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Chapter 3: Drugs, Alcohol and Mental Health > Mental Health > Flashcards

Mental Health Flashcards

Mental Health (Compulsory Assessment and Treatment) Act 1992 (Sections 2, 38, 39, 41, 109, 110C and 122B)

1
Q

Explain Section 2 - Interpretation?

A

(1) In this Act, unless the context otherwise requires -
. Mental Disorder
* In relation to any person, means an abnormal state of mind (whether of a continuous or an intermittent nature), characterized by delusions, or by disorders of mood or perception or volition or cognition, of such a degree that it -
(a) Poses a serious danger to the health or safety of that person or of others; or
(b) Seriously diminishes the capacity of that person to take care of himself or herself
. And mentally disordered, in relation to any such person, has a corresponding meaning.

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2
Q

Explain Section 38 - Assistance when person may need assessment?
Clue: Responsibilities of DAO

A

(1) Anyone who believes that a person may be suffering from a mental disorder may at any time request the assistance of a duly authorised officer.

(2) The duly authorised officer who receives the request must -
(a)

(3) If the duly authorised officer decides that the person needs to have a medical examination, but not urgently, he or she must -
(a)

(4) If the duly authorised officer decides that the person needs to have a medical examination urgently, he or she must -
(a)

(5) A duly authorised officer who receives a request need not comply with subsections (3)(a) or (4)(a) to (d) …
(6) A medical practitioner doing an examination under subsections (3)(a) or (4)(b) or (d) …

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3
Q

Explain Section 39 - Assistance in respect of outpatients and inpatients on leave?

A

(1) This Section applies to -
(a) Every patient who is subject to assessment otherwise than in a hospital; and
(b) Every patient who is subject to a community treatment order; and
(c) Every patient who is subject to an inpatient order but is on leave from the hospital in accordance with Section 31 of this Act.

(2) Anyone may at any time request the advice or assistance of a duly authorised officer in relation to any aspect of the care, treatment, or conduct of a patient to whom this Section applies.
(3) On any such request, a duly authorised officer shall take the following steps:

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4
Q

Explain Section 40 - Assistance in taking or returning proposed patient or patient to place of assessment or treatment?

A

(1) This Section applies to -
(a) Every proposed patient or patient who -

(b) Every patient who -
(c) Every patient who -
(2) On becoming aware of a proposed patient or patient to whom this Section applies, a duly authorised officer may take all reasonable steps to -

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5
Q

Explain People with mental distress in relation to Prevention First.

A
  • The Police operating strategy, Prevention First, requires all staff to consider the use of Police discretion and alternative resolutions in appropriate circumstances.
  • When dealing with a person suffering mental distress, Prevention First means taking a holistic approach to any offending and seeking out opportunities to prevent re-offending. This includes leveraging off community services (e.g. DAO, CAT) to protect vulnerable people.
  • Ensure that incidents involving a person with a mental impairment are resolved through the Mental Health (Compulsory Assessment and Treatment) Act 1992 where appropriate so that health assistance is provided to the people who need it.
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6
Q

Explain People with a mental disorder?

A
  • The Mental Health (Compulsory Assessment and Treatment) Act 1992 provides for the assessment, treatment and care of people who have, or are suspected of having, a mental disorder.
  • The Act also defines their rights.
  • The Mental Health (CAT) Act 1992 details Police powers and duties when:
    . they help Health authorities
    . deal with mentally disordered persons on private property or
    . wandering at large or
    . Return a patient absent without leave from a hospital
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7
Q

Explain Police role under the Mental Health (CAT) Act 1992?

A

The responsibility for providing services under the Mental Health (CAT) Act 1992 rests primarily with the mental health services but Police provide assistance where legislation provides for Police intervention.

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8
Q

Explain Memorandum of Understanding?

