Judgments of Financial Abilities of Severely Mentally Ill Individuals: A Comparison of Self-Report and an Objective Measure

When clinicians are asked to assess the financial capacity of those with severe mental illnesses, they often use a patient self-report. However, agreement between self-reported financial abilities and actual performance has not been established. In this study, concordance between self-reported financial abilities and performance of financial tasks on the Direct Assessment Functional Status (DAFS) scale was examined among 24 persons with severe mental illnesses with a guardian/payee, 25 without a guardian/payee, and 25 nonaffected controls. The groups were generally similar in the proportion of agreement between self-reported and performance-based financial abilities. However, the financially dependent group evidenced a significant discrepancy between self-reported ability to balance a chequebook and their performance on the DAFS relative to comparison groups, indicating that the accuracy of the severely mentally ill participants' self-reported financial abilities can be compromised. Thus, performance-based measures should be employed when assessing financial capacity.