Mental Health Act Flashcards
“What are the prerequisites for a patient to be admitted as an involuntary patient to a psychiatric admission centre? Who has to assess the patient to retain them, and when does the patient have to be reviewed by the magistrate? What are the requirements for a patient to receive involuntary treatment for a further period up to 6 months?
A 21 year old male is brought to ED by police. He is aggressive and disoriented. Discuss approach. What is mental health act & how is guardianship different”
Pre-requisites for INVOLUNTARY admission under MHA in NSW:
If the person is suffering from a mental illness or disorder such that there is reasonable grounds for believing that involuntary admission and treatment is necessary;
- for the persons own protection from harm, or
- for the protection of others from serious harm
Mentally ill person
- hallucination
- delusions
- formal thought disorder
- severe mood disturbance
- sustained irrational behaviour
Mentally disordered person
- irrational behaviour that forms reasonable grounds for admission
MUST consider whether there is a less restrictive environment in which a mentally ill person can be safely and appropriately managed, if so then admission under MHA is not appropriate.
MHA - Who has to assess the patient for them to be retained?
There are a number of pathways for involuntary detention in MHU under the NSW MHA 2007.
s19-26 include police officers, ambulance officers, medical practitioners, magistrate, primary carer, etc.
Once arrived at a declared mental health facility, the act requires two, further examination for the person to be detained - these examinations are to be completed on the ‘Form 1’ sheet.
- one of the two examinations must be done by a psychiatrist, and the 3rd always by a psychiatrist
1st examination
- within 12 hours of being sectioned, ideally an authorised medical officer, or another accredited person
2nd examiantion
- to occur as soon as possible
- if mentally disordered, then can detain for no longer than 3 working days
- otherwise requires mental health inquiry with tribunal to determine whether ongoing detainment is appropriate, this must be conducted as soon as is practicable
MHA - when does patient have to be reviewed by the magistrate?
When to be reviewed by magistrate:
- if detained as being mentally ill, then must be reviewed by a mental health tribunal (involving magistrate/solicitor) as soon as is practicable
MHA - What are the requirements for a patient to receive involuntary treatment for a further period up to 6 months
Treatment period of up to 6 months
- Patients detained involuntarily must be reviewed by a mental health review tribunal every 3 months if their period of detention is to be extended beyond 3 months initially. This must occur every 3 months for the first 12 months, and then every 6 months past the first year.
A 21 year old male is brought to ED by police. He is aggressive and disoriented. Discuss approach. What is mental health act & how is guardianship different
Approach:
1) complete section under MHA
2) arrange for first examination within 12 hrs of arrival at mental health facility
3) would conduct a full psychiatric assessment to determine if patient is mentally ill, or mentally disordered, undertake any appropriate verbal de-escalation + chemical sedation
4) Determine appropriate location/setting of management (inpatient vs out, voluntary vs involuntary), and complete Form 1
5) second examination to be conducted as soon as possible
How is Guardianship different to MHA?
Guardianship provides for a legally-appointed decision maker as acceptable to the person/patient to make medical and other decisions on their behalf if necessary.
On the other hand, the mental health act does not currently provide for a legal advice or an independent person to make decisions. Simply provides the framework for detainment of mentally ill/disordered patients in the interest.
