Mental Health Act

Question 1

What are the 10 Millan Principles of the MHA?

Answer 1

Non discrimination 
Equality
Respect for diversity
Reciprocity
Informal care
Participation 
Respect for carer
Lest restrictive 
Benefit
Child welfare

Question 2

What are the 5 criteria for detention under the MHA

THIS IS CORE KNOWLEDGE

Answer 2

Likely mental disorder
Significantly impaired decision making
Determining treatment required (STD & CTO)
Significant risk; health, safety or welfare of patient, safety of others
Informal/ voluntary care not appropriate

Question 3

When is emergency detention used?

Answer 3

If there is an undesirable delay in granting a short-term detention certificate

Question 4

What encomapasses a mental disorder?

Answer 4

Mental illness
Intellectual impairment
Personality disorder

Question 5

What is NOT classed as a mental disorder?

Answer 5

Sexual orientation or deviation
Transsexualism
Transvestism
Dependence of alcohol or drug use
Behaviour that causes harassment, alarm or distress to others
Acting as not other prudent people would act

Question 6

What is SIDMA?

Answer 6

Significantly Impaired Decision Making Ability

Question 7

What is classed as “treatment”?

Answer 7

Nursing care
Psychological intervention (CBT, interpersonal therapy)
Rehab
Medication
ECT
Refeeding
Specialised intervention (OT, SALT, diuretics)

Question 8

What constitutes as significant risk to the health, safety or welfare of a patient?

Answer 8

Suicide
Self-harm
Wandering
Vulnerability
Deterioration in mental state
Physical health; starvation; dehydration 
Poor self-care
Retaliation from others due to aggressive behaviour

Question 9

What constitutes as significant risk to others?

Answer 9

Aggression 
Violence
Sexual assault 
Intimidation 
Arson

Question 10

How long does an emergency detention last for?

Answer 10

72 hour assessment

Question 11

Can you give treatment under an emergency detention?

Answer 11

No

Question 12

Can FY1s sign an emergency detention?

Answer 12

No; fully registered doctor

Question 13

Can you appeal an emergency detention?

Answer 13

No

Question 14

Who else needs to be involved in the administration of an emergency detention?

Answer 14

Mental health officer; social worker with training in MHA

Question 15

How long does a short term detention last?

Answer 15

28 days of assessment

Question 16

Can you give treatment under a short term detention?

Answer 16

Yes

Question 17

Who needs to cosign a short term detention?

Answer 17

Approved medical practitioner (AMP) e.g. reg or consultant PLUS an MHO

Question 18

Can a short term detention be appealed?

Answer 18

Yes

Question 19

Can a short term detention be extended?

Answer 19

Yes; by 3 days to put together an application for a CTO or 5 days once a CTO application is approved

Question 20

How long does a CTO (compulsory treatment order) last?

Answer 20

6 months

Question 21

Who needs to cosign a CTO?

Answer 21

AMP
MHO
Report from 2 independent doctors to formulate a care plan and an MHO report

Question 22

Does there need to be a tribunal for a CTO?

Answer 22

Yes; mandatory

Renewal at 6 months then yearly

Question 23

When are you allowed to give treatment in an emergency detention?

Answer 23

To save pts life
To prevent serious deterioration 
Alleviate serious suffering
Prevent a patient from being a danger to themselves or others
This is under common law

Question 24

What is a T4 certificate?

Answer 24

Certificate to indicate treatment was given under an emergency detention

Question 25

What are the exceptions to treatment under a STD or CTO?

Answer 25

``` ECT Nutrition by artificial means Vagus nerve stimulation Transcranial magnetic stimulation Any medicine given for the purpose of reducing sex drive Neurosurg ```

Question 26

What is an advance statement?

Answer 26

Written statement that is signed when the person is compos mentis Sets out how they would prefer or prefer not to be treated

Question 27

Can you overrule an advance statement?

Answer 27

Yes

Question 28

What is a named person?

Answer 28

Pt can choose someone to support them and protect their interests Notified of, attend and are represented at tribunal hearings

Question 29

What are the laws around advocacy and the MHA?

Answer 29

Everyone with a mental disorder has the right of access to an independent advocate

Question 30

What are the nurses holding power?

Answer 30

Registered mental health nurses or intellectual disability nurses can hold pts for up to 3 hours if deemed necessary for the health, safety or welfare of patients and others

Question 31

What powers do the police possess?

Answer 31

Removal of patients to a place of safety from a public place; cannot remove people from their homes without a warrant

Question 32

What is the purpose of the mental welfare commission?

Answer 32

``` Encourage best practice Publish information and guidance Carry out visits to patients Investigate poor practice Medical examinations Inspect patient records ```