Low mood - mental health capacity Flashcards
What are the core principles of the mental health capacity Act 2005?
- Assume to have capacity
- not to be treated unstable to make a decision unless all practicable steps have been taken without success
- not to be treated as unstable to make decision just because they make an unwise decision
- for someone who lacks capacity, best interest should be made
- less restrictive of persons rights and freedom of action
Who does the MCA act apply to?
- applies to adults who lack capacity
- for people 16+ must first presume capacity
- test a patients capacity
When does a person lack capacity?
- unable to make (or communicate) a decision
- understand relevant info
- retain relevant info
- use or weigh info
- communicate decision - inability is due to an impairment of or a disturbance in the functioning of, the mind or brain
- recall capacity
- decision specific and time specific
- permanent or temporary
- not assumed
What do decisions about treatment depend on?
- advance decision to refuse treatment
- lasting power of attorney
- persons best interests
What do decisions about the persons detention depend on?
whether the person is being deprived of their liberty
What is ADRT?
Advance decision to refuse treatment
- made by 18+ must be respected if competent, valid and applicable
- must be written, signed and witnessed
What is a LPA?
Lasting power of attorney
- if 18+ can consent to or refuse treatment on their behalf if person lacks capacity
- needs specific authorisation to decide about non(provision) of life sustaining treatment
- best interests
What to do if patient lacks capacity and no ADRT or LPA?
- Decisions made in persons best interests
- regard for persons beliefs and values, past and present wishes and feelings
- balancing exercise to decide
What is deprivation of liberty?
- involves 18+ person being required to remain for treatment against will
- permissible if it protects person from harm, is proportionate, no less restrictive alternatives, best interests
- there are safeguards to check hospitals and care homes
Who are involved in decisions?
- doctors must consult:
- person (maximise autonomy)
- welfare attorney
- court appointed deputy
- anyone named by patient
- IMCA
What do the IMCA do?
advise on the patients best interests if no one else available to do so
What is the mental health act 1983?
- area complies with the European convention on human rights
- act supplemented by a code of practice
To whom does the MHA apply?
- anyone and everyone
- children dealt with under Children Act 1989
- mental disorder
- pose a risk to themselves or others
Who applies the MHA?
- Patients
- nurses (detain for 4hrs)
- doctors (detain for 72hrs)
- police ( 24hrs)
- nearest relative
What does an AMHP do?
approved mental health practitioner
- applies to a hospital to accept a patient
- usually social worker with specific training
- two recommendations from doctors
- must know patient or have special training under MHA
What is an S2 MHA 1983?
For assessment and treatment
- up to 28 days
- if patient has a mental disorder of a nature or degree that warrants detention in hospital for assessment
- detention is in the interests of own health or safety or to protect others
What is a S3 MHA 1983?
for treatment
- up to 6 months
- if disorder means they should be detained in own or others interests
- treatment only possible if detained
- appropriate treatment is available
What treatment does the MHA cover?
- basic nursing care
- some types of medication
- ECT (safeguards s583)
- psychotherapy
any treatment must be in order to treat cause or the sequala of the mental disorder
What are the safeguards within the MHA?
S2 = person and their nearest relative is told how to appeal, legal advice provided, care team makes reports within 7 days, independent tribunal held within 7 days
S3 = same but within a month, hearing every 6 months, tribunal reviews annually
Difference between focus of MHA 1983 and MCA 2005?
- people who have mental disorder and pose risk to themselves
- people who lack capacity due to an impairment
Difference between treatment of MHA 1983 and MCA 2005?
- given involuntarily
- given in best interests
Differences between detention/liberty in MHA 1983 and MCA 2005?
- Detention: required to prevent harm to person or others, required for treatment of mental disorder
- deprivation of liberty: persons best interests, not have to be specific treatment
