Legal Aspects of Psychiatry

Question 1

Why do we have mental health law?

Answer 1

To ensure the rights and power to treat and provide compulsory care to patients with a mental disorder is not abused.

Question 2

How is mental disorder defined in the 2003 mental health act (care and treatment)?

Answer 2

Any mental illness, personality disorder or learning disability however caused or manifested.

Question 3

Who can be detained under the 200s Mental Heath Act?

Answer 3

> 18years

<18 can still detained just need a child /adolescent specialist.

Question 4

Who can administer the mental health act?

Answer 4

Any fully registered doctor.

Not an FY1 as they are not fully registered.

Question 5

How long can someone be detained for under the mental health act?

Answer 5

Emergency Detention certificate - 72hrs
Short-term detention certificate - 28days
Compulsory Treatment order - 6 months
Nurses holding power - 3hours

Question 6

What are the requirements for an emergency detention certificate?

Answer 6

Registered medical practitioner must consider it likely that the patient has a mental disorder and because of that their decision making ability with regard to medical treatment is impaired.
Must also be satisfied that it is a matter of urgency, there is significant risk to patient or others if not and making arrangement for short term would make an undesirable delay.

Question 7

What are the requirements for a short term certificate?

Answer 7

Approved medical practitioner must consider it likely that:
The patient has a mental disorder
Decision making is impaired
Necessary to determine or give treatment.
Risk to themselves/others

Question 8

What are the requirements for a compulsory treatment order?

Answer 8

Application to mental health tribunal by mental health officer.
GP and approved mental health practitioner or 2 approved mental health practitioners must provide reports.
Patient has disorder
Treatment is available and would help deterioration.
Risk to themselves/others
Impaired decisions

Question 9

How is an adult defined under the Adults with incapacity act 2000?

Answer 9

Any person who is 16 or above.

Question 10

What are the principles of the Adults with incapacity act?

Answer 10

Intervention must benefit the adult.
Intervention must be least restrictive in relation to freedom of adult.
Account must be taken of the past and present wishes of the adult.
Where practical the account should be taken of the views of relatives/carers/relevant others.

Question 11

What are the different areas of capacity a person might have?

Answer 11

Property
Welfare including medical
Financial

Question 12

What powers can be given under the adult with incapacity act 2000?

Answer 12

Intervention order - one off power required. Application to the court.

Guardianship order - someone else is appointed to make decisions on behalf of the adult.

Question 13

What will the adults with incapacity act not authorise?

Answer 13

Use of force or detention unless immediately necessary.
Action that would be inconsistent with any decision made by a competent court.
Placing an adult in a hospital for treatment against their will.

Question 14

What is the Criminal Justice and Licensing act 2010?

Answer 14

Act determine the criminal implications of someone who commits a crime with a mental health disorder.

Presumed responsible for your actions until proven otherwise.

Question 15

When is a person unfit for trial?

Answer 15

The person is incapable by reason of a mental or physical condition to participate effectively in a trial.
Can they understand nature of charge, understand the purpose and follow the trial, understand evidence that may be given against them, instruct and otherwise communicate with their legal representative, or any other factor that court deems relevant.

Question 16

What is diminished responsibility?

Answer 16

Person who would otherwise be convicted of murder is convicted of culpable homicide as they are found to have diminished responsibility if at the time their ability to determine control of conduct is impaired by reason of abnormality of mind.

Question 17

What are restricted patients?

Answer 17

Patients that are deemed by the first minister to be kept in a state hospital.
Approx 300 min Scotland.

Question 18

What is an assessment order?

Answer 18

1 registered medical practitioner.
Court satisfied there are reasonable grounds that mental disorder needs detention in a hospital, civil risk criterion met, treatment, suitable bed available in 7 days, assessment could not be undertaken in a hospital.

Question 19

What is a treatment order?

Answer 19

Court satisfied on basis of evidence from 2 medical practitioners of mental disorder that is treatable and there is civil risk. Suitable bed within seven days and there is no reasonable alternative.

Lasts until final disposal or another order is granted.

Question 20

What is a restriction order?

Answer 20

Court must be satisfied that following criteria are met:
The antecedents of person and the risk that as a result of their mental disorder they would commit offences is large.
Necessary for protection of public.
Without limit of time.
Need to hear oral evidence from at least 1 medical practitioner.
Must be reviewed annually.

Question 21

What is a compulsion order?

Answer 21

Court satisfied on evidence of 2 medical practitioners of mental disorder, availability of treatment, significant risk, necessary to be in hospital. Need to consider level of security and if necessary.