A
  • The New Zealand Police and the Ministry of Health have a Memorandum of Understanding (MOU) governing the practical implementation of the Mental Health Act.
  • It:
    . Covers responsibilities, transportation of patients and use of force, and forms the basis of local agreements with the local mental health service.
    . Provides that the duly authorised officer (“DAO”) is the official in charge at any incident that requires the Mental Health (CAT) Act 1992 to be invoked and a response from Police and the mental health service. The DAO should request Police assistance only when the particular powers and specific expertise of Police are required.
    . Provides that where a person needs to be assessed under the Mental Health (CAT) Act 1992 that this should take place in the least restrictive environment possible (such as in the community or a health facility like an emergency department)
    . States that a person’s degree of intoxication should not delay any mental health assessment.
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9
Q

Explain Assessment and Treatment procedure?

A
  • This Act sets out procedures for assessment and, if necessary, treatment of persons who are thought to have mental disorders.
  • The procedure involves the mental health service and the Courts.
  • Police provide assistance only when required as statutorily provided for in the Act.
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10
Q

What is the Definition of mental disorder and the Role of the DAO, responsible clinician and the Court?
Clue: Section 28(1) of the Mental Health (CAT) Act 1992 refers

A
  • The legal definition of ‘mental disorder’ is very technical and may differ from the usual meaning of the term ‘mental disorder’.
  • Anyone who believes that a person may be suffering from a mental disorder can ask a DAO for assistance.
  • A DAO is required to investigate and decide whether or not the person needs to have a medical examination, and whether this is required urgently.
  • The DAO must arrange for a health practitioner to examine the person.
  • If ther are reasonable grounds for believing the person is suffering from a mental disorder, he or she can be certified for compulsory assessment, and a responsible clinician (usually a psychiatrist or doctor) must carry out a further examination.
  • If found to be mentally disordered, the person can be compelled , by order of the Court (either through a community treatment order or inpatient order) to undergo treatment as long as that persons mental disorder continues
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11
Q

What is a mental disorder?

A
  • ‘Mental Disorder’ is defined in the Mental Health (CAT) Act 1992 to mean a person is in an abnormal state of mind (continuous or intermittent) who may be delusional, or their mood or perception may be such that it poses a serious danger to the health and safety of that person or others, or seriously diminishes the capacity of such persons to look after themselves.
  • Key words in the above definition are:
    . (i) “…poses a serious danger…”, and
    . (ii) “…seriously diminished capacity … to look after themselves”.
  • Therefore, a number of persons that Police likely come into contact with and they perceive as suffering a mental disorder, do not meet the criteria of the Mental Health (CAT) Act 1992, which Health professionals must follow when considering whether to detain someone.
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12
Q

‘Mental Disorder’ does not include…

A
  • Section 4 of the Mental Health (CAT) Act 1992 explains that the Act’s compulsory assessment and treatment procedures may not be invoked simply because of a person’s:
. Political, religious or cultural beliefs
. Sexual preferences
. Criminal or delinquent behaviour
. Substance abuse
. Intellectual disability
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13
Q

Police Powers to assist DAO’s - Authority.

A

You have legal powers under Section 41 of the Mental Health (CAT) Act 1992 to assist DAO’s.

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14
Q

When you can assist…Part 1

Clue: Section 41(2) & (3) of the Mental Health (CAT) Act 1992 refers

A
  1. When you can assist
    - If a person is believed to have a mental disorder and needs a medical examination urgently, Police may help the DAO to effect Section 38(4)(b) of the Mental Health (CAT) Act 1992, e.g. enable a medical practitioner to examine the person

What you can do

  • If you are helping a DAO to have a medical practitioner examine a person, you:
  • may enter the premises where the person is, and
  • must produce identification/evidence that you are a Police Constable if not in uniform
  • may detain the person for up to 6 hours or the time it takes to complete the medical examination, whichever is shorter.
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15
Q

When you can assist…Part 2
Clue: (Section 38(4)(d) of the Mental Health (CAT) Act 1992 refers) and (Section 41(2) & (4) of the Mental Health (CAT) Act 1992 refers)

