Mental Health Act and Adults with Incapacity

Question 1

What are the 5 criteria that all must be met for detention under the mental health act?

Answer 1

1) They (likely) have a mental illness – defined as a mental health disorder, personality disorder or learning disability of any cause (does NOT cover alcohol intoxication, dependence, withdrawal or disorders of sexual preference)
2) Treatment must be available
3) Significant risk to their own safety, health or welfare or significant risk of safety to others
4) SIDMA (Significantly impaired decision making ability)
5) The detention is necessary – voluntary/ community care cannot be done

Question 2

Explain what is meant by SIDMA?

Answer 2

SIDMA – this is a specific test of capacity – is the person unable to make treatments about their treatment because of their mental illness? E.g. I don’t want to take my antipsychotics because they are really trackers made by FBI or I don’t want to come in to hospital because I want to jump off a bridge due to my suicidal thoughts

Question 3

Emergency detention is _____ and allows _____

Answer 3

72 hours - allows assessment but not treatment

Question 4

Who can do an emergency detention?

Answer 4

FY2 or above - where possible include MHO

Question 5

Is there a right of appeal with an emergency detention?

Answer 5

no (by time appealed detention likely over)

Question 6

Short term detention is for ____ and allows _____

Answer 6

28 days and allows assessment and treatment

Question 7

Who can do a short term detention?

Answer 7

can only be done by an approved medical practitioner (those who have passed royal college exam so usually ST4 and above in psychiatry), approval is needed from MHO

Question 8

Is there a right of appeal in short term detention?

Answer 8

yes

Question 9

Compulsory treatment order lasts ______ and allows ______ they have them as ______ and ______

Answer 9

6 months (then can be renewed for year), allows for detention and treatment, exist for hospital and community

Question 10

Process for CTO?

Answer 10

need a mental health tribunal
2 independent doctor reports - treating consultant psychiatrist and patient GP
MHO report
care plan

Question 11

Difference in criteria for short term and emergency vs CTO?

Answer 11

In emergency and short term detention the person only needs a likely mental disorder i.e. 50% or more sure, but in CTO they need to have a diagnosed mental disorder i.e. 100 % sure

Question 12

Under emergency detention urgent treatment can be given if one of 3 criteria? What must be filled out after?

Answer 12

• To save life
• To alleviate serious suffering
• To prevent the patient from being a danger to themselves or others

T4 certificate

Question 13

What is advance statement?

Answer 13

• These are written when the patient is well and explains how they would prefer to be treated in the future
• Should be regarded when making decisions but sometimes it is not practical to follow everything they have requested

Question 14

What is a named person?

Answer 14

• Person to support and protect the interests of the patient, the person has the right to be notified of, attend and be represented at tribunal hearings
• If under 16 the default named person is the guardian

Question 15

Explain what is meant by advocacy?

Answer 15

• Every person with a mental disorder has the right to access independent advocacy
• Advocates are independent of NHS, help them write statements, understand their rights etc.
• Brought in as part of 2003 act

Question 16

Describe mental health tribunal?

Answer 16

• These are organized by Mental Health Tribunal Service Scotland
• There is a panel with doctors, solicitors, named person, patient etc.
• The Act in 2003 moved these so that they no longer take place in court but separately as these tribunals in community/ hospital

Question 17

Role of nurses ?

Answer 17

• Registered mental health nurse or intellectual disability nurse can detain a patient who is already in hospital and receiving treatment for up to 3 hours
• They are authorized to do this when it is necessary for the protection of health, safety or welfare of the patient or the safety of others
• 3 hours gives enough time to allow a doctor to come and assess the patient

Question 18

Role of police?

Answer 18

• Police can remove someone who appears to have a mental disorder and in need of care and treatment from a public place to a place of safety
• They can detain someone for up to 24 hours to allow an assessment to be carried out

Question 19

What does MHC do?

Answer 19

• Mental welfare commission was brought in for the 2003 act which is an independent body that oversees rights of patients

Question 20

What is a section 47 certificate?

Answer 20

the adults with incapacity act

Question 21

What is adults with incapacity act, what does it allow you to do?

Answer 21

For treatment of a physical disorder in someone without capacity to consent to that treatment, this act is for adults (over 16 years old)

A section 47 certificate:
* Authorizes the practitioner to provide reasonable interventions related to the treatment authorized
* Does not authorize force unless immediately necessary and only for as long as necessary
* Does not specifically authorize the transport of the adult to the place of treatment
* Used to authorize treatment of a physical disorder

Question 22

5 principles of the adults with incapacity act?

Answer 22

• Intervention must benefit the adult
• Such benefit cannot reasonably be achieved without the intervention
• Take account of past and present wishes
• Consult with other relevant persons
• Encourage the adult to use residual capacity