Mental Health Act and Mental Capacity Act

Question 1

What is section 2 for?

Answer 1

Assessment and treatment

Question 2

How long does a section 2 last?

Answer 2

28 days

Question 3

What is a section 3 for?

Answer 3

Treatment

Question 4

How long can a section 3 last?

Answer 4

6 months

Question 5

Who can do a section 2 and 3?

Answer 5

2 doctors and an AMHP

One doctor must be section 12 approved and ideally the other knows the patient

Question 6

What is a section 5(4)

Answer 6

6 hours nurse holding power

Question 7

What is a section 5(2)?

Answer 7

72 hours junior doctor holding power

Question 8

What is a section 136?

Answer 8

72 hours police arresting power

Question 9

What is a section 135?

Answer 9

A warrant to enter someone’s property

Question 10

What conditions need to be met in order to section someone?

Answer 10

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

Question 11

By sectioning someone what two powers does it give you?

Answer 11

To determine where a patient should be

To treat their MENTAL illness (or when a physical illness is directly causing a mental illness)

Question 12

What is the four part test of capacity?

Answer 12

1) ability to understand
2) weight up
3) retain
4) communicate

Question 13

What are the five principles associated with the mental capacity act?

Answer 13

1) always assume capacity
2) support decision making
3) unwise decisions are allowed
4) best interests
5) least restrictive to achieve ends

Question 14

What is a section 17a?

Answer 14

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

Question 15

In terms of the MCA, what ways can individuals be supported to make their own decisions?

Answer 15

Interpreters
Communication aids
Time

Question 16

Capacity to decide is specific to the decision in question. True or false?

Answer 16

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)

Question 17

If there is a possibility of capacity returning and decision can be delayed, should it?

Answer 17

Yes

Particularly important in those with delirium

Question 18

What are the 2 stages in testing for capacity?

Answer 18

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

Question 19

In terms of advance care planning for a person who has lost capacity, previous wishes can be established by…

Answer 19

An advanced statement
The views of legal proxy with powers appropriate to decision in question
Verbal statements made by the person before capacity lost

Question 20

An advance decision to refuse treatment (ADRT) must be both…

Answer 20

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.

Question 21

What is an advanced statement?

Answer 21

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

Question 22

In an advanced decision, there are things you cannot include such as..

Answer 22

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

Question 23

Does an advanced decision need to be in writing?

Answer 23

Only if you want to refuse life sustaining treatment

Question 24

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…

Answer 24

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

Question 25

What is the purpose of DOLS?

Answer 25

To ensure that people who cannot consent to their care agreements in a care home or hospital are protected if those arrangements deprive them of their liberty

Question 26

The DOLS are an amendment to what? And apply where?

Answer 26

The MCA of 2005

They apply in England and Wales only

Question 27

Who do care homes / hospital have to ask to deprive someone of their liberty?

Answer 27

Local authority

= requesting a standard authorisation

Question 28

What safeguards are gained as part of DOLS?

Answer 28

Someone appointed with legal powers to represent them
Right to challenge authorisations in the Court of Protection
Access to Independent Mental Capacity Advocates