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Psychiatry > Legal Aspect of Psychiatry > Flashcards

Legal Aspect of Psychiatry Flashcards

1
Q

What are the main acts that are used in psychiatry?

A

Mental Health (Care and Treatment)(Scotland) Act 2003

Adults with Incapacity (Scotland) Act 2000

Criminal Procedure (Scotland) Act 1995

Criminal Justice and Licensing (Scotland) Act 2010

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2
Q

What are the principles of the Mental Health (Care and Treatment)(Scotland) Act 2003?

A

Principles (anyone who uses act must consider)

  • Non-discrimination
  • Equality
  • Respect for diversity
  • Reciprocity
    • Providing same care to others that you would do to yourself
  • Informal care
  • Participation
  • Respect for carers
  • Least restrictive alternative Benefit
  • Child welfare
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3
Q

What does the Mental Health (Care and Treatment)(Scotland) Act 2003 define mental disorder as?

A
  • Any mental illness
  • Personality disorder
  • Learning disability
  • However caused or manifested
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4
Q

In Mental Health (Care and Treatment)(Scotland) Act 2003, what is not considered to be a mental disorder?

A

If only one of these things is not a mental disorder:

  • Sexual orientation
  • Sexual deviancy
  • Transexualism
  • Transvestism
  • Dependence on, or use of, alcohol or drugs
  • Behaviour that causes, or is likely to cause, harassment, alarm or distress to any other person
  • Acting as no prudent person would
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5
Q

Who can be detained using the Mental Health (Care and Treatment)(Scotland) Act 2003?

A

Who can be detained:

  • Anyone can be detained
    • If children need child/adolescent specialist to do application
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6
Q

What are the key civil powers of the Mental Health (Care and Treatment)(Scotland) Act 2003?

A
  • Emergency detention certificate (EDC)
    • Authorises detention for up to 72 hours
    • Registered medical practitioner (not FY1)
    • Must be likely
      • Patient has mental disorder and
      • Patients ability making decisions for that disorder impaired
      • Risk to safety and welfare of patient or other person
  • Short term detention certificate (STDC)
    • Authorises detention for up to 28 days
    • Approved medical practitioner
    • Consider it likely that
      • Patient has mental disorder
      • Unable to make decisions about treatment of that disorder
      • Necessary to detain patient for purpose of determining treatment
      • If patient not contained would be risk of safety for themselves or others
      • Granting of this certificate is necessary
  • Compulsory treatment order (CTO)
    • Authorises detention for up to 6 months
    • Application to Mental Health Tribunal made by Mental Health Officer
    • Tribunal considers evidence and makes decision
      • Mental Health reports (GP and approved medical practitioner or 2 approved medical practitioners)
    • Satisfied that
      • Patient has mental disorder
      • Medical treatment available and likely prevent deterioration
      • Without treatment risk of harm
      • Mental disorder impairs decision making ability
      • Making of compulsory treatment order necessary
  • Nurses holding power
    • Authorises detention for up to 3 hours (change in 2015 act)
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7
Q

The following authorised detention for how long:

  • emergency detention certificate
  • short term detention certificate
  • compulsory treatment order
  • nurses holding power
A
  • Emergency detention certificate
    • Up to 72 hours
  • Short term detention certificate
    • Up to 28 days
  • Compulsory treatment order
    • Up to 6 months
  • Nurses holding power
    • Up to 3 hours (changed in 2015 act)
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8
Q

Who can use the following:

  • emergency detention certificate
  • short term detention certificate
  • compulsory treatment order
A
  • Emergency detention certificate (EDC)
    • Registered medical practitioner (not FY1)
  • Short term detention certificate (STDC)
    • Approved medical practitioner
  • Compulsory treatment order (CTO)
    • Application to Mental Health Tribunal made by Mental Health Officer
    • Tribunal considers evidence and makes decision
      • Mental Health reports (GP and approved medical practitioner or 2 approved medical practitioners)
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9
Q

What are the general things that must be considered likely to use the key civil powers of the Mental Health (Care and Treatment) (Scotland) Act 2003?

