Mental Health Act

Question 1

What is the mental health act?

Answer 1

Legal framework for keeping patients in hospital against their wishes for assessment and treatment of a mental health disorder

Question 2

What is it called when a patient with capacity agrees to be admitted to hospital voluntarily?

Answer 2

Voluntary or informal admission

Informal admission does not involve detention under the Mental Health Act Section 131

Question 3

Who is involved in using the mental health act?

Answer 3

Approved mental health professional (AMHP)
Social worker or mental health nurse that helps organise and contribute to Mental Health Act assessments

Section 12 doctor
Qualified and approved doctor who can undertake Mental Health Act assessments

Responsible clinicians

Nearest relative

Independent Mental Health Advocate (IMHA)
Independent person allocated to a patient being detained under the Mental Health Act

Role is to support the person, help them understand the situation and express themselves

Question 4

What is a mental health act assessment?

Answer 4

Detailed evaluation to determine whether to detain someone

Question 5

Who is the primary person to make an application for a mental health act assessment?

Answer 5

Approved mental health professional (AMHP)

or

Nearest relative

Question 6

What criteria must be met to use the MHA?

Answer 6

• The presence of a mental disorder as defined by law
• Disorder is of a certain nature or degree
• Significant risk to the persons health,
  safety, or safety of others
• No alternative to hospital admission as
  a means of safeguarding that risk – so
  cannot manage in a less restrictive
  setting

Question 7

What is the definition of a mental disorder?

Answer 7

Any disorder or disability of the mind

Question 8

What are the principles of the mental capacity act?

Answer 8

• Presumption of capacity at all times
• A right to support individuals in making their own decisions
• A right to make unwise decisions

Question 9

What is capacity?

Answer 9

Ability to make a decision

Question 10

If decisions are made on behalf of patients without capacity what should be done?

Answer 10

• Least restrictive of their freedom of action
• In the bests interests

Question 11

If someone is intoxicated or under the effects of drugs do they have capacity?

Answer 11

If at the time they are unable to make a decision in relation to impairment
They lack capacity

Question 12

What are the 4 parts of the capacity test?

Answer 12

1) Understand the information
2) Retain the information
3) Use or weight it up
4) Communicate the decision

Question 13

What are advance decisions?

Answer 13

(anticipatory refusals)
- Only relate to medical treatments
- Must be over 18 and have capacity
- Cannot require a doctor to give treatment
- Only for refusal of medical treatment in a specific type

Question 14

What is a deprivation of liberty safeguards or DOLS for?

Answer 14

• Patients in hospital or care homes who lack capacity
• MDT assessment

Question 15

What replaced DOLS?

Answer 15

Liberty Protection Safeguards (LPS)

Question 16

What is Section 2?

Answer 16

Compulsory admission for assessment following a Mental Health Act assessment with a maximum period of 28 days

2 doctors, 1 should be section 12(2) approved
1 AMHP

Can appeal section 2 within first 14 days, heard within 7 days by tribunal

Cannot be renewed

Ends in discharge or further detention under Section 3

Question 17

What is Section 3?

Answer 17

Compulsory admission for treatment

2 doctors, 1 should be section 12(2) approved
1 AMHP

Can have 1 appeal to both hospital managers panel and tribunal

Max period of 6 months
Clinician then can arrange to renew it for further treatment

Detention under section 3 needs a mental health act assessment

Patients can be detained straight under section 3 from community, but normally follows section 2

Question 18

What is Section 4?

Answer 18

Detain patients for up to 72 hours in urgent scenarios where other procedures cannot be arranged in time

Requires an AMHP and one doctor

Followed by a mental health act assessment

Question 19

What is Section 5(2)?

Answer 19

Used in an emergency to detain patients who are in hospital voluntarily

Lasts up to 72 hours

Requires only one doctor

Followed by a mental health act assessment

Cannot be done in the ED

Not appealable

Question 20

What is Section 5(4)?

Answer 20

Used in an emergency to detain patients who are in hospital voluntarily

Lasts up to 6 hours

Requires only one nurse

Followed by a mental health act assessment

Cannot be done in the ED

Question 21

What is Section 17?

Answer 21

Allows patients who are detained to be granted leave from the hospital
The Responsible Clinician (RC) is responsible for approval

Question 22

What is Section 117?

Answer 22

Anyone who has been on section 3 is entitled to S117 aftercare from local authority

Question 23

What is Section 135?

Answer 23

Law enforcement can enter premises where there is reasonable belief that an individual is suffering from a mental disorder and take the individual to a place of safety

Question 24

What is Section 136?

Answer 24

Used by police to remove someone that appears to have a mental health disorder from a public place and take them to a place of safety to be assessed

Lasts up to 24 hours

Followed by a mental health act assessment

Question 25

What is community treatment order?

Answer 25

Patient on S3, well enough to leave hospital but may default from treatment
Treatment necessary for patient’s health, safety or protection of others
Patient can be recalled to hospital

Question 26

What are forensic sections?

Answer 26

Patients who are prisoners or committed significant crimes, not detained under S2 or S3