A
  1. When you can assist
    - If the person must go to the medical practitioner for the examination but is unwilling to go, you can help the DAO to take the person and ensure that he or she is examined.
    (Section 38(4)(d) of the Mental Health (CAT) Act 1992 refers)

What you can do
- If you are helping DAO to take a person to a medical practitioner to be examined, you:
* may enter the premises where the person is, and
* must produce identification/evidence that you are a Police Constable if not in uniform
* may take the person to the place of the medical examination and detain the person there for up to 6 hours or the time it takes to complete the medical examination, whichever is shorter.
(Section 41(2) & (4) of the Mental Health (CAT) Act 1992 refers)

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16
Q

When you can assist…Part 3
Clue: (Section 40(2) of the Mental Health (CAT) Act 1992 refers) and (Section 41(2), (5) & (6) of the Mental Health (CAT) Act 1992 refers)

A
  1. When you can assist
    - You can also help a DAO take all reasonable steps to take or return proposed patients and patients to places of assessment or treatment if they are refusing to attend or are absent without leave.

What you can do

  • If you are helping a DAO take or return a person to a place of assessment or treatment, you:
  • may enter the premises where the person is, and
  • must produce identification/evidence that you are a Police Constable if not in uniform
  • may take the person to the place they are required to attend and detain the person there for up to 6 hours or the time it takes to conduct the assessment, examination, review or treatment that the person was refusing to attend for, whichever is the shorter, or
  • may take the patient back to the hospital
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17
Q

What is the preferred action when assessing the patient?

A

The preferred action is to have a doctor assess the person in the person’s home. Only if this cannot be done should the DAO take the person to another place.

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18
Q

Explain “Warrant required”?

A

Under Section 41(7) of the Mental Health Act, you must not exercise your powers to enter without a warrant if it would be reasonably practicable to obtain one.

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19
Q

Explain when No documentation other than the warrant is required?
Clue: Section 113A of the Mental Health (CAT) Act 1992 refers

A
  • Only a Police Constable or the Director of Area Mental Health Services can apply for a warrant.
  • However, it has been agreed between Police and the Ministry of Health that the warrant may be completed by either the Police Constable or the DAO.
  • The Police Constable must sign and swear it.
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20
Q

Police responsibilities when “not in uniform”?

A

Under Section 41(2)(b) of the Mental Health Act, if you are not in uniform when exercising your powers to assist a DAO, you must produce to the occupier your badge or any other evidence that you are a Police Constable.

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21
Q

When “Arrest provisions apply”?

Clue: Section 122A of the Mental Health (CAT) Act 1992 refers

A
  • Sections 30, 31 and 34 of Crimes Act 1961 apply to your power to take and detain as if it were a power of arrest, with any necessary modifications.
  • Specifically:
    . Section 30 of the Crimes Act protects you from criminal responsibility if you arrest the wrong person in good faith and on reasonable and probable grounds believed the person to be the one named in the warrant.
    . Section 31 confers all statutory powers of arrest without warrant on all Constables.
    . Section 34 confers the power to assist a Constable in an arrest on anyone asked to do so.
22
Q

Explain “Using force”?

A
  • Under Section 122B (1) & (2) of the Mental Health (CAT) Act 1992, if you are acting in an emergency when assisting a DAO, you can use such force as is reasonably necessary in the circumstances.
  • Use the operational threat assessment tool TENR (Threat, Exposure, Necessity, Response) to assess whether any use of force is necessary and proportionate, given all the circumstances known at the time.
  • If you use more than minimal or inconsequential force under this section, you must complete a Tactical Options Report (TOR). This report will be collated and forwarded to the Director of Area Mental Health Services on your behalf.
23
Q

Caution when “using force”?

A

Caution: if you act without statutory authority, you have no protection from civil or criminal liability even if you have acted in good faith.

