Legal aspects

Question 1

What is meant by best interests

Answer 1

• If a person is deemed to lack capacity, decisions can be made on their behalf in their best interests with regards to care and treatment by relevant professionals and family members

Question 2

Who is considered by the mental health act

Answer 2

1. Mental illness of a nature or degree which warrants further assessment or treatment in hospital
2. Risks to their health, their safety or their detention is necessary for the protection of others
3. Their care can no longer be safely provided in the community
4. They do not agree to come into hospital informally or they lack the capacity to make that decision

Question 3

What are the different sections involved with the mental health act

Answer 3

• Section 2 – admission for up to 28 days for assessment (and treatment) of mental illness
• Section 3 – admission for up to 6 months for treatment of mental illness
• Section 5(2) – emergency detention of a hospital inpatient applied by a doctor (F2 or above) for up to 72 hours and triggers formal MHA assessment
• Section 136 –
o detention applied by police (following discussion with mental health professional) for a person in a public place, placing themselves or others in danger
o Police must have reasonable belief their behaviour is secondary to mental illness
o Lasts for 24 hours and triggers formal MHA assessment in place of safety

Question 4

What is meant by a DoLs

Answer 4

deprivation of liberty:
• If a person is deemed to lack capacity and their activity is restricted they are being deprived of their liberty
• Restrictions include continuous supervision and control and not being free to leave
• DoLS are in place to provide a legal framework to protect the patient:
o Provided with representative (often family member or involved individual)
o Right to challenge DoLS in Court of Protection
o Mechanism for DoLS to be reviewed
• Urgent DoLs available and valid for 7 days (can be extended for further 7 days whilst awaiting assessment)
• DoLS can be authorised for 12 months and then must be reviewed

Question 5

What is an advanced directive

Answer 5

• Completed when someone has capacity and used to inform decisions when lose capacity such as in Best Interests Meeting
• Can only refuse specific treatment

Question 6

What are the 5 principles of the mental capacity act

Answer 6

• Every adult has the right to make his or her own decisions and must be assumed to have capacity to do so unless it is proved otherwise. This means that it must not be assumed someone cannot make a decision for themselves just because they have a particular medical condition or disability, or because they lack capacity in other areas.
• People must be supported as much as possible to make their own decisions before anyone concludes that they cannot do so. This means that every effort should be made to encourage and support the person to make the decision for himself/herself. If a lack of capacity is established, it is still important that the person is involved as far as possible in making decisions.
• People have the right to make what others might regard as unwise or eccentric decisions. Everyone has their own values, beliefs and preferences which may not be the same as those of other people. People cannot be treated as lacking capacity for that reason.
• Anything done for or on behalf of a person who lacks mental capacity must be done in their best interests.
• Anything done for, or on behalf of, people without capacity should be the least restrictive of their basic rights and freedoms. This means that when anything is done to, or for, a person who lacks capacity the option that is in their best interests and which interferes the least with their rights and freedom of action must be chosen.

Question 7

How is mental capacity evaluated

Answer 7

1. Do they understand the information relating to a decision
2. Can they retain the information relating to a decision
3. Can the balance the pros and cons of the decision
4. Can they communicate their decision