Mental Capacity Act and Mental Health Act Flashcards
1
Q
Two types of law
A
- Statute law - passed by act of parliament eg MCA, MHA
- Case law - interpretations of the law made by judges, then makes new law from that circumstance
2
Q
Phobia and capacity
A
- Phobia can affect capacity
- eg needle phobia can cause so much distress can affect capacity
3
Q
Parental influence on consent for a 16 year old
A
- Will be involved in best interests decision
- Do not just follow what they say but take into account in terms of best interests
4
Q
3 necessary aspects of consent
A
- Informed - appropriate level of info
- Competetent - does person have capacity
- Voluntary - not coerced by relatives, medics, nurses etc
5
Q
Types of consent
A
- Implied
- Withdrawn
- Verbal, non verbal or written
- Under age 16 may be competent - Gillick competence
6
Q
Aspects of mental capacity act 2005 - what is it etc
A
- Single test of capacity - decision specific
- Best interest checklist if no capacity
- Can have AD or LPA for future planning
- Specific legal safeguards for incapacitated adults - deprivation of liberty safeguards
- IMCA - independent MC advocates can be used (eg if no family member)
7
Q
Principles of MCA
A
- Presume capacity
- Try to support the individual in every way possible to make their own decisions
- Can be unwise decision
- Use least restrictive option in terms of their freedom
- Best interests
- Decision specific
- If in doubt - 2nd opintion, legal opinion, case conference, courts referral
8
Q
Options for difficult decisions re mental capacity
A
- Second opinion
- Court of protection
9
Q
What is advanced decision?
A
- Can’t request treatment
- But can refuse certain treatments
- Only relates to medical treatments
- Used when have capacity to be used when someone doesn’t have capacity and over 18
10
Q
restrictions for LPA
A
- Can’t have been previously bankrupt
- Need to still make best interest decisions
11
Q
Capacity in terms of drugs/alcohol/phobias
A
- If at time unable to make decision because of impairment of or disturbance in the functioning of the mind or brain
- = person lacks capacity
12
Q
4 part of capacity assessment
A
- Understand
- Retain - can you repeat back to me what I have said to you?
- Weigh up - severe distress can impair capacity, psychotic beliefs can influence
- Communicate back - in ANY way that we can understand
13
Q
Unborn child and capacity act
A
- Unborn child has no rights under MCA
- Until they’re born
14
Q
Best interests decision - whats involved?
A
- All decisions if lack capacity should be made in best interests
- Patient can participate even though lack capacity
- If regain capacity and not urgent, best interest may be to wait to make decision
- Consider patients past and present wishes, take into account advanced decisions, LPA etc
15
Q
Who is DOLs for?
A
- Patients in hospital or care homes who lack capacity
- Lead by social workers
16
Q
What can MHA be used for?
A
Can only be used to enforce treatment for MH conditions
17
Q
Principles of MHA
A
- Minimise undesireable effects of mental illness
- Least restrictive
- Participation of patient and nearest relative (legal list of relatives that we work down and check, not NOK)
- Equity, effectiveness and efficacy
18
Q
Criteria for implementing MHA
A
- Presence of mental disorder as defined by law (or suspiscion of)
- Disorder is of a certain nature (type of illness eg relapsing remitting, psychotic) or degree (mild, moderate or severe)
- Significant risk to persons health, safety or safety of others
- No alternative to hospital admission as a means of safeguarding that risk - cannot manage in less restrictive setting
Health = risk of worsening as no insight and refuse meds
19
Q
Define mental disorder
A
any disorder or disability of mind
20
Q
Section 5(4)
A
- Power granted to registered mental health nurses to detain an inpatient (someone already on psych ward) for up to 6 hrs for medical assessment where mental illness is suspected
- Cannot be done in A&E - not inpatient
- Form complete, submitted to hospital managers
21
Q
Section 5 (2)
A
- RMO (in control clinician eg consultant or on call) or nominated deputy
- Can detain inpatient for up to 72hrs under MHA
- Cannot be done in A&E
- No appeal
- Legal form for hospital managers, allows MHA to be completed
22
Q
Section 2
A
- For assessment (and treatment)
- 3 people - 2 doctors (one of which is section 12 (2) approved) and one AMHP (mostly social workers)
- All three should agree
- Community or inpatient - anywhere except prison
- Section for maximum of 28 days - can be ended at anytime
- Can appeal within first 14 days
23
Q
What is appeal?
A
- Tribunal
- Looks a evidence so far, checks decision is correct for ongoing management
24
Q
What is section 3?
A
- Already know diagnosis, just need treatment
- 2 doctors and 1 AMHP (one doctor section 12 (2) approved)
- Community or inpatient - except prison
- Section for maximum of 6 months for treatment - end at any time
- Can appeal at any point
25
Q
What people can discharge someone from section?
A
- Consultant - (RC - responsible clinician)
- Tribunal if appeal and tribunal agrees
- Hospital managers
- Nearest relative power of discharge - give consultant 72hrs notice
26
Q
What is section 136?
A
- Police power to remove a person to a place of safety from a public place for an assessment by AMHP and 1 doctor
- Can be A&E, place of safety assessment unit
- Held up to 24hrs
- Police stay with person
- If needed second doctor attends for MHA assessment for section 2 or 3
27
Q
Section 135
A
- Police can remove person from own home, need warrant for this
- To place of safety
28
Q
Section 17
A
- Whilst detained in hospital under S2 or S3 patient may have leave under S17
- Leave to walk, go home for several hours overnight or longer
29
Q
What is section 117?
A
- Anyone who has been on section 3 is entitled to section 117 aftercare from social care etc
30
Q
What is community treatment order?
A
- On section 3 can be considered for CTO
- Patient well enough to leave hospital but may stop treatment/attending follow up (usually on depot)
- Treatment is necessary for patients health, safety or protection of others
- Allows a patient to be recalled to hospital if they do not comply with rules of CTO (take meds, attend f/u)
- Can appeal
31
Q
What are forensic sections/ministry of justice?
A
- Section of MHA that need to go through ministry of justice
- Patients who are prisoners or comitted significant crimes would not be detained under S2 or 3
- Ministry of justice might include a restriction order to prevent discharge or leave/transfer without them approving
32
Q
A
