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Psychiatry > Mental Health Act > Flashcards

Mental Health Act Flashcards

1
Q

Definition of a ‘mental disorder’

A

any disorder or disability of mind (excluding drugs and alcohol; includes paraphiliac)

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2
Q

Who are people detained under the MHA or on Community Treatment Orders under the care of?

A

A responsible clinician

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3
Q

Under the MHA code of practice lists ‘guiding principles’, what does one of them include with regards to the patients involvement with treatment?

A

The patient must be as fully involved in planning treatment as possible and their wishes should be taken into account

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4
Q

What is a Section 2 under the MHA?

A

An Assessment Order

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5
Q

How long does a section 2 last?

A

Lasts up to 28 days, in which, all assessments should be done

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6
Q

Can a section 2 be renewed?

A

No

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7
Q

Who identifies and informs the nearest relative?

A

AMHP

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8
Q

Who can give a Section 2?

A

Two doctors (on separate teams) who agree for detainment for assessment In hospital and at least one of them must be ‘section 12 approved’.

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9
Q

Once it has been decided to detain with a section 2 what does the AMHP (approved mental health professional) do?

A

Applies to hospital managers for the individual to be admitted

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10
Q

Can you give treatment under Section 2 order?

A

Yes

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11
Q

If the patient is still unwell/not responding to treatment under the Section 2 what would you do?

A

Detain under Section 3 - but would need another psychiatric assessment with 2 doctors, at least 1 section 12 approved and an AMHP

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12
Q

What evidence is required for a Section 2 detainment?

A

o Patient is suffering from a mental disorder of a nature or degree that warrants detention in hospital for assessment
o The patient ought to be detained for his/her own health or safety, or for the protection of others

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13
Q

What type of order is a Section 3?

A

Treatment order

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14
Q

How long does a Section 3 last for initially?

A

6 months

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15
Q

Can a Section 3 order be renewed?

A

Yes

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16
Q

How long can a Section 3 be renewed for?

A

Can be renewed initially for 6 months, then renewed annually. Can be renewed indefinitely

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17
Q

Who needs to be there to detain under Section 3?

A

Agreed by two doctors from different teams and one must be Section 12 approved and AMHP

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18
Q

Must the nearest relative be consulted for a Section 3?

A

Yes, unless it is not practicable to do so

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19
Q

What can you do if the nearest relative objects to Section 3?

A

Cannot go ahead until legal action is taken to remove title of nearest relative from person who is objecting

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20
Q

What can patients be discharged on to from a Section 3?

A

Community Treatment Order

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21
Q

What evidence is required for a Section 3?

A

o Patient is suffering from mental disorder of a nature or degree that makes it appropriate for the patient to receive medical treatment in a hospital
o The treatment is in the interests of his or her health and safety and the protection of others
o Appropriate treatment must be available for the patient

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22
Q

When is a Section 4 used?

A

in a crisis and someone is in urgent help and there is no time to arrange admission under Section 2 or Section 3

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23
Q

How long can a person be detained under Section 4?

A

up to 72 hours after one doctor has said urgent admission is needed

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24
Q

Who usually makes the application for a Section 4?

A

An AMHP

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25
Q

What occurs during the Section 4 period?

A

A second doctor assesses and come to a conclusion as to detain under Section 2, Section 3, admit to hospital voluntarily or discharge

26
Q

What evidence is required for a Section 4?

A
  • The patient is suffering from a mental disorder of a nature or degree that warrants detention in hospital for assessment
  • The patient ought to be detained for his or her own health or safety or the protection of others
  • There is not enough time for a 2nd doctor to attend (risk)
27
Q

What is a Section 5?

A

when a patient is admitted informally or voluntarily, and are not detained, so are free to come and go. But if the patient becomes acutely unwell and is starting to not comply with medication or are a risk to themselves or others and wants to leave, they may need to be detained.

28
Q

What is a Section 5(4)?

A

Nurses holding power - used if a patient is already admitted but wanting to leave. Used when a doctor is not available.

29
Q

How long does a section 5(4) last?

A

up to 6 hours but ends when a doctor arrives on the ward

30
Q

Can patients be treated coercively under a Section 5(4)?

A

No

31
Q

What is a Section 5(2)?

A

Doctors holding power - used when an admitted patient wants to leave

32
Q

How long does a Section 5(2) last?

A

72 hours

33
Q

What should be done when under a Section 5(2)?

A

should have a MHA assessment by another doctor and AMHP - one doctor should be Section 12 approved.

34
Q

Which doctors are able to use a Section 5(2)?

A

Any doctor trained in psychiatry or GP

35
Q

Can patients be treated coercively under a Section 5(2)?

A

No

36
Q

Which Sections are powers used by Crown and Magistrates’ Court?

A

Sections 35, 36, 37, 38, 41, 47, 48, 49

37
Q

What is Section 35?

