Creative Communication - Assessing Decision-Making Capacity in an Adult with Selective Mutism

Abstract: Selective mutism is an anxiety disorder in which an individual is unable to speak in certain social situations though may speak normally in other settings. Selective mutism in adults is rare, though people with this condition might have other methods of communicating their needs outside of verbal communication. Healthcare professionals rely on a patient’s ability to communicate to establish if they have decision-making capacity. This commentary responds to a case of a young adult patient with selective mutism and social anxieties that significantly limited his ability to communicate with anyone in the healthcare team. This required a creative, patient-centered approach to engage in meaningful communication.