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Psych Y5 > Legislation and Risk > Flashcards

Legislation and Risk Flashcards

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1
Q

What does section 1 of the MHA outline?

A

Who it applies to

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2
Q

When was the MHA first introduced? When was it amended?

A

Introduced 1984

Amended 2007

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3
Q

When does the MHA apply?

A

When a person with a mental illness requires assessment or treatment against their wishes but in the interests of their own safety or to protect others

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4
Q

What does section 2 of the MHA cover?

A

Detention for assessment of mental illness

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5
Q

How long does S2 of the MHA apply for?

A

28 days

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6
Q

What section of the MHA governs detention for assessment of mental illness?

A

S2

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7
Q

What section is used for inpatient management of a mental illness?

A

Section 3

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8
Q

How long does a section 3 last for? What about renewal?

A

6m

Can be renewed after this and then at 1yr, then yearly

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9
Q

What section of the MHA governs inpatient treatment of mental illness?

A

S3

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10
Q

Can you refuse treatment under a section 2 or 3? Exception?

A

Generally no but consent is generally required for ECT unless certain criteria met
ECT can be given if potentially life saving or to prevent serious deterioration, and as long as it doesn’t interfere with advance wishes or directives of LPA

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11
Q

How does the application process work for a S2/3?

A

Must be made within 14d of assessment by 2 separate doctors no more than 5 day apart

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12
Q

After how long does a S3 have to be reviewed and by whom?

A

3m by a Second Opinion Appointed Doctor SOAD

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13
Q

What section governs leave under a S2/3?

A

17

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14
Q

What section governs post S2/3 aftercare?

A

S117

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15
Q

What is section 17 of MHA for?

A

Governs leave under S2/3

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16
Q

What is section 117 of the MHA for?

A

Governs post S2/3 aftercare

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17
Q

What does S4 of MHA do? How long for and by whom?

A

Governs emergency assessment

Applies for 72 hours and only requires 1 doctor

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18
Q

What is a section 5(2)? How long does it apply for?

A

Doctors holding power

Stops informal patient from leaving for 72 hours

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19
Q

What is a section 5(4)? How long does it last for?

A

Nurses (prescribing grade) holding power

Works for 6hr

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20
Q

What is section 135 of MHA otherwise known as and what is it for?

A

Warrant to search and remove

For police to remove patient from private place and take to safe place

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21
Q

What is a section 136 otherwise known as? What’s it for?

A

Mentally disordered persons found in public places

Allows police to remove people from public and take to safe place (136 suite)

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22
Q

What section allows police to remove individual from private place?

A

135

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23
Q

What section allows police to remove people from public place?

A

136

24
Q

What is a Community Treatment Order and what is it for?

A

Out of hospital supervision for people post D/C from section 3
Makes sure they are compliant with treatment and allows them to be brought back in if not, aiming to prevent revolving door effect

25
Q

What section governs IMHAs?

A

130

26
Q

What does section 130 of MHA govern?

A

IMHAs

27
Q

When was MCA produced?

A

2005

28
Q

What are the 5 core principles of the MCA?

A

Presumption of capacity in adults over 16 unless proven otherwise
Individual should be supported in decision as much as poss
People have the right to unwise decisions
If lacking capacity, decisions should be made in best interest
If lacking capacity, decisions should try to be for least restrictive option

29
Q

What section of the MCA outlines the 5 core principles?

A

1

30
Q

What does Section 1 of the MCA outline?

A

Its 5 core principles

31
Q

What is the two stage functional test of capacity?

A

Stage 1 does the individual have a disturbance in brain or mind functioning
If so Stage 2 does this impact on their capacity to make this decision I.e. Can they:
a) understand all relevant info
b) retain the info long enough to make decision
c) weigh it up to make decision
d) communicate decision in any way

32
Q

What is a Lasting Power of Attorney? Who can appoint them?

A

Someone appointed to make decisions for an individual in future should they lack capacity
Any adult over 18 can have one

33
Q

What 3 types of decisions can LPAs appoint?

