Mental Health Act Flashcards
What is the criteria for use of an Emergency Detention certificate (section 36)?
When it’s necessary as a matter of urgency to detain patient in hospital to permit full assessment of patient’s mental state and if not detained = risk to themselves or others:
- Likely pt. has a mental health disorder
- Pt. ability to make medical decisions significantly impaired as a result of the mental disorder
- It is necessary as a matter of urgency to detain you in hospital, to help decide what medical treatment you need
- That if you were not detained in hospital, there would be a significant risk to you, or to other people
- That making arrangements with a view to granting a short-term detention certificate would involve undesirable delay.
Does an Emergency detention certificate (section 36) authorise treatment?
NO - only in an emergency scenario (life-saving or preventing a serious deterioration in condition) - if this is done then form T4 must be filled out to inform Mental Welfare Commission
How long does an emergency detention certificate (section 36) last?
72 hours - have 72 hours to get patient into a hospital. Transfers to hospital should take place as soon as possible within that period and should be carried out sensitively. Pt. can be kept in hosp. under the emergency detention certificate for a further 72 hours (3 days) from the time of admission.
Who can apply an emergency detention certificate (section 36)?
Any medical practitioner usually with consent of a mental health officer. (if no MHO specify WHY). Then this is reviewed by an approved medical practitioner ASAP - who revokes it or grant a short term detention certificate.
Is there a right to appeal an emergency detention certificate (section 36)?
NO - There is no right of appeal to the Tribunal against an emergency detention certificate. This is because it would not be practical to organise an appeal in such a short time.
What is the criteria of use of a short term detention certificate (section 44)?
- You have a mental disorder
- Your ability to make decisions about medical treatment is significantly impaired, as a result of your mental disorder; and
- It is necessary to detain you in hospital, to help decide what medical treatment you need and to give you that treatment
- If you were not detained in hospital, there would be a significant risk to you, or to other people
- Granting a short-term detention certificate is necessary.
The hospital managers have a duty to provide you with information about your detention in hospital and your rights. They should tell you about independent advocacy services and help you to access the support of an independent advocate, if you wish to do so.
Does a short term detention certificate (section 44) authorise treatment?
- The purpose of a short-term detention certificate is to allow you to be assessed and/or treated in hospital.
- You can be given treatment for your mental disorder in accordance with the rules set out in part 16 of the Act. -You can be given some treatment, including medication, without your consent. However, your views and wishes about treatment should be taken into account, including where these are expressed in an advance statement.
Who can grant a short term detention certificate (section 44)?
Before granting the certificate, the AMP must consult a mental health officer ( MHO) and get his/her agreement. Before deciding whether to agree to the certificate, the MHO should see you and discuss matters with you, unless there is a good reason why they cannot do this.
How long does a short term detention certificate (Section 44) last for?
If you are not in hospital when the certificate is granted, then arrangements will be made to transfer you to hospital. The Act says that you have to be transferred to hospital within 72 hours (3 days) of the certificate being granted. Transfers to hospital should take place as soon as possible within that period and should be carried out sensitively. Once you have been admitted to hospital, you can be kept there under the certificate for up to a further 28 days from the day you are admitted.
Can you extend short term detention certificates (section 44)?
It is possible for the certificate to be extended beyond the 28 day period. If your condition has got worse towards the end of that period and extra time is needed to put together an application for a compulsory treatment order, then you can be detained for a further 3 days. Where an application for a CTO has been submitted to the Tribunal, then you can be detained in hospital under the short-term detention certificate for a further 5 days.
What is an responsible medical officer (RMO)?
When a short term detention certificate has been applied, the hospital managers are under a duty to ensure that a psychiatrist is appointed as your responsible medical officer ( RMO).
Your RMO should keep your condition under review. If he/she thinks that it is no longer necessary for you to be detained in hospital under the Act, then he/she will revoke the short-term detention certificate. You will then be free to leave the hospital, or to stay as a voluntary patient, if you have agreed to do so. If he/she believes that you do need to be detained in hospital, or receive treatment under the Act beyond the period authorised by the certificate, then they may decide to make an application for a compulsory treatment order ( CTO).
Is there a right to appeal a short term detention certificate (section 44)?
Yes. You or your named person can apply to the Tribunal to have the short-term detention certificate revoked. You can get information about how to do this from the Tribunal ( see here). However, you should consider seeking advice from a solicitor. You will be entitled to legal aid to allow a solicitor to represent you at any Tribunal hearing. A solicitor may also be able to instruct an independent medical report which might support your case.
What is a ‘named person’?
- replaces the ‘nearest relative’ (except under emergency detention certificates)
- has official standing
- may often be a partner or carer
- represents and looks after the interests of the patient
- must have their views taken into account
- can be chosen by the patient. If not chosen, primary carer is named, whom failing, the nearest relative. In addition, the Tribunal can appoint a named person.
- must be nominated in writing, witnessed by a prescribed person; the nominee can refuse or later revoke the nomination
- named person must be aged 16 or over and only persons only aged 16 or over can appoint named persons
- can apply to the Tribunal, and can appear or be represented at the Tribunal
- should receive information on the whereabouts of the patient if he or she is subject to an emergency detention certificate
- must be interviewed by the mental health officer if an application for a short-term detention certificate or compulsory treatment order is being made
Who can apply for a compulsary treatment order (section 64)?
Only a mental health officer can apply for a compulsory treatment order, once he or she has received two mental health reports- usually AMP report and other medical report- AMP or not (usually GP)
The application must occur within 14 days of the date of the second of the two medical examinations which gave rise to the mental health reports
What is the criteria for a compulsary treatment order (section 64)?
- the patient must have a mental disorder
- medical treatment would be likely to prevent the mental disorder worsening, or alleviate its effects
- significant risk to health, safety and the welfare of the patient, or to the safety of others, exists if medical treatment is not provided
- the patient’s ability to make decisions about his or her treatment is significantly impaired by mental disorder
- the order is necessary
