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COVID-19 Vaccination in those with mental health difficulties: A guide to assist decision-making in England, Scotland, and Wales

Ross, Callum; Brown, Penelope; Brown, Christian; Chopra, Arun; Adshead, Gwen; Tracy, Derek; Towers, Kevin; McKay, Colin; Black, Isra; Forsberg, Lisa


Callum Ross

Penelope Brown

Christian Brown

Arun Chopra

Gwen Adshead

Derek Tracy

Kevin Towers

Isra Black

Lisa Forsberg


There is currently no specific guidance addressing vaccine hesitancy in those with mental health difficulties in the United Kingdom. This is particularly problematic when one considers that individuals with serious mental illnesses are at greater risk of infection and have poorer health outcomes for a range of reasons. There are also many individual and system level barriers to vaccination in this group. When an affected adult lacks the capacity to make a decision for themselves, it often falls to healthcare professionals to make a decision on that person's behalf and in their best interests. This article explores this matter with regard to the law in practice in the English and Welsh, and Scottish, jurisdictions and consider this with relevance to the safest approach that doctors and other healthcare professionals should take in working with patients for whom mental disorder may impact on decision-making capacity. The article focuses on psychiatric inpatients, including those who are detained involuntarily, to consider whether, and in what circumstances, COVID-19 vaccination should be given to individuals who cannot or do not consent.

Journal Article Type Article
Acceptance Date Feb 1, 2022
Online Publication Date Mar 11, 2022
Publication Date 2022-10
Deposit Date Apr 11, 2022
Publicly Available Date Apr 12, 2022
Journal Medicine, Science and the Law
Print ISSN 0025-8024
Electronic ISSN 2042-1818
Publisher SAGE Publications
Peer Reviewed Peer Reviewed
Volume 62
Issue 4
Pages 275-282
Keywords Medical law, legal system, law, human rights, COVID-19, vaccination
Public URL


COVID-19 Vaccination In Those With Mental Health Difficulties: A Guide To Assist Decision-making In England, Scotland, And Wales (680 Kb)

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Copyright Statement
This article is distributed under the terms of the Creative Commons Attribution-NonCommercial 4.0 License ( which permits non-commercial use, reproduction and distribution of the work without further permission provided the original work is attributed as specified on the SAGE and Open Access page (

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