A
  • Mental disorder
  • Significant impairment of decision making ability for medical treatment about disorder
  • Significant risk to health, safety or welfare of person or others
  • Treatment available
  • Order necessary
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10
Q

Who are considered to be important others in the Mental Health (Care and Treatment) (Scotland) Act 2003?

A
  • Named person
    • A right to be party to proceedings
    • Must be nominated by patient and witnessed and named person have witness acceptance
  • Access to advocacy
    • Right of every person with a mental disorder
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11
Q

How does the Adults with Incapacity (Scotland) Act 2000 define “adults” and “incapable”?

A
  • Adult
    • Person who has attained age of 16 years
  • Incapable
    • Incapable of
      • Acting or
      • Making decisions or
      • Communicating decisions or
      • Understanding decisions or
      • Retaining the memory of decisions
    • Must be due to mental disorder or of inability to communicate because of physical disability, but not people who for example need translator or hearing aid – if able to overcome
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12
Q

What are the principles of the Adults with Incapacity (Scotland) Act 2000?

A
  • Intervention must benefit adult
  • Intervention least restrictive in relation to freedom of adult
  • Account must be taken of past and present wishes of adult
  • Where practical accounts should be taken of
    • Views of relatives and carers
    • Views of relevant others (guardians, attorneys etc)
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13
Q

If someone has capacity, is it for everything?

A
  • Presumed to be present unless proven otherwise
  • Situation dependent
    • May have capacity for some decisions, but not for other
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14
Q

What are the 3 areas that the Adults with Incapacity (Scotland) Act 2000 covers?

A

Act covers 3 areas:

  • Property
  • Welfare (medical)
  • Financial
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15
Q

What are the powers from the Adults with Incapacity (Scotland) 2000 act?

A
  • Intervention order
    • One off power required
    • Application to court
  • Guardianship order
    • Someone else is appointed to make decisions on behalf of adult (financial or welfare or both)
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16
Q

What is an intervention order?

A
  • Intervention order
    • One off power required
    • Application to court
17
Q

What is a guardianship order?

A
  • Guardianship order
    • Someone else is appointed to make decisions on behalf of adult (financial or welfare or both)
18
Q

What are power limitations (does not authorise) of the Adults with Incapacity (Scotland) 2000 Act?

A

Power limitations, does not authorise:

  • Use of force or detention unless immediately necessary and only for as long as necessary
  • Action which would be inconsistent with any decision by a competent court
  • Placing an adult in hospital for treatment of mental disorder against his will
19
Q

What are police powers under the Criminal Procedure (Scotland) Act 1995?

A
  • Removal from public place
  • Appear to be in immediate need of care or treatment to a place of safety
  • Detain for up to 24 hours
  • Purpose to allow assessment and make arrangements for their care and treatment
20
Q

Under the Criminal Procedure (Scotland) Act 1995, how long can the police detain people for?

A

Up to 24 hours

21
Q

The Criminal Procedure (Scotland) Act 1995 dictates treatment can be given when to those involved in a crime?

A

Treatment can be given at any point in court processing if involved in crime

22
Q

What are the powers under the Criminal Procedure (Scotland) Act 1995?

A
  • Assessment order
    • One registered medical practionioner
    • Pre-trial order
    • Court satisfied reasonable grounds that
      • Mental disorder
      • Detention in hospital necessary
      • Civil risk met
      • Treatment
      • Suitable bed available within 7 days
      • Assessment could not be undertaken in hospital
  • Treatment order
    • Lasts until final disposal
    • Same criteria as assessment order
    • Now treatment can be given, which cannot be given under assessment order
  • Compulsion order
    • Court satisfied on evidence of two medical practitioners (one of whom is approved)
      • Mental disorder
      • Availability of treatment
      • Significant risk
      • Necessary to be in hospital
    • Need to consider security risk
    • Lasts 6 months
  • Restriction order
    • For most serious offences
    • Doctor must give oral evidence
    • Court satisfied that criteria met
      • Having regard to nature of offence charged
      • The antecedents of the person and
      • The risk as a result of mental disorder would commit offences if set at large
    • Without time limit
23
Q

