Mental Health Act & Capacity Flashcards
State the ten Millan principles
- non discrimination
- equality
- respect of diversity
- reciprocity
- informal care
- participation
- respect for carers
- least restrictive
- benefit
- child welfare
What is the criteria for the use of the mental health act?
- (likely) mental disorder
- significantly impaired decision making ability
- determine/give treatment
- significant risk
- informal/voluntary care not appropriate
What is classed as a mental disorder?
Mental illness, learning disability or personality disorder
Describe SIDMA
Mental disorder alone, affects ability to believe understand and retain information to make and communicate decisions
What form of treatment can be given under the mental health act?
Nursing, psychological interventions, rehabilitation, medication, ECT, referring, specialist intervention (OT/SALT/dietician)
What sort of thing counts as significant risk?
Suicide, self harm, wandering, vulnerability, physical state, deterioration in mental health, poor self care, retaliation from others due to aggressive behaviour
Name the three types of detention under the mental health act
- emergency
- short term
- compulsory treatment order
Describe emergency detention order
72 hours, does not authorise treatment can be given by a fully registered doctor (FY2). Where possible consult a mental health officer. No right to appeal.
What treatment can be given under emergency detention?
Only treatment that will save the patients life, prevent serious deterioration, alleviate extreme suffering - must complete T4 form
Describe short term detention
Up to 28 days for assessment and treatment
Approved by medical practitioner and MHO
Right to appeal
Can be extended if CTO required (3 days to apply or 5 days once submitted)
What treatment is not allowed under a short term detention?
ECT, artificial nutrition, nerve stimulation, transcranial magnetic stimulation, drugs to alter libido, neurosurgery
Describe a compulsory treatment order
Initially up to 6 months
Approved by medical practitioner plus MHO
2 independent doctor reports - AMP or GP
Care plan
MHO report
Tribunal in court, treatment authorised for up to 2 months and order reviewed at 6 months
What is an advance statement?
Signed when the patient is well it is witnessed and dated. How they would prefer to be treated in the future - can be overruled.
How long does nurses holding power last?
Up to 3 hours
How long do policing powers last?
24 hours
What is consent?
Permission for something to happen, given freely without coercion - legally capable and must be informed and cover the period of intervention
What is meant by informed consent?
Patient must understand the intervention, what the benefits and side effects are
What can help to gain informed consent?
Translator, SALT, friends/relative, written/visual aids, timing
Define capacity
Ability to make a decision
What three factors make up capacity?
- understand and retain information
- use and weigh information to make a decision
- communicate that decision
Describe the Adults with Incapacity Act 2000
- Intervention must benefit adult
- Such benefit cannot reasonably be achieved without
- Take account of past and present wishes
- Consult with relevant people
- Encourage the adult to use residual capacity
What does section 47 of the adults with incapacity act allow?
Practitioner to provide interventions related to the treatment authorised
- does not authorise force unless immediately necessary nor transport to place of treatment
What is a power of attorney?
Granted whilst the person still has capacity - person can act as their financial and/or welfare attorney. In case capacity is lost in the future
What is guardianship?
Applied for by one or more individuals or local authority.
Granted by sheriff, different types - welfare or financial. Cannot place a person in hospital against their will if the adult does not comply - the sheriff will issue a compliance order
At what age is a child presumed to have capacity?
16 years
When is it best to use the MHA in children?
Use of force, IM medication, invasive treatment, detrimental impact on relationship with carer
