Mental Capacity Act and Mental Health Act Flashcards
State some routine investigations that can be done for individuals presenting with cognitive decline
- Mini-Mental State Examination (MMSE) for dementia
- FBC (B12 anaemia)
- U&Es (electrolytes disturbance)
- Thyroid function tests (hypothyroidism)
- Toxicology screen (substance misuse)
- Sleep studies (sleep apnoea)
State the use for section 2 of the mental health act (MHA) and how long it lasts for
Use:
- Admission for assessment of mental health (including treatment)
Lasts:
28 days - but can’t be renewed
State how many clinicians are needed to approve a section 2 mental health act (MHA) order
2 doctors (one of which is section 12 approved)
1 AMHP (approved mental health practitioner)
State the use for section 3 of the mental health act (MHA) and how long it lasts for
Use:
- Treatment of an established mental health illness (well known to mental health services) or following an admission under section 2
Lasts:
6 months - but can be renewed yearly as required
Can be discharged before the 6 months is complete
State how many clinicians are needed to enforce section 2 or 3 of the mental health act (MHA) order
1 AMHP (approved mental health practitioner)
2 doctors (one of which is section 12 approved)
Additional requirement:
- Doctor needs to have a diagnosis and treatment plan
- Additional doctor needs to review plan in 3 months
State when section 4 of the mental health act (MHA) is used and for how long it lasts
Use:
- For emergencies (when applying Section 2 would cause delay)
Lasts:
- Up to 72 hours
State the use of section 5(2), who can use it and how long it lasts
Used for patients previously informal that want to leave
- 5(2) can be used by Doctors
- Hold patient for up to 72 hours (3 days)
State the use of section 5(4), who can use it and how long it lasts
Used for patients previously informal that want to leave
- 5(4) can be used by nurses
- Hold patients for up to 6 hours / time it takes for doctor to assess
State the use of section 135
- Allows entrance to residence and take individual to a place of safety
- Able to detain a person from a private residence (not in public)
State the use of section 136
- Able to detain a person from a public place (not private residence)
What types of conditions can be treated under the mental health act (MHA) (rough categories)
- Mental illness (eating disorder)
- Learning disability
- Personality disorder
State the main aim of the mental capacity act (MCA)
Aims to identify patients who may lack capacity to consent or patients who refuse treatment, with an aim to protect them
State the 4 components to mental capacity assessment
Understand information
Retain information
Weigh up information
Communicate decision regarding information
State the 5 principals of mental capacity (I HELP)
Interest (best) - always act in the patient’s best interests
Help patient to make decisions e.g. interpreters
Eccentric or unwise decisions are allowed
Least restrictive - decisions made should be least restrictive
Presumption of capacity, until proven otherwise
State the differences in the following advanced care plans
1. Advanced decision / directive
2. Advanced statement
3. Lasting power of attorney
- Advanced decision / directive
- LEGAL DOCUMENT
- Relates to future treatment only
- Specific refusal of treatment in a future treatment that is signed by a patient (capacity at time of signing)
- Cannot demand treatment
- Cannot refuse basic care needs e.g. food - Advanced statement
- NOT A LEGAL DOCUMENT
- Verbal or written statement
- General statements for wishes and preferences if they were to lose capacity in the future
- Can include treatment but also general wishes e.g. what food they like - Lasting power of attorney
- Patient with capacity appoints an attorney (family or close friend) to make decisions on their behalf if they lose capacity in the future