24
Q

Procedures for assisting DAOs - Limitations of your powers and assistance.

A
  • Your powers to enter premises and detain a person can be used only to assist a DAO who is acting under Section 38(4)(b) or (d), or Section 40(2) of the Mental Health (CAT) Act 1992 .
  • Limit your assistance to that which is necessary to affect a reasonable solution to the problem. Continually assess the appropriateness of the actions requested of you, and tell the health professional if they are proposing that you act outside your powers or ability.
25
Q

When Checking credentials.

A

If a DAO asks for your assistance, carefully check credentials of the person making the request.

26
Q

Check the certificate.

A

If a DAO asks you to help them to take or return a patient to an assessment or treatment place (if the patient is refusing to attend or is absent without leave), ask to see a copy of the relevant assessment certificate or compulsory treatment order.

27
Q

Explain “Using force to transport the person”?

A
  • In the situation when a person must go to the medical practitioner for the examination but is unwilling to go, you can use force to transport the person in limited circumstances as set out in Section 122B of the Mental Health (CAT) Act 1992.
  • In the situation when a proposed patient or patient is refusing to attend an assessment or treatment place or is absent without leave, you can use force only if there is an emergency and only as is reasonably necessary in the circumstances.
  • If the person is being transported to attend for assessment and treatment under Section 9, 11 or 13 of the Mental Health Act, do not use force unless a health professional has issued a notice under the relevant section and this has been explained to the patient.
  • The notice states the reason for the assessment examination, the time and place of the assessment and the person who will perform it. The person cannot be moved without this.
  • In all situations, use force only if:
    . In your opinion it is justified, and
    . The DAO gives you clear instructions to do so, and
    . The patient would be likely to suffer harm, or to harm other people, or damage property if force is not applied, and
    . The force used is necessary and proportionate given all the circumstances known at the time.
  • You must know which section you are acting under, and be sure of what it says.
  • If you use more than minimal or inconsequential force, complete a Use of Force report.
28
Q

Explain “Indemnity against civil claims”.

A
  • Do not use force unless:
    . The District has obtained a general indemnity from the mental health service against civil claims for damage, or
    . The DAO has been informed, and has accepted responsibility for the damage and asked you to continue.
29
Q

When “Taking the person to a Police station”?

A
  • Using a Police station as a clinic for assessment is unsuitable unless there is absolutely no alternative, for example, there is no nearby hospital.
  • If you are asked to take the person to the station, you are not obliged under Section 41 of the Mental Health (CAT) Act 1992 to do so. You can, if appropriate, advise the DAO that the patient can be taken only to a hospital or some other treatment facility.
  • If the person is violent or the hospital does not have a bed, Police are sometimes asked to detail the person at a Police station.
  • If the person has not committed an offence and is not under arrest, this should be done only as a last resort.
30
Q

Six hour detention limit.

A

Do not detain a person for longer than six hours.

31
Q

Bill of Rights.

A

If you detain a person, you must comply with the requirements of the New Zealand Bill of Rights Act 1990.

32
Q

If the DAO is not present.

A
  • If the person who requested your assistance is not at the scene, do not do the job of a health professional.
  • If the matter is not urgent, decline to take further action.
  • Police should not be routinely involved in applications for compulsory assessment.
  • Remember: It may be appropriate to use (where the circumstances exist which allow the use of those powers) powers provided by other statutes to enter the premises, such as the power to enter premises under Search and Surveillance Act 2012.
33
Q

When “Assisting a medical practitioner” - explain “Authority”?

A

Your powers to assist a medical practitioner are contained in Section 110C of the Mental Health (CAT) Act 1992.

