Mental Health Act Flashcards
WHat is the mental health act (MHA) used for?
Ensure patients with mental disorders impairing their judgement receive effective treatment
What are the 10 Millan Principles upheld in the Mental Health Act (MHA)?
- Non Discrimination
- Equality
- Respect for Diversity
- Reciprocity
- Informal Care
- Participation
- Respect for Carers
- Least Restrictive
- Benefit
- Child Welfare (no lower age limit on mental health act)
WHat are the 5 criteria which must be met for detainment under the MHA?
- (Likely) Mental Disorder
- Significantly Impaired Decision Making Ability
- Determining treatment required (Giving treatment – STD and CTO)
- Significant risk (safety of patient or others)
- Informal/voluntary care not appropriate
What IS considered a mental disorder that would allow detainment under the MHA?
Mental Illness
Learning Disability
Personality Disorder
What is NOT considered a mental disorder that would allow detainment under the MHA?
- Sexual orientation/deviancy
- Transsexualism/Transvestism
- Alcohol/drug dependence
- Behaviour likely to cause harassment, alarm or distress
- Acting as no other prudent person would act
Why is incapacity different from “Significantly Impaired Decision Making Ability” (SIDMA)?
SIDMA = mental disorder alone
Incapacity = also disease of the brain, physical disability, impaired cognition
HOw should SIDMA be documented properly to prove their decision making is impaired?
- Explain symptoms they are experiencing
- What mental disorder this links to
- How this impairs their decision making
Aside from medical treatment, what other treatment can be given under the mental health act?
Nursing care Psychological interventions Rehabilitation ECT Refeeding Specialist intervention (OT, SALT, Dietetics)
What would indicate that a patient is a risk to themself?
- Suicide
- Self harm
- Wandering (e.g. in dementia)
- Vulnerability
- Deterioration in mental state
- Physical health – starvation, dehydration
- Poor self care
- Retaliation from others due to aggressive behaviour
What would make you concerned that a patient is a risk to others?
Aggression Violence Sexual assault Intimidation Arson
WHen would hospital admission be seen as the “least restrictive option”?
If patient is:
- refusing to remain in hospital
- Incapable of making a decision about remaining in hospital
- Unable to be treated in the community due to level of risk
- Community treatment failed
What is an Emergency Detention Order?
Patient with a likely mental disorder can be detained for up to 72 hours (should be reassessed every 24 hours or so to make sure this is still appropriate)
Does NOT authorise DR to give any treatment
No right of appeal => patient cannot contact solicitor for legal action
Who can issue an Emergency Detention Order?
Fully registered doctor (FY2 and above)
Where possible, a mental health officer (MHO)
should also agree to it
What is a Short Term Detention?
A patient with a likely mental disorder can be detained for up to 28 days for assessment/treatment
Patients have the right to appeal => can get a lawyer involved if they wish
For how long can a Short Term Detention be extended?
3 days if extra time needed to put together CTO application
OR 5 days once CTO application submitted
How long does an initial Compulsory Treatment order last and what happens after it is reviewed?
Initially 6 months, then patient is reviewed
If CTO requires renewal, then this is completed at the 6 month mark, and then annually going forward.
Who and what reports are required to issue a compulsory treatment order (CTO)?
- Approved Medical Practitioner + Mental Health Officer
- Reports from 2 independent doctors (2 AMPs or AMP+ Patient’s GP)
- Care plan
- MHO report
- MHO makes application to the tribunal service as a tribunal is mandatory
How long is treatment authorised for during a CTO and Short Term Detention?
Treatment authorised for up to 2 months of detention
When may urgent treatment be given under an Emergency Treatment Order (aka where you are not authorised to give treatment) ?
- To save the patient’s life
- To prevent serious deterioration in patient’s condition
- To alleviate serious suffering
- To prevent the patient from being a danger to themselves or others
What certificate must be completed after 7 days of Emergency Treatment?
T4 certificate
What treatments cannot be given under an STD or CTO
ECT Nutrition (e.g. NG tube feeding) Vagus Nerve Stimulation Any medicine to reduce sex drive Neurosurgery
What is an Advance Statement?
- Paperwork signed when the person is well
- How they would prefer to be treated if they were to become ill in the future
- Witnessed and dated
An Advance Statement can’t be overruled. TRUE/FALSE?
FALSE
it can be overruled
What are the rights of a named person?
- Patients choose person to support them and protect their interests
- They have the same rights to be notified of, attend be and represented at Tribunal hearings as the patient does
- they also gain a copy of detainment paperwork on the patient’s behalf
What is an independent advocate and why do some mental health patients choose to have one?
Every mental health patient has a right to an independent advocate should represent their wishes without judging or giving a personal opinion
Who MUST be present on the panel at a Mental Health Tribunal to authorise a CTO, and where do they take place?
Panel – a psychiatrist, a convenor (solicitor) and a third person with other experience (e.g. MH patient or MH nurse)
Take place in hospital
Who else is allowed to be present at a Mental Health Tribunal?
Patient + their solicitor
Approved Medical Practitioner + solicitor
Mental Health Officer (MHO)
Named person + solicitor
Curator Ad Litem (Legal representative from court to represent best interest of patients who lack capacity)
Nursing Staff
Who can issue a Nurse’s Holding Power to keep a patient admitted whilst waiting on a doctor to complete a detention order?
Registered mental health nurse OR intellectual disability nurse
How long can patients be held under “Nurses Holding Power” ?
Up to 3 hours
What is involved in Policing Powers and how long can this be in place?
- Removal to a place of safety from a public place
- Patient appears to have mental disorder and is in need of care and treatment
- Held for up to 24 hours to allow assessment to be carried out
When would it be appropriate to use Section 47 of the Adults with Incapacity act instead of an Emergency or Short Detention order under the mental health act?
If a patient was in very ill health and needed immediate treatment
- using the MHA involves documentation and the presence of certain people (e.g. MHO/ psychiatrist)
- EDO also doesnt allow for treatment but AWI does
