10 - Psychiatry and the Law Flashcards
What is the Mental Health Act and what criteria must be met for this to be used?
Allows people with a ‘mental disorder’ to be admitted to hospital, detained, and treated without their consent if they will not be admitted voluntarily
- Must have a mental disorder
- Detainment is for the safety of themselves or others
- Must be a treatment
Can you treat a physical health issue under the MHA?
No unless it is a result of their mental health condition e.g refeeding in anorexia
What are the 5 guiding principles that need to be considered when giving treatment under the MHA?
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.
What is the definition of a mental health disorder under the Mental Health Act?
‘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
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?
Admission for assessment
Lasts 28 days
AMHP applies for section under recommendation of two doctors, one of which is section 12 (2) approved
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?
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
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?
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
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 voluntary patient in hospital may be legally detained by a doctor for 72 hours
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 section 5(4) is similar to a section 5(2) but is used by nurses and only lasts for 6 hours
What is the difference between section 4 and section 5?
Section 4 patient is not inpatient
Section 5 patient is a voluntary inpatient
What section cannot be used by a doctor in ED?
5(2)
Can only use common law as they are not an inpatient
What is section 17?
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
What is section 117?
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
What is section 135?
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
What is section 136?
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
How do you assess Capacity?
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
Should you do an operation on someone who is drunk and unable to consent due to lack of capacity under ‘best interests’?
If operation can be delayed until they have sobered up WAIT
Can you appeal a section 2?
Yes if within first 14 days
What is a Community Treatment Order?
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