34
Q

When you can assist - You can help a medical practitioner do any of these things … part 1
Clue: Section 110(4) of the Mental Health (CAT) Act 1992 refers

A
  1. If the practitioner needs to urgently examine a person who is acting in a manner that gives rise to a reasonable belief that the person is mentally disordered and is in the interests of self/others, you can assist that practitioner when called upon to do so.
35
Q

When you can assist - You can help a medical practitioner do any of these things … part 2
Clue: Section 110A(5) of the Mental Health (CAT) Act 1992 refers

A
  1. If the practitioner issues a certificate that the person urgently needs an assessment examination and believes the person is a significant danger to himself or herself or others and needs to be sedated in his or her own interest, you can help the doctor administer the drug (I.e. restrain the person for the practitioner)
36
Q

When you can assist - You can help a medical practitioner do any of these things … part 3
Clue: Section 110B(4) of the Mental Health (CAT) Act 1992 refers

A
  1. When the person is undergoing the assessment examination, you can help the medical practitioner who carries the assessment out.
37
Q

Police powers under Section 110C.

A
  • Under Section 110C(1) and (2) of the Mental Health Act, you:
    . May enter the premises where the person is,
    . Must produce identification/evidence that you are a Police Constable if not in uniform
    And may at the request of the medical practitioner:
    . Detain the person where he or she is, or
    . Take the person or proposed patient to a place nominated by the doctor and detain the person or proposed patient there.
  • For each situation, you can detain the person for the time it takes to conduct the medical exam but in any event for no longer than six hours.
38
Q

Procedures: Steps if you are asked to assist a medical practitioner.
Clue: 5 provided

A
  1. Verify the urgency with the medical practitioner (you cannot use force unless it is an emergency).
  2. If necessary, and when authorised under the Act, use force to detain the person, or to take the person to a place nominated by the medical practitioner for an assessment and detain that person there.
  3. Advise the person of their rights under the New Zealand Bill of Rights Act 1990 where they are detained.
  4. Ensure that you do not detain the person for more than six hours.
  5. If you use more than trifling force, complete a Use of Force report. Send a copy of the report to the Director of Area Mental Health Services.
39
Q

Authority when dealing with “Mentally disordered person wandering at large”.

A
  • If you find a person wandering at large in any public place who you reasonably believe may have a mental disorder, you have powers to apprehend under Section 109 of the Mental Health Act, which relates to mentally disordered persons in a public place.
  • You should only do this if you think that it would be desirable in the interests of the person or of the public to do so.
40
Q

Definition of public place.

A
  • A ‘public place’ is defined in Section 2 of the Summary Offences Act 1981.
  • Note: A person is also in a public place if they are in any aircraft, hovercraft, ship or ferry or other vessel, train, or vehicle, which is in a public place.
41
Q

Making enquiries to locate a person and reasonably believe they may be mentally disordered and requiring assessment for inpatient treatment.

A
  1. Check the person’s status (QP) - they may have been reported missing from a psychiatric hospital or other mental health facility.
  2. If the person has a known psychiatric history, call your local DAO’s or Mental Health services and ask if they have any information about the person.
  3. Ask the DAO(s) to find out whether the person is on leave from a psychiatric hospital. If so, their leave may be revoked and the patient returned to the hospital by either a DAO, the person who has charge of the person while on leave, or yourself.
42
Q

Power to detain for an examination.

A
  • If you find a person in a public place who is acting in a manner that gives rise to a reasonable belief that he or she may be mentally disordered, the Mental Health (CAT) Act 1992 states that you can:
    . Take the person to a Police station, hospital, surgery or other appropriate place, and that you must
    . Arrange for a doctor’s examination as soon as practicable
  • You can take this action under Section 109(1) of the Mental Health Act, if you think it would be in the interests of the person or of the public.
  • Note: You do not have to assess whether the person is mentally disordered. It is sufficient that the persons behaviour give rise to a reasonable belief that the person may be mentally disordered.
43
Q

Medical practitioners examination.