Criminal Procedure (Scotland) Act 1995:

  • main difference between assessment order and treatment order?
A

Treatment can only be given under treatment order, not assessment order

24
Q

Criminal Procedure (Scotland) Act 1995:

  • to use assessment order, treatment order, compulsion order and restriction order court must be satisfied about what?
A
  • Assessment order
    • Court satisfied reasonable grounds that
      • Mental disorder
      • Detention in hospital necessary
      • Civil risk met
      • Treatment
      • Suitable bed available within 7 days
      • Assessment could not be undertaken in hospital
  • Treatment order
    • Same criteria as assessment order
  • Compulsion order
    • Court satisfied on evidence of two medical practitioners (one of whom is approved)
      • Mental disorder
      • Availability of treatment
      • Significant risk
      • Necessary to be in hospital
  • Restriction order
    • Court satisfied that criteria met
      • Having regard to nature of offence charged
      • The antecedents of the person and
      • The risk as a result of mental disorder would commit offences if set at large
25
Q

Criminal Procedure (Scotland) Act 1995:

  • how long does compulsion and resitrction orders last?
A

Compulsion order - 6 months

Restriction order - without time limit

26
Q

What does the Criminal Justice and Licensing (Scotland) Act 2010 do?

A

Is an act that modifies Criminal Procedure Act and Mental Health Act

27
Q

What does the Criminal Justice and Licensing (Scotland) Act 2010 say about criminal responsibility?

A

Criminal responsibility:

  • Person not responsible for conduct causing offence, and to be acquitted if they have a mental disorder
  • Personality disorder or learning disability does not qualify

A person could be responsible at the time but now at the trial are not well – unfit for trial:

  • Unfit if established incapable, by reason of mental or physical condition, of participating effectively in the trial
  • In determining if a person is unfit for trial the court is to have regard to
    • Ability of person to
      • Understand nature of charge
      • Understand requirement to tender a plea to charge and effect of plea
      • Understand purpose of and follow the course of trial
      • Understand evidence may be given against the person
      • Instruct and communicate with person’s legal representative
  • Being unable to recall event is not a reason to be unfit for trial
28
Q

Criminal Justice and Licensing (Scotland) Act 2010:

  • when is a person considered unfit for trial?
A
  • Unfit if established incapable, by reason of mental or physical condition, of participating effectively in the trial
29
Q

Criminal Justice and Licensing (Scotland) Act 2010:

  • in determining if a person is unfit for trial the court must have regard to what?
A
  • In determining if a person is unfit for trial the court is to have regard to
    • Ability of person to
      • Understand nature of charge
      • Understand requirement to tender a plea to charge and effect of plea
      • Understand purpose of and follow the course of trial
      • Understand evidence may be given against the person
      • Instruct and communicate with person’s legal representative
  • Being unable to recall event is not a reason to be unfit for trial
30
Q

What is diminished responsibility?

A

Diminished responsibility:

  • A person who would otherwise be convicted of murder is instead to be convicted of culpable homicide (manslaughter in England) on grounds of diminished responsibility
  • Only applies to charge of murder
  • Being under influence of drugs or alcohol at time does not of itself qualify for this
31
Q

What are restricted patients?

A

Persons detained in hospital under compulsion order with a restriction order, have usually committed a crime punishable by imprisonment but due to mental disorder are detained in hospital for treatment with no time limit

32
Q

What forensic sections use restricted patients?

A

Forensic sections:

  • Compulsion Order and Restriction Order of 1995 act
  • Assessment Order of 1995 act
  • Treatment Order of 1995 act
  • Interim Compulsion Order
  • Transfer for Treatment Direction 1995 act
  • Hospital Direction of 1995 act
33
Q

What are the effects of being “restricted”?

A

Effect of being restricted:

  • Subject to specific restrictions defined in 2003 act
  • Special provision for leave
    • MAPPA and SGMHD
  • Oversight by Scottish ministers

Psychiatry (20 decks)

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