A

Used to send an accused person on remand for a report

38
Q

What is Section 36?

A

Used to send an accused person on remand for treatment?

39
Q

What is Section 37?

A
  • A court can rule that someone convicted of an offence should be detained in hospital for treatment, rather than being sent to prison
  • Sometimes referred to as a ‘HOSPITAL ORDER’
  • Somewhat equivalent to a Section 3
  • Psychiatrists can take them off a Section 37 if they get better
  • TREATMENT IS THE SENTENCE
40
Q

What is Section 41?

A
  • Is a RESTRICTION ORDER
  • Can be added to a section 37 for the protection of public (SECTION 37/41)
  • Ministry of Judgement closely monitors patients who are under restriction order
  • Judges use it for serious offences e.g. manslaughter
  • Can be sent to prison after their treatment
  • TREATMENT IS PART OF THE SENTENCE
41
Q

What is a Section 38?

A

• Allows someone who is convicted of an offence to be sent to hospital for assessment before they are sentenced, sometimes referred to as interim hospital order

42
Q

What is Section 47?

A
  • Used to transfer a sentenced prisoner to a hospital for treatment
  • Not allowed leave
43
Q

What is Section 48?

A
  • Used to transfer a prisoner on remand to hospital for treatment
  • Not allowed leave
44
Q

What is section 49?

A

• Restriction order that accompanies the section 47 or 48

45
Q

Which Sections can be used by Police Powers?

A

Section 135 and 136

46
Q

What is Section 136?

A
  • Allows police to take someone from a public place to a place of safety, if think they need immediate care or control
  • A ‘place of safety’ might be at a mental health hospital or A&E or police department.
  • People can be held on this power for 72 hours
  • During the 72 hours, should be seen by a doctor and an AMHP, may be placed on section 2 or 3 (with another doctor – one must be section 12 approved), admitted as informal or voluntary patient or discharged.
  • Police are only able to use a cell as ‘place of safety’ if the person is violent, never children or young people. Can only be used up to 24 hours.
47
Q

What is Section 135?

A
  • Allows police to gain entry to someone’s premises to allow assessment under MHA or to return someone who has left the hospital and is absent without leave
  • Taken to a place of safety
  • Requires a warrant from Magistrates’ Court before power can be used
  • When patient is to be assessed under a MHA an AMHP and a doctor must accompany the police
48
Q

What is a Community Treatment Order?

A

Usually for people having repeated, relapses after Section 3 discharge into community.
Can mediate under order in community e.g. depot injections every 2 weeks to prevent relapses.

49
Q

What are the conditions attached to a CTO?

A
  • Staying at particular address
  • Attending for treatment at a particular time or place
  • Taking medication
  • Etc.
50
Q

Who decides to discharge on a CTO?

A

A responsible clinician with supporting recommendation from an AMHP

51
Q

What would cause a patient to be recalled on a CTO?

A

Failure to comply with the conditions of their CTO

52
Q

How long does a CTO recall last for?

A

up to 72 hours

53
Q

What must be done in the time of a CTO recall?

A

an assessment then patient either returned to community/become voluntary patient/have CTO revoked and placed under Section 3 again.§

54
Q

What is a Section 17?

A

Leave of absence when detained in hospital which must be authorised by a responsible clinician

55
Q

What are the patients rights when under the MHA?

A
  • Be given information about their section, and what it means to be in hospital
  • Appeal to a MENTAL HEALTH TRIBUNAL, against their section
  • Get help and support from an advocate
  • Meet with hospital managers
  • Complain
  • Correspondence and visitors, as well as telephone access
  • Vote
  • Receive care after hospital
56
Q

What are the family member’s rights under MHA?

A
  • Apply for the patient to be sectioned
  • Receive information about their sectioning
  • Discharge you if you are sectioned and apply to MENTAL HEALTH TRIBUNAL if this is refused
  • Object to the sectioning of the patient
57
Q

Who has the duty to inform sectioned patients of their rights to appeal against detention?

A

Hospital managers

58
Q

Which sections do the patients have no right to appeal against?

A

Sections 4, 5(4), 5(2), 136

59
Q

Who can patients appeal to against their section?

A

o Hospital managers

o First-Tier Tribunal (Mental Health) / Mental health review Tribunal for Wales

60
Q

Do people have the right to appeal CTOs?

A

yes

61
Q

What is Section 117 Leave?

A

This is free ‘aftercare’ that is offered and provided under the MHA for those who had been sectioned on Sections 3, 37, 47 or 48 of MHA; including people who have been discharged onto supervised community treatment.

62
Q

How long does Section 117 aftercare last for?

A

Aftercare provided under Section 117 is continued until formal discharge from the section and the patient should be invited to the discharge meeting.

Psychiatry (40 decks)

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