Mental Health Act Flashcards
What is the purpose of the MHA (1983)?
Essential framework for care of those with a mental disorder
Represents balance between rights of the individual and society’s responsibility to protect people from the harm which mental disorder can cause
What are the two main types of legislation found in the MHA?
Legislation that can only be used if someone has a mental disorder and fulfils other criteria: detention must be necessary to protect patient’s health or safety, or safety of others
Legislation to enable assessment and treatment of mental disorder
How is mental disorder defined?
Any disorder or disability of the mind
Dependency on alcohol or drugs is excluded from the definition
What is the criteria for detention under the MHA?
Treatability test replaced with appropriate treatment test.
Can only detain if medical treatment is available which is appropriate to mental disorder and all other circumstances of the case. Will include distance from home, cultural requirements.
Must be clinical purpose to detention.
Purpose of treatment must be to alleviate or prevent worsening of symptoms.
What does the MHA say about ECT?
Capacity threshold for imposition
Except in an emergency, ECT can only be given with a capable patient’s consent, or where pt incapable of giving consent (in the absence of an advance refusal).
ECT for patients under 18 years must be authorised by a second opinion doctor (SOAD) whether or not detained or consenting
What is a mental health review tribunal?
It is an order-making power deals with appeals and referrals related to S2, S3 and others like CTO
What is a CTO?
Intended to allow a patient to live in the community, while subject to certain conditions, and continue to receive the medical treatment they need
Government envisaged that this would help stop the ‘revolving door’ - cycle of admission and discharge
What is the criteria for a CTO?
Currently detained under treatment order (not restricted cases)
The patient is suffering from a mental disorder which makes it appropriate to receive treatment.
Necessary for the health or safety of the patient or protection of others
If recalled Tx can be provided in the detaining hospital
What is a section 2?
28 days (then discharged or detained under Section 3 for Tx)
Assessment & Tx of mental health disorders.
Used if: no previous admissions, no Tx plan in place, unclear if pt would accept admission or medication voluntarily.
Application can be made by AMHP or NR. 2 recommendations required from doctors (one section 12 approved). One Dr should know the patient, and both must personally examine the patient, up to 5 days apart.
Pt can apply to MHRT within 1st 14 days.
NR can apply for discharge within 72 hours notice – can be blocked by the RC.
What is a section 3?
6 months (then discharged or renewed for further 6 months, thereafter at yearly intervals).
Tx of mental health disorders. Applied for in same way as Section 2 (AMHP or NR apply - two doctors), but AMHP cannot act if NR objects - NR can be displaced by Court.
Pt can apply to MHRT during each section period & section renewals trigger automatic MHRT. NR can apply for discharge within 72 hours notice, can be blocked by RC (NR may then apply to MHRT)
What is a section 4?
72 hours
Detention & assessment only – not Tx
For emergency situations with urgent clinical need and second medical opinion not available & would delay the assessment / detention).
AMHP or NR can make application.
2nd medical recommendation converts to a Section 2: should be completed at earliest opportunity.
What is a section 5(2)?
72 hours
Doctor can detain informal patient already admitted to hospital.
Ends when pt assessed for section 2 or 3, or decision that no MHA assessment is necessary.
