Legal Aspects of Psychiatry

Question 1

How is a mental disorder defined?

Answer 1

Any mental illness, personality disorder or learning disability
However caused or manifested

Question 2

Who can be detained?

Answer 2

Anyone

<18 need child/adolescent specialist

Question 3

How long is detention authorised for under an emergency detention certificate?

Answer 3

72hrs

Question 4

How long is detention authorised for under a short term detention certificate?

Answer 4

28 days

Question 5

How long is detention authorised for under aa compulsory treatment order?

Answer 5

Up to 6 months

Question 6

How long is detention authorised for under a nurses holding power?

Answer 6

Up to 3hrs

Question 7

What is required to implement an Emergency Detention certificate?

Answer 7

Registered medical practitioner
Must be likely that:
 - Patient has mental disorder
 - Because of above, the patients decision making regards to medical treatment
Must be urgent and the patient at risk

Question 8

What is required to implement an short term Detention certificate?

Answer 8

Approved medical practitioner
Must be likely that:
 - Patient has mental disorder
 - Impaired decision making 
 - Decision to do so is necessary 
 - If not detained, there is risk to patient or others

Question 9

What is required to implement an Compulsory Treatment Order?

Answer 9

Application to Mental Health Tribunal 
2 approved medical practitioners
Satisfied that:
 - Patient has mental disorder
 - Medical Rx is available that would help
 - Without Rx there is risk to health, safety or welfare
 - Impaired decision making
 - The Order is necessary

Question 10

What are the criteria for detention?

Answer 10

(Suspected) Mental disorder
Significant impairment of decision making ability for medical treatment
Significant risk to self or others
Treatment available
Order necessary

Question 11

Who are the important individuals in mental health detention?

Answer 11

Named persons

Access to advocacy

Question 12

What is required to establish an individual’s named person?

Answer 12

Nominated by patient and witnessed

Named person must have witnessed acceptance

Question 13

What are the considerations when applying to the mental health act?

Answer 13

Intervention must benefit adult, being as least restrictive as possible
Account taken of wishes of adult and account taken of views of relevant others

Question 14

How does the law regard capacity?

Answer 14

Capacity ASSUMED present unless proven otherwise

Question 15

What are the main areas of capacity?

Answer 15

Property
Welfare (medical)
Financial

Question 16

What are the legal powers over capacity?

Answer 16

Intervention Order (1 off)
Guardianship Order (make decisions for someone else)

Question 17

Use of the Mental Health Act doesn’t authorise what?

Answer 17

• Use of force or detention unless immediately necessary and for only as long as necessary
• Action inconsistent with any decisions by court
• Placing an adult in hospital for treatment of mental disorder against his will

Question 18

What are the Police Powers over mentally disordered offenders?

Answer 18

Removal from public place
Detain for up to 24hrs
Allow assessment and arrangements for their care

Question 19

What are the requirements of an Assessment Order?

Answer 19

Court satisfied there are grounds of: 
 - Mental disorder
 - Detention in hospital is necessary
 - Civil criterion met
 - Treatment 
 - Suitable available within 7 days
 - Assessment could not be undertaken 
Consider circumstances and alternative means

Question 20

What are the requirements of a treatment order?

Answer 20

Court satisfied by argument of 2 medical practitioners that:

• Treatable Mental disorder
• Civil risk
• Bed within 7 days

Question 21

What are the requirements of a compulsion order?

Answer 21

Court satisfied by argument of 2 medical practitioners that:
- Treatable mental disorder
- Significant risk
- Necessary to be in hospital
Consider restriction and level of security needed

Question 22

What are the requirements of a compulsion order?

Answer 22

Oral evidence from atleast 1 medic that:
- Regarding nature of offence of which adult is charged
- As result of mental disorder adult would commit offences
NO LIMIT OF TIME of restriction

Question 23

What are the effects of a restriction order?

Answer 23

Restriction without time limit
Must review annually
Patient and named person can apply for a review by tribunal
Automatic hearing if none in last 2 years

Question 24

What are the type of state hospitals in the UK?

Answer 24

High, Medium and Low security with Community centres

Question 25

What are the roles of state hospitals?

Answer 25

Necessary to detain subjects under Mental Health Act who require treatment under conditions of special security on account of dangerous/criminal propensities