A
  • If the medical practitioner considers that:
    . There are reasonable grounds for believing that the person may have a mental disorder, and
    . It is desirable for the person to have an assessment examination urgently in the person’s own interests of any other person.
  • The medical practitioner must issue a medical certificate under Section 109(3) of the Mental Health (CAT) Act 1992 and make an application for a preliminary assessment (Sections 8, 8A and 8B).
  • If the medical practitioner decides that the person does not have a mental disorder, the person should be released.
    (Sections 109(2), (3) and (3A) refer)
  • Consideration should be given to passing the care of the person to a family member or friend.
44
Q

Power to detain if the situation is urgent under Section 109.

A
  • If the assessment under Section 109(3) of the Mental Health (CAT) Act 1992 is urgent, you can:
    . Continue to detain the proposed patient at that place until the examination has been conducted, or
    . Take the proposed patient to a place nominated by the medical practitioner for the purpose of the examination, and detain the proposed patient there until the examination has been conducted.
  • Note: You can detain the person for no longer than 6 hours for the purposes of this examination.
45
Q

Authority when dealing with “Mentally disordered person on private property”.

A
  • Police have no power under the Mental Health (CAT) 1992 Act to enter private property or to detain a person with a mental disorder on private property, unless asked to do so by a DAO or medical practitioner.
  • When dealing with a person with a medical disorder on private property, use the operational threat assessment tool, TENR, to assess the threat, exposure, the necessity to act now, later or not at all, and to develop an appropriate response.
  • Consider the use of Police discretion and alternative resolutions in appropriate circumstances, as required by the Police operating strategy, Prevention First.
  • If action is required, and appropriate response may involve seeking help from the DAO, the persons doctor, family, friends or associates (as explained in the Initial procedure in Dealing with people with mental disorders) or using other legislation to enter the premises.
46
Q

Powers to enter premises.

Clue: Section 8, Section 7, Section 14 and Section 18

A
  • Remember Police officers have an implied licence to enter a property, just like any member of the public.
  • If requested to leave by a lawful occupier of the property, in the absence of a lawful justification to remain, Police must leave.
    . Police can also enter a property if requested to do so by a lawful occupier of that property.
  • However, if you suspect a person has committed an offence that is punishable by imprisonment and for which he or she can be arrested without a warrant, Section 8 of the Search and Surveillance Act 2012 allows you to enter private premises to search for and arrest that person without a warrant.
  • You can only enter the premises if you believe the person will leave to avoid arrest, and/or destroy, conceal, alter or damage evidence, unless you arrest him or her immediately.
  • You can also enter private premises under Section 7 of the Search and Surveillance Act 2012, to search for and arrest a person if you suspect that the person is unlawfully at large, for example, the person is subject to an inpatient order and is absent without leave.
  • Section 14 of the Search and Surveillance Act 2012 allows you to enter private property or a vehicle without a warrant if you suspect there is a risk to life or safety that requires an emergency response.
  • It also allows warrantless entry if you have reasonable grounds to suspect that your entry will stop or prevent and offence being committed that might injure someone, damage or cause serious loss of property.
  • Finally, there are other particular circumstances in which you can lawfully enter a property, for example, under Section 18 of the Search and Surveillance Act 2012, you can enter a private property if you have reasonable grounds to suspect that a person is in possession of firearms but by reason of a mental condition is incapable of having proper control of them.
47
Q

Power to prevent suicide.

A

Under Section 41 of the Crimes Act 1961, you can use such force as may be reasonably necessary to prevent a suicide or the commission of any offence that would be likely to cause immediate and serious injury to anyone, or serious damage or property, or to prevent an act that you believe, on reasonable grounds, would amount to suicide if committed.

48
Q

Explain Trespass?

A

Depending on the circumstances, you may be able to take action under the Trespass Act 1980.

49
Q

Explain Retaking a patient.

A

If the person is absent from hospital without leave, you may be able to use your powers to return the person.

50
Q

Calling a DAO or medical practitioner on private premises.

A

If none of the above apply and you must take action, call a medical practitioner or DAO to the scene.

Chapter 3: Drugs, Alcohol and Mental Health (4 decks)

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