Mental Health Act and Mental Capacity Act Flashcards
What is section 2 for?
Assessment and treatment
How long does a section 2 last?
28 days
What is a section 3 for?
Treatment
How long can a section 3 last?
6 months
Who can do a section 2 and 3?
2 doctors and an AMHP
One doctor must be section 12 approved and ideally the other knows the patient
What is a section 5(4)
6 hours nurse holding power
What is a section 5(2)?
72 hours junior doctor holding power
What is a section 136?
72 hours police arresting power
What is a section 135?
A warrant to enter someone’s property
What conditions need to be met in order to section someone?
1) the presence of a mental disorder
2) risk to self, others or own health
3) that the patient is unwilling or lacks the capacity to go along with the plan on a voluntary basis
By sectioning someone what two powers does it give you?
To determine where a patient should be
To treat their MENTAL illness (or when a physical illness is directly causing a mental illness)
What is the four part test of capacity?
1) ability to understand
2) weight up
3) retain
4) communicate
What are the five principles associated with the mental capacity act?
1) always assume capacity
2) support decision making
3) unwise decisions are allowed
4) best interests
5) least restrictive to achieve ends
What is a section 17a?
Community treatment order
Can be used to recall a patient to hospital for treatment if they do not comply with conditions of the order in the community, such as complying with medication
In terms of the MCA, what ways can individuals be supported to make their own decisions?
Interpreters
Communication aids
Time
Capacity to decide is specific to the decision in question. True or false?
True
Capacity may be present for some choices (e.g what to have for breakfast) but not others (e.g decided whether to have operation)
If there is a possibility of capacity returning and decision can be delayed, should it?
Yes
Particularly important in those with delirium
What are the 2 stages in testing for capacity?
1) the patient cannot make a decision due to a condition of mind or brain
- dementia, delirium, learning disability, severe depression
2) the person cannot understand, retain, weigh up, or communicate information relevant to the decision in question - evidence of inability to do this must be recorded
In terms of advance care planning for a person who has lost capacity, previous wishes can be established by…
An advanced statement
The views of legal proxy with powers appropriate to decision in question
Verbal statements made by the person before capacity lost
An advance decision to refuse treatment (ADRT) must be both…
Valid - signed by the patient, dated and witnessed. Must be no evidence that the patient has changed their mind
Applicable - relevant to current situation. If document concerns life sustaining treatment, it must state the refusal applies even though it may shorten life.
What is an advanced statement?
Allows you to make general statements describing your wishes and preferences about future care should you be unable to make or communicate a decision at the time.
Includes religious beliefs, food and drink preferences, types of clothes, music, who to visit you
In an advanced decision, there are things you cannot include such as..
Choose to refuse basic care that is essential to keeping you comfortable e.g pain relief, nursing care etc
Choose to refuse the offer of food or drink by mouth
Ask for anything unlawful e.g euthanasia
Demand specific treatment that healthcare professionals consider clinically unnecessary
Does an advanced decision need to be in writing?
Only if you want to refuse life sustaining treatment
People who lack capacity should only be deprived of their liberty when it is in their best interest, and in the least restrictive way possible. Examples of deprivation of liberty include…
Medication being given against a person’s will
Staff having complete control over a patient’s care or movements for a long period
Staff making all decisions about a patient - choices about assessment, treatment and visitors
