10 - Psychiatry and the Law Flashcards

1
Q

What is the Mental Health Act and what criteria must be met for this to be used?

A

Allows people with a ‘mental disorder’ to be admitted to hospital, detained, and treated without their consent if they will not be admitted voluntarily

  1. Must have a mental disorder
  2. Detainment is for the safety of themselves or others
  3. Must be a treatment
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2
Q

Can you treat a physical health issue under the MHA?

A

No unless it is a result of their mental health condition e.g refeeding in anorexia

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3
Q

What are the 5 guiding principles that need to be considered when giving treatment under the MHA?

A

Purpose principle: MHA must be used to minimize the undesirable effects of mental disorder by maximizing their safety and well-being and protecting others from harm.

Least restrictive principle: people taking action without a patient’s consent must attempt to keep to a minimum the restrictions they impose on the patient’s liberty

Respect principle: people taking decisions under the MHA must recognize andrespect each patient including their race, religion, culture, age, etc

Participation principle: patients must be involved in their care as much as ispracticable. The involvement of family and friends is encouraged

Effectiveness, efficiency, and equity principle: this refers to the most appropriate use of resources to meet the needs of patients.

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4
Q

What is the definition of a mental health disorder under the Mental Health Act?

A

‘any disorder or disability of the mind’

The Act also contains an exception for people with learning disabilities and dependence on drugs or alcohol. A disability will only fall within the definition of a mental disorder if it is associated with abnormally aggressive or seriously irresponsible conduct

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5
Q

What is section 2 of the MHA, how long does it last and what criteria needs to be met for it to be put into action?

A

Admission for assessment

Lasts 28 days

AMHP applies for section under recommendation of two doctors, one of which is section 12 (2) approved

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6
Q

What is section 3 of the MHA, how long does it last and what criteria needs to be met for it to be put into action?

A

Admission for treatment

Lasts up to 6 months but can be renewed for a further 6 months then 12 months

Requires an AMHP and 2 doctors, both of whom must have seen the patient in the past 24 hours

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7
Q

What is section 4 of the MHA, how long does it last and what criteria needs to be met for it to be put into action?

A

Emergencies where a section 2 would cause “an undesirable delay”

It requires the recommendation of only one doctor and either an AMHP or the nearest relative

Allows a person to be detained for up to 72 hours, whereby it is usually converted to a section 2

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8
Q

What is section 5 (2) of the MHA, how long does it last and what criteria needs to be met for it to be put into action?

A

A voluntary patient in hospital may be legally detained by a doctor for 72 hours

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9
Q

What is section 5(4) of the MHA, how long does it last and what criteria needs to be met for it to be put into action?

A

A section 5(4) is similar to a section 5(2) but is used by nurses and only lasts for 6 hours

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10
Q

What is the difference between section 4 and section 5?

A

Section 4 patient is not inpatient

Section 5 patient is a voluntary inpatient

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11
Q

What section cannot be used by a doctor in ED?

A

5(2)

Can only use common law as they are not an inpatient

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12
Q

What is section 17?

A

Leave of absence from the hospital that they are detained

The responsible clinician agrees to a time-limited leave of absence. Often for family visits or a trial visit home prior to discharge. Sometimes, a member of staff might escort a patient on leave

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13
Q

What is section 117?

A

Aftercare & the Care Programme Approach (CPA)

Provision of after-care for patients who have been detained on the ‘long sections’ (3, 37, 47, or 48)

No patient should be discharged without planned aftercare: the systematic assessment of health and social needs, an agreed care plan, the allocation of a keyworker, and regular reviews of progress

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14
Q

What is section 135?

A

Allows the police to force entry into someone’s premises to allow an assessment under the MHA to be made, or to bring them to a ‘place of safety’

A warrant from a Magistrates’ Court is required before this power can be used

The police must be accompanied by an AMHP and/or a doctor

Lasts 36 hours

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15
Q

What is section 136?

A

Allows police to arrest a person ‘in a place to which the public have access’ who they believe to be suffering from a mental disorder in order to convey them directly to a ‘place of safety’

72 hours

During which time they should be seen by a doctor and by an AMHP who can choose to complete a MHA assessment, admit them informally or discharge them from the section

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16
Q

What are the 5 key principles of the mental capacity act?

A
  • A person is assumed to have capacity unless proven otherwise
  • Steps must be taken to help a person have capacity
  • An unwise decision does not mean a person lacks capacity
  • Any decisions made under the MCA must be in the person’s best interests
  • Any decisions made should be the least restrictive to a person’s rights
17
Q

How do you assess Capacity?

A

For a person to lack capacity they must show an ‘impairment of, or disturbance in, the functioning of the mind or brain’ AND they are unable to undertake any of the following:

  • Understand relevant information
  • Retain the relevant information
  • Weigh up the relevant information
  • Communicate a decision

Remember it is time and decision specific

18
Q

If an adult and a 17 year old child both have capacity to make decisions about their medical treatment, what can the child not do that the adult can do?

A

Refuse life saving treatment

19
Q

Should you do an operation on someone who is drunk and unable to consent due to lack of capacity under ‘best interests’?

A

If operation can be delayed until they have sobered up WAIT

20
Q

Can you appeal a section 2?

A

Yes if within first 14 days

21
Q

What is a Community Treatment Order?

A

When discharging someone on a section 3 they can be signed onto this

Compulsory treatment in the community but if certain conditions not met or risk to self/others then subject to recall to hospital immediately

Lasts same amount of time as Section 3 and can be renewed