Mental Health Act + Adults With Incapacity Flashcards
What are the 5 criteria for detention under the MHA?
- likely mental disorder
- significantly impaired decision making ability (SIDMA)
- determining treatment required (giving treatment STD + CTO)
- significant risk to health/safety/welfare of patient or safety of others
- informal/voluntary care not appropriate
What is the difference between SIDMA and incapacity?
SIDMA applies to mental illness only
Incapacity includes organic brain disease, impaired cognition etc
What are the different types of detention in the MHA?
Emergency detention
Short term detention
Compulsory treatment order
How long can a patient be held under emergency detention?
72 hours
Who can carry out emergency detention?
Full registered doctor –> FY2 and above
Where possible, MHO should also agree to it
How long can a patient be detained under a short term detention?
Up to 28 days
Who is a short term detention approved by?
Approved medical practitioner (AMP) - usually psychiatrist
AND a mental health officer (MHO)
Can a short term detention be extended?
Can be extended by 3 days if need to apply for CTO
Or 5 days once CTO application submitted
How long can a patient be detained under a CTO?
Initially up to 6 months
How in a CTO granted?
Reports from 2 independent doctors (2 AMPs or AMP + GP), a care plan + MHO report
–> application to tribunal services
When is a CTO reviewed?
Renewed at 6 months, then yearly
Which types of detention can be appealed?
Short term + CTO
can’t appeal an emergency detention
Can treatment be given under emergency detention?
Only emergency treatment
In which emergency circumstances can treatment be given under an emergency detention?
To save patients life
To prevent serious deterioration
To alleviate serious suffering
To prevent danger to patients or others
Which form must be completed if giving treatment under emergency detention?
T4
What are the guidelines for giving treatment under a short term detention or CTO?
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
Which section of the MHA is emergency detention?
section 36
Which section of the MHA is short term detention?
section 44
What is an advanced statement?
Written statement, signed by the patient when they are well
Detailing how they would prefer/prefer not to be treated
What is a named person?
Person chosen by patient to support them and protect their interests
Can nurses detain patients against their will?
Yes - nurses holding power
registered mental health nurse or intellectual disability nurse
How long can a patient be detained with a nurses holding power?
Up to 3 hours
- patient must be in hospital + receiving treatment
What powers do the police have to detain people under the MHA?
If person appears to have a mental disorder + in need of care/treatment:
- can remove to place of safety from a public place
How long can a person be detained with policing powers?
Up to 24 hours
What are the criteria for valid consent?
Given freely without duress or coercion Legally capable of consenting Cover the intervention/procedure Informed Enduring
What are the three requirements for having capacity to consent?
- Understand and retain information
- Weigh that information to make a decision
- Communicate that decision
What are the 3 main components of the Adults with Incapacity (AWI) Act 2000?
Section 47 Certificate of Incapacity
Power of Attorney
Guardianship
When is a Section 47 Certificate used?
To authorise treatment of a physical disorder in someone without capacity to consent to that treatment
What is the difference between Power of Attorney and Guardianship?
POA –> granted by patient while they still have capacity
Guardianship –> applied for by another person/authority once the patient has lost capacity
When is MHA used over AWI and why?
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
What is the age of legal capacity in Scotland?
16
–> presumed to have capacity to make most decisions
Can a child under 16 have capacity to consent?
Yes - based upon ability to understand and weigh up options, rather than age
What should be done if a young person lacks capacity to make a decision about their care?
Ask one parent for consent
- if parents disagree, seek legal advice
Can the MHA be used for children?
Yes - no lower age limit
In which circumstances should the MHA be used for children, rather than parental consent?
Use of force
Use of IM injection
Certain treatments e.g. NG tube feeding, ECT
Detrimental impact on relationship with carer
