Mental Health Act

Question 1

What is section 2 of the mental health act?

Answer 1

Person is detained in hospital for up to 28 days for the purpose of assessing a mental health disorder and how they respond to treatment. This detainment is used when the person is not known to services or have not been assessed in hospital before.

Question 2

What is the criteria for Section 2 of the mental health act?

Answer 2

1) The patient must be suffering from a mental health disorder
2) The mental health disorder must be severe and with a high risk of relapse in absence of treatment
3) Within the interests of the patient’s health/safety

Section 2 only lasts 28 days and beyond this patients must be discharged, remain as a voluntary inpatient or be detained under Section 3.

Question 3

What is Section 3 of the mental health act?

Answer 3

Detaining patients for the purposes of treatment for up to 6 months if they are well known to psychiatry services or following Section 2 assessment and the criteria includes:
-> Sufferring from a mental disorder of a degree that warrants treatment for the safety of the patient or others. The necessary treatment can only be provided under Section 3 detainment and appropriate treatment is available, with a minimum of preventing further deterioration.

Treatment can be provided without the patient’s consent for 3 months; beyond this, the approval of a SOAD is required.

Question 4

How is detainment under Section 2 and 3 determined?

Answer 4

Must be agreed by 2 doctors who complete a form detailing their reasons for detaining the patient and one of the doctors must have received approval under Section 12 of the mental health act to certify that they have knowledge for the assessment/treatment of mental health disorders.

An approved mental health practitioner (AMHP) must meet the patient and discuss the case with the closest relative, taking the reccomendations from the doctors and making the final decision to apply for the patient to be admitted into hospital.

Question 5

What is Section 12 of the mental health act?

Answer 5

A medically-qualified doctor who has been recognised as having the expertise for the assessment and treatment of mental disorders with the ability to deprive patients of their liberty and human rights

Question 6

What is Section 4 of the mental health act?

Answer 6

In cases of urgent necessity, an emergency application for the detainment of a patient for 72 hours in hospital.

It requires only one recommendations from a doctor that must be Section 12 approved for an Approved Mental Health professional to enable for the patient to be admitted onto a mental health unit while arrangements for assessment under Section 2 and 3 are made.

Question 7

What is Section 5 of the mental health act?

Answer 7

Emergency detainment of a patient who has been already informally admitted into the hospital to enable time for a full assessment under Section 2 or 3.

This act excludes patients receiving treatment or assessment in the Emergency Department, and concerns about these patients require an urgent follow up with their GP, community mental health team or the police

Question 8

What is section 5.2 of the mental health act?

Answer 8

A doctor such as a consultant or on-call resident psychiatrist is authorised to detain a patient for up to 72 hours if it is likely that the patient will leave if not detained.

Question 9

What is Section 5.4 of the mental health act?

Answer 9

A nurse has the authority to detain a patient for up to 6 hours if it appears that the patient is sufferring from a mental health disorder that it is necessary for their protection or others to detain them and the patient’s consultant or the consultant’s deputy is not immediately available to make an application under 5.2.

Question 10

What is Section 136 of the mental health act?

Answer 10

A police officer has the authority to remove an individual from a public place who appears to be sufferring from a mental health disorder AND in need of immediate care and control to a place of safety for up to 24 hours

Question 11

Which places can Section 136 not be applied?

Answer 11

Places of residence such as a flat, room or garden and garage connected to the house, excluding multiple use residencies.

Question 12

What is considered a place of Safety under the MHA?

Answer 12

->Residential accommodation provided by social serves
->Hospital including emergency department
->Police station
->Home if the occupier agrees

Question 13

What is the criteria for the use of police stations in the mental health act?

Answer 13

-> Individual must be over 18
-> Should only be used in exceptionational circumstances

Question 14

What is a community treatment Order?

Question 15

Which groups lack capacity but cannot be detained under the Mental Health Act?

Answer 15

1) People with a mental disorder receiving care that involves continuous supervision and control in a setting other than hospital. This includes those with dementia or learning disabilities.

2) People receiving hospital based care for a physical condition, but have a mental disorder that requires continuous care and control

3) People receiving hospital treatment for a mental disorder that impairs capacity and do not object to admission or treatment of their condition

Mental Health act can only be used for detention of patients IN hospital.

Question 16

What is a Community treatment order?

Answer 16

Order by a clinician for a patient under the Mental Health act Section 3 to receive supervised treatment in the community for a minimum of 6 months, with a right for support from an Independent Mental Health advocate. This is for patients who do not require detainment in hospital if appropriate treatment is available in the community, however the clinician must be able to recall the patient back to hospital if necessary.

Question 17

What are the conditions for a community treatment order?

Answer 17

Patients must make themselves abvailable to meet with their appointing clinician if asked to renew their CTO
Patient must see the second opinion appointed doctor, who is responsible for giving and approving mental treatment under the MHA.

Clinicians are able to change the conditions of a CTO without the approval of an AMHP. Clinicians cannot recall a patient on the basis of refusing medical treatment however they can recall them based on becoming unwell without treatment.

Question 18

What is an SOAD?

Answer 18

Second opinion appointed doctor who is responsible for safeguarding the rights of a patient under the Mental Health Act who do not have the capacity to consent to treatment or refuse treatment. They provide an independent expertise if the treatment is necessary, clinically defensible and considerations are given to the rights of the patient.

They are responsible for providing approval for treating a patient against their consent who is detained under Section 3 after 3 months.

Question 19

What is Section 135 of the mental health act?

Answer 19

Valid for up to 24 hours, where police have the powers to detain someone within their home who is deemed to be at risk to themselves or others and remove them to a safe place.

Question 20

What is sublimation?

Answer 20

Redirecting negative thoughts/feelings into positive ones.

Question 21

What is reaction formation?

Answer 21

Acting in the opposite way to thoughts or feelings.