Capacity, Consent and the Mental Health Act

Question 1

Define consent

Answer 1

Consent (noun) permission for something to happen or agreement to do something

Consent (verb) give permission for something to happen

Question 2

Define capacity

Answer 2

Capacity is the ability to make a decision

Question 3

What does section 47 of the adults with incapacity act allow?

Answer 3

• Authorises the practitioner to provide reasonable interventions related to the treatment authorised
• Does not authorise force unless immediately necessary and only for as long as necessary
• Does not specifically authorise the transport of the adult to the place of treatment

Question 4

5 principles of the adults with incapacity act?

Answer 4

1) Intervention must benefit the adult
2) Such benefit cannot reasonably be achieved without the intervention
3) Take account of past and present wishes
4) Consult with other relevant persons
5) Encourage the adult to use residual capacity

Question 5

When should the AWIA be used?

Answer 5

to authorise the treatment of a physical disorder in someone who lacks the capacity to consent

Question 6

Explain power of attorney?

Answer 6

this is someone chosen when the patient has capacity

this gives someone else the powers to act as financial and or welfare attorney if capacity is lost

Question 7

Explain guardianship?

Answer 7

this is granted by the sheriff
cannot place the adult in hospital for treatment of a mental disorder against their will
if the adult doesn’t comply with guardian wishes thought the sheriff can issue a compliance order

Question 8

5 criteria for detention under the mental health act?

Answer 8

(Likely) Mental Disorder
Significantly Impaired Decision Making Ability
Determining treatment required (Giving treatment – STD & CTO)
Significant risk
Informal/voluntary care not appropriate

Question 9

When should emergency detention be done vs short term?

Answer 9

When there is an undesirable delay in granting a Short Term Detention certificate

Question 10

What is defined as mental disorder under the mental health act?

Answer 10

mental illness, learning disability, personality disorder

Question 11

How long is an emergency detention order for?

Answer 11

72hrs

Question 12

Process of getting an emergency detention order?

Answer 12

must be done by F2 or above

where possible MHO should also agree

Question 13

In emergency detention order is there a right of appeal?

Answer 13

no

Question 14

In emergency detention order are you authorised to give treatment?

Answer 14

no but in emergencies NOT under this act you could give treatment

Question 15

How long is a short term detention for? What can be done?

Answer 15

up to 28 days for assessment/ treatment

Question 16

Process of getting a short term detention order?

Answer 16

can only be done by approved medical practitioner (criteria for this e.g. certain post grad psychiatric exams) plus approval from MHO is needed

Question 17

When can short term detention be extended?

Answer 17

when putting together an application for CTO

Question 18

Does short term detention have a right of appeal?

Answer 18

yes

Question 19

How long is CTO for?

Answer 19

initially lasts up to 6 months

Question 20

Process of getting a CTO?

Answer 20

must know there is a mental disorder (with short term and emergency detention there just needs to be a likely disorder)
approved by MHO and approved medical practitioner
need reports from 2 independent doctors, care plan and MHO report
MHO makes application to the tribunal service and there is a mandatory tribunal

Question 21

In emergency detention when can urgent treatment be given?

Answer 21

to save life
to alleviate serious suffering
to prevent the patient from being a danger to themselves or other

Question 22

What needs to be filled in after giving treatment to someone under emergency detention?

Answer 22

T4 certificate

Question 23

Authorisation for treatment with CTO or short term detention? Exceptions?

Answer 23

2 months medication
exceptions include: ECT, nutrition by artificial means, vagal nerve stimulation, transcranial magnetic stimulation, any medicine with the purpose of reducing sex drive, neurosurgery

Question 24

Describe advance statements?

Answer 24

these are written when the patient is well and explains how they would prefer to be treated in the future
should be regarded but practically, not everything can be followed

Question 25

Describe named persons?

Answer 25

person to support and protect the interests of the patients, the person has the right to be notified of, attend and be represented at tribunal hearings
if under 16 the default named person is the guardians

Question 26

Describe advocacy?

Answer 26

every person with a mental disorder has the right to access independent advocacy
this is independent of the NHS and helps them write statements etc

Question 27

Describe the mental health tribunal?

Answer 27

organised by mental health tribunal service Scotland

there is a panel with doctors, solicitors, named person, the patients etc

Question 28

Powers of nurses to detain?

Answer 28

Registered mental health nurse or intellectual disability nurse
Patient is in hospital and receiving treatment
Necessary for protection of health, safety or welfare of patient or safety of others
Up to 3 hours (to allow doctor to attend and determine if they can hold them under the mental health act)

Question 29

Policing powers?

Answer 29

Removal to a place of safety
From a public place
Appears to have a mental disorder and is in need of care and treatment
Up to 24 hours to allow and assessment to be carried out