Mental Health Act

Question 1

What year was the Mental Health Act passed and amended?

Answer 1

1983 (2007)

Question 2

Describe the aims of the mental health act.

Answer 2

Specifies the rights of those with mental disorder
Outlines when they may be admitted to hospital, assessed and treated against their will
Any decisions made under the act must minimise undesirable effects of mental disorder, maximise safety and wellbeing, promote recover and protect the patient and others from harm

Question 3

What is an informal patient?

Answer 3

Those who come into mental health hospital voluntarily

Question 4

Describe a MHA section 2.

Answer 4

Covers hospital admission of patients against their will when they are considered to have a mental disorder that requires inpatient care

Question 5

Who is usually admitted under MHA section 2?

Answer 5

Those not known to services or previously sectioned

Question 6

How long does the MHA section 2 last?

Answer 6

28 days

Question 7

How does an application for MHA section 2 work?

Answer 7

Application for hospital admission made to hospital managers by an Approved Mental Health Professional (AMHP) within 14 days of interviewing patient, including the views of the patients’ nearest relative
Applications for hospitalisation can also be made by a nearest relative
Two doctors must assess the patient to confirm sectioning under MHA, one of which is an approved doctor

Question 8

Describe a MHA section 3.

Answer 8

Focusses on appropriate treatment for mental health disorder
For those in the community who are known to mental health services or with previous section or already in hospital having undergone assessment/treatment under section 2

Question 9

How long does the MHA section 3 last?

Answer 9

Up to 6 months initially and may be renewed

Question 10

How does an application for MHA section 3 work?

Answer 10

Initiated by AMHP or relative, relative has the power to block sectioning
Two doctors must agree that sectioning criteria is met

Question 11

What occurs when a patient with capacity refuses medication within 3 months of sectioning?

Answer 11

Under a section, patients can be given doses to treat their mental illness against their will for up to 3 months from date of section

Question 12

What occurs when a patient refuses medication after 3 months of sectioning?

Answer 12

With or without capacity the RC must get a recommendation that treatment should continue from a second opinion appointed doctor
T3 form must be completed and SOAD must consult two other non-doctor HCPs involved in care

Question 13

What cannot be given to a patient under sectioning without consent?

Answer 13

ECT

Question 14

What must be included on T2 and T3 forms?

Answer 14

All individual medicines/groups of medicines likely to be used to treat the mental disorder are listed
Including PRN
If classes are specified, the number included and which are excluded should be specified
Route of administration and max dose for all medicines must be specified
Usually kept with prescription charts

Question 15

What is a community treatment order?

Answer 15

The RC can impose certain conditions on the patient when they are discharged into the community following a section 3 admission
Often concern engagement with services and adherence to treatment
RC applies to the NHS trust for a CTO and requires AMHP approval
Lasts 6 months but can be renewed
If the patient breaches the CTO or their health deteriorates, they may be brought back into hospital against their will

Question 16

What year was the Mental Capacity Act passed?

Answer 16

2005

Question 17

When does a person lack mental capacity?

Answer 17

If they do not meet one of these four criteria:

• Understand the information related to the particular decision to be made
• Remember the information long enough to make a particular decision
• Weigh up or use the information as part of the decision making process
• Communicate the particular decision in anti form

Question 18

What are the 5 key principles when making decisions on behalf of others?

Answer 18

• Must be assumed to have capacity unless established otherwise
• Not assumed to be unable to make the decision unless all practical steps have been taken to help them without success
• Must not be treated as unable to make a decision if they make an unwise one
• Any decision made on behalf of someone must be done so in their best interests
• Consideration must be given for whether the purpose it is needed for can be achieved in a way that is less restrictive on the persons rights/freedoms

Question 19

What is the Deprivation of Liberty Safeguards (DoLS)?

Answer 19

For those lacking mental capacity in hospitals or care homes, acts as protection if care givers determine they must be deprived of liberty to keep them safe
Lasts for 12 months with no renewal option

Question 20

What is advanced care planning?

Answer 20

Voluntary conversation between patient and HCP where future decisions and priorities if mental capacity is affected in the future

Question 21

What is an independent mental capacity advocate?

Answer 21

Provide safeguards for those lacking capacity without family support

Question 22

What is lasting power of attorney?

Answer 22

Person affected nominates trusted family member/friend to make decisions in the future
Must be registered with the public guardian
Cannot involve life sustaining treatment unless stated in paperwork

Question 23

What are advanced decisions?

Answer 23

Enables those 18+ with mental capacity to refuse specified medical treatment in the future when they may lack capacity
Health professionals should do all in their power to find out whether patients have advance decisions in place
Advance decisions can be over-ridden if there is evidence the person would have changed their mind
Cannot be used to demand treatment, only refuse

Question 24

What are advanced statements?

Answer 24

Like advanced decisions but not legally binding
Can be used for general decisions like washing and eating
May be used to request or refuse medication

Question 25

When is covert administration appropriate?

Answer 25

Only be used when a patient refuses to take their medication and does not have mental capacity to understand
Medicines involved in covert administration must be considered essential for health and wellbeing of the patient or others
Medicines should be administered in the least restrictive way