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Psychiatry > Mental Health Act + Adults With Incapacity > Flashcards

Mental Health Act + Adults With Incapacity Flashcards

1
Q

What are the 5 criteria for detention under the MHA?

A
  1. likely mental disorder
  2. significantly impaired decision making ability (SIDMA)
  3. determining treatment required (giving treatment STD + CTO)
  4. significant risk to health/safety/welfare of patient or safety of others
  5. informal/voluntary care not appropriate
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2
Q

What is the difference between SIDMA and incapacity?

A

SIDMA applies to mental illness only

Incapacity includes organic brain disease, impaired cognition etc

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3
Q

What are the different types of detention in the MHA?

A

Emergency detention
Short term detention
Compulsory treatment order

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4
Q

How long can a patient be held under emergency detention?

A

72 hours

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5
Q

Who can carry out emergency detention?

A

Full registered doctor –> FY2 and above

Where possible, MHO should also agree to it

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6
Q

How long can a patient be detained under a short term detention?

A

Up to 28 days

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7
Q

Who is a short term detention approved by?

A

Approved medical practitioner (AMP) - usually psychiatrist

AND a mental health officer (MHO)

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8
Q

Can a short term detention be extended?

A

Can be extended by 3 days if need to apply for CTO

Or 5 days once CTO application submitted

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9
Q

How long can a patient be detained under a CTO?

A

Initially up to 6 months

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10
Q

How in a CTO granted?

A

Reports from 2 independent doctors (2 AMPs or AMP + GP), a care plan + MHO report
–> application to tribunal services

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11
Q

When is a CTO reviewed?

A

Renewed at 6 months, then yearly

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12
Q

Which types of detention can be appealed?

A

Short term + CTO

can’t appeal an emergency detention

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13
Q

Can treatment be given under emergency detention?

A

Only emergency treatment

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14
Q

In which emergency circumstances can treatment be given under an emergency detention?

A

To save patients life
To prevent serious deterioration
To alleviate serious suffering
To prevent danger to patients or others

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15
Q

Which form must be completed if giving treatment under emergency detention?

A

T4

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16
Q

What are the guidelines for giving treatment under a short term detention or CTO?

A

2 months medication can be given, but exceptions:

  • ECT
  • nutrition
  • vagal nerve stimulation
  • transcranial magnetic stimulation
  • any medications with purpose of reducing sex drive
  • neurosurgery
17
Q

Which section of the MHA is emergency detention?

A

section 36

18
Q

Which section of the MHA is short term detention?

A

section 44

19
Q

What is an advanced statement?

A

Written statement, signed by the patient when they are well

Detailing how they would prefer/prefer not to be treated

20
Q

What is a named person?

A

Person chosen by patient to support them and protect their interests

21
Q

Can nurses detain patients against their will?

A

Yes - nurses holding power

registered mental health nurse or intellectual disability nurse

22
Q

How long can a patient be detained with a nurses holding power?

A

Up to 3 hours

- patient must be in hospital + receiving treatment

23
Q

What powers do the police have to detain people under the MHA?

A

If person appears to have a mental disorder + in need of care/treatment:
- can remove to place of safety from a public place

24
Q

How long can a person be detained with policing powers?

A

Up to 24 hours

25
Q

What are the criteria for valid consent?

A 
Given freely without duress or coercion
Legally capable of consenting
Cover the intervention/procedure
Informed
Enduring
26
Q

What are the three requirements for having capacity to consent?

A
  1. Understand and retain information
  2. Weigh that information to make a decision
  3. Communicate that decision
27
Q

What are the 3 main components of the Adults with Incapacity (AWI) Act 2000?

A

Section 47 Certificate of Incapacity
Power of Attorney
Guardianship

28
Q

When is a Section 47 Certificate used?

A

To authorise treatment of a physical disorder in someone without capacity to consent to that treatment

29
Q

What is the difference between Power of Attorney and Guardianship?

A

POA –> granted by patient while they still have capacity

Guardianship –> applied for by another person/authority once the patient has lost capacity

30
Q

When is MHA used over AWI and why?

A

MHA if actively resisting treatment for a mental health disorder (or physical consequences of a mental health disorder)
–> provides more protection for the patient than AWI

31
Q

What is the age of legal capacity in Scotland?

A

16

–> presumed to have capacity to make most decisions

32
Q

Can a child under 16 have capacity to consent?

A

Yes - based upon ability to understand and weigh up options, rather than age

33
Q

What should be done if a young person lacks capacity to make a decision about their care?

A

Ask one parent for consent

- if parents disagree, seek legal advice

34
Q

Can the MHA be used for children?

A

Yes - no lower age limit

35
Q

In which circumstances should the MHA be used for children, rather than parental consent?

A

Use of force
Use of IM injection
Certain treatments e.g. NG tube feeding, ECT
Detrimental impact on relationship with carer

Psychiatry (12 decks)

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