if someone needs to make a big decision but other people doubt they can make it.  This may be because of their disability. An assessment can be done to check if they can make the decision themselves or not. If they can’t, a best interest decision can be made by other people on their behalf.

It should always be presumed that you are able to make your own decisions.  This is unless you have difficulty with the following:

  • understanding the information you need. For example, what the outcome will be or remembering the information for long enough to make a decision
  • weighing up your options and making a choice
  • communicating your decision in any way.  For example, by blinking or squeezing a hand

No-one can decide a person lacks mental capacity.  Even if they think the person has made a bad or strange decision. If the person cannot make a decision at a certain time, they may still be able to:

  • make it at another time
  • make decisions about other things

When others make decisions on your behalf, they must follow the Mental Capacity Act. For more information have a look at the Mental Capacity page on this Sheffield Local Offer page.

No-one should make a decision for a young person if it can wait until they can do it themselves. Parents and professionals must always support them to be involved as much as possible in a decision made on their behalf. Even if the young person does not have the capacity to make it themselves. Communication aids can help to do this.

You may need an independent advocate to help collect your opinions and put your view across. Professionals in health, education or social care can ask for an independent advocate if needed. You can get help from an advocate at age 16+.

Click on the logo below for more information.

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When you reach the end of compulsory school age some rights on EHC plans transfer from you parents to you.  This is the last Friday in June of the school year in which you turn 16.

These are:

  • the right to ask for an EHC needs assessment
  • the right to make decisions about the content of your EHC plan
  • the right to ask that a particular education setting is named in your plan
  • the right to request a personal budget
  • the right of appeal to the SEND tribunal.

Your parents may still want to advocate on your behalf once you’ve turned 16. If this is the case, SENDSARS would need consent from you to share information with your parents.

If your parents think you don't have the mental capacity to make decisions, they should speak to SENDSARS.  They will work with social care around the assessments needed for this.

Gillick competence is about decisions made about clinical or medical treatment. Children under the age of 16 can consent to their own treatment.  Consent is when a person is able to say yes or agree to something.  This is if they’re believed to have enough understanding to know what’s involved in their treatment. This considers:             

  • the child’s age, maturity and mental capacity
  • their understanding of the issue and what it involves.  This includes:
    • advantages
    • disadvantages
    • potential long-term impact           
  • their understanding of the risks:
    • what it involves
    • what can happen from making their decision                        
  • how well they understand any advice or information they have been given              
  • their understanding of any other options, if available         
  • their ability to explain their thinking around how they got to their decision.

This is known as being Gillick competent. If a child or young person under the age of 16 is considered Gillick Competent, they have the right to:

  • give consent to medical treatment
  • refuse medical treatment

This means the decision of parents will be overruled unless there are:

  • issues about making the decision (mental capacity)
  • there are safeguarding worries. This would then be referred to the appropriate agency.

Where a decision could possibly cause death or severe permanent injury the case will be referred to the Court of Protection.

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