Mental Health Act x Mental Capacity Act Flashcards
What do the MHA and MCA broadly allