Legalities Flashcards
What is the Mental Health Act (1983)?
Outlines the rights and legal framework for assessing and sectioning someone under the mental health act
There are several different types of section but they all pertain to assessing and treating MENTAL HEALTH CONDITIONS ONLY
- MHA cannot be used to treat physical symptoms
What assessments must take place before someone can be sectioned?
1) 2 x doctors must see the pt
- One must be a psychiatrist who is Section 12 approved
- The other should be someone who knows the pt (often a GP but can be a hospital doctor as well)
2) An AMHP (allied mental health professional)
- Often a social worker
It is the AMHP that is responsible for submitting the sectioning documentation
What are the 5 following principles which should be followed when sectioning someone?
1) Least restrictive - maximising independence
2) Empowerment and involvement of the pt
3) Respect and dignity
4) Purpose and effectiveness
5) Efficiency and equality
What criteria must someone fit before they can be sectioned?
1) They MUST be suffering from a MENTAL DISORDER that warrants detention in hospital
AND
2) They must be of danger to themselves or others
AND
3) They must be unwilling to go to hospital voluntarily
(NB if someone lacks capacity then even if they volunteer to come into hospital you still technically section them because their decision is not valid)
What is section 2?
Sectioning for assessment
Someone who is being admitted, often with a first presentation of a mental disorder, so that they can have their mental disorder properly assessed
DOES NOT INVOLVE TREATMENT
How long can a section 2 last for?
Up to 28 days
What is section 3?
Sectioning for treatment
Someone who is being admitted, often with a previously known formal diagnosis of a mental disorder, so that they can receive treatment
This treatment ONLY extends to treatment of their mental disorder
How long can a section 3 last for?
Up to 6 months
How many times can a section 3 be appealed?
Twice within the first 6 months
Yearly after this
What can treatment involve under a section 3?
Active management of the mental disorder
Treatment of the causes of the mental disorder - can involve some physical treatments to treat underlying organic disorder
Treatment of the consequences of the mental disorder
- Eg TPN in self-neglect
What is a section 5 (2)?
Doctor’s holding power
For patients who are ALREADY INPATIENTS who are displaying a mental disorder
If the pt wants to leave but you believe this will be of significant detriment to their health/wellbeing or they are at risk to others and/or you believe they do not have the capacity to make such a decision then a section 5 (2) can be used to HOLD SOMEONE IN HOSPITAL UNTIL A FORMAL MENTAL HEALTH ASSESSMENT CAN BE PERFORMED BY A PSYCHIATRIST
How long does a section 5 (2) last?
Up to 72hrs
Who can perform a section 5 (2)?
FY2 or above
Does a section 5 (2) include physical treatment?
No does not include physical treatment - cannot treat someone until MHA has been carried out
Can a section 2 be appealed?
Yes within the first 14 days
What is a section 5 (4)?
Nurse’s holding power
How long can a section 5 (4) last for?
6 hours
Must see a doctor who can either revoke or complete 5 (2) within the 6hrs
What is a section 135?
Police power that gives police a warrant to search private premises and remove someone and take them to a place of safety (police station or hospital)
What is a section 136?
Gives the police the right to remove them from public places if they believe they need assessment or help from mental health services
The case must be discussed with a mental health professional before
How long does a section 136 last?
Up to 36 hours
What is the criteria for assessing capacity?
1) Understand information about the decision
2) Retain that information
3) Weigh up that information to make a decision
4) Communicate their devisions by any means
Capacity is specific to what?
Time and decision specific
NB all persons aged 18 yrs or over are assumed to have capacity unless proven otherwise
What may be used to determine a patient’s best interests?
1) Persons past and present wishes
2) Beliefs and values
3) Thoughts of people close to them
4) Lasting power of attorney
5) IMCA = Independent mental capacity advocate
What is a lasting power of attorney?
Allows a person to stipulate who they would wish to manage their health and welfare decisions, and/or decisions about their property and finances
What is the court of protection?
Can be used to make declarations concerning
capacity and can appoint deputies to make decisions on behalf of others
What is an independent mental capacity advocate?
If the person who lacks capacity does not have anyone else to advocate for them, an IMCA must become involved if the decision is about ‘serious medical treatment’ or DoLS
What is a DoLS?
Deprivation of Liberty Safeguards
Apply to any person who lacks capacity and is deprived of their liberty in their best interests (regardless of whether they object or not). Occurs in care homes, general hospital wards, mental health wards.
Deprivation defined as:
“If the acid test is whether a person is under the complete supervision and control of those caring for her and is not free to leave the place where she lives”
What are the timeframe of a DoLS?
Urgent = up to 7 days or standard = up to 1 year
Outline MHA vs MCA
Assessing and/or treating a mental disorder = MHA
Treating a physical illness = MCA (unless that illness is the result of a mental disorder, then use the MHA as it can give you authority to treat)
If you need to treat a physical illness in someone who is detained under MHA then you can use the MCA to authorise this
What is a section 37?
A court order for someone to go to a secure hospital instead of a prison
2 doctors must agree the person is mentally unwell
What is a section 47?
For people who are sentenced prisoners
Allows you to transfer them to a hospital to assessment and treatment
What is a section 49?
A restriction order that applies the same levels of restriction as prison
Cannot leave on their own free will - all dictated by the ministry of justice