A

Health
Welfare
Financial

34
Q

What is an Enduring Power of Attorney EPA?

A

Like an LPA but only make financial and property management decisions not healthcare

35
Q

What is the role of the Court of Protection?

A

Appoints people who lack capacity someone to supervise decision making - a Deputy

36
Q

What do Public Guardians do?

A

Protect people lacking capacity from abuse with help of Office of Public Guardian
Maintain register of LPA and EPAs and Deptutied and supervise these

37
Q

Who is responsible for supervising and monitoring LPAs, EPAs and CoP Deputies?

A

Public Guardians

38
Q

What are Deprivation of Liberty Safeguards?

A

Series of checks to make sure care that restricts patients liberty is appropriate and in their best interest

39
Q

What do IMCAs do?

A

Represent individuals lacking capacity to supervise decision making, such as where the person lives or who cares for them (and serious medical care where no next of kin)

40
Q

What does DoLS aim to do?

A

Provide person with representative e.g. Family member, friend, carer or IMCA
Provide right to Court of Protection appeal
Provide review and monitoring systems for DoL

41
Q

What 6 parts are involved in assessing for DoLS?

A

Patient 18 or over?
Mental health disorder present?
Does patient have capacity?
Is a DoL taking place and is the decision in their best interest?
Eligible for MHA detention?
Any refusals in place? E.g. Advance directives/decisions, court appointed deputies or LPA

42
Q

How long does regular DoLS last for?

A

12m

43
Q

Who carries out DoLS assessments?

A

2 people
A best interests assessor e.g. Nurse, OT, social worker, psychologist
Plus a mental health assessor usually psychiatrist

44
Q

What is the psychological model of suicide proposed by Shneidman?

A

Five main elements:
Psyche ache
Lethality - planning, intent, access to means etc.
Cognitive constriction - inability to generate alternatives
Acute suicidality lasts only for a short term
Ambivalence/duality - e.g. Someone slitting their throat and asking for help

45
Q

What is the 4 step interpersonal-psychological model of suicide developed by Thomas joiner?

A

Four steps required for suicide to occur
Psyche ache/perturbation
Perceived burdonsomeness to others
Lack of belonging/connectedness to others
Acquired ability/capability for lethal action - must lose some fear

46
Q

What are the 3 main suicide methods touted by internet/media sites?

A

Cocktail overdose
Disposable bbqs
Helium

47
Q

What is the most method of completed suicide attempts in the U.K.?

A

Hanging

48
Q

What is the most common self harm/suicide attempt method in the U.K.?

A

Overdose

49
Q

What template is useful for thinking about narrative risk assessment, underpinned by the stress vulnerability model?

A

Hazards/external influences
Current clinical risk factors
Long term (lifelong) risk factors - statistical weighting
Protective/mediating factors

50
Q

What is the single best predictor or future suicide attempt?

A

Previous suicide attempt

51
Q

What are arguably the 3 most important long term risk factors for suicide?

A

Previous attempt or related
Problem solving ability (think about job, education etc.)
Personality structure, background trauma

52
Q

What is important to ask about in terms of FH of suicide?

A

Explore fully - who, how, when, why, where

Did you find them

53
Q

How can social history influence suicide risk?

A 
Social class 1 or 5 are higher risk
Unemployed older males who live alone statistically more likely
Social isolation, divorced or widowed etc.
54
Q

Current social clinical risk factors for suicide?

A 
Debts/unpaid bills etc
Recent loss or bereavement (or anniversary of)
Interpersonal problems
Shame, guilt
School, work problems
55
Q

What sorts of things do you consider when thinking about hazards/external influences for suicide?

A

GP/regular service contact
Learning difficulties, other vulnerabilities
Environmental factors e.g. Do they live near a train line, tower block?
Other meds available in family cupboard etc.
Hobbies - do they like hunting or shooting for example

56
Q

How to screen for risk of violence?

A

Do you have any present violent thoughts?
If yes - who against, how would you do it, could you get them etc.
Do you carry a weapon?

Psych Y5 (13 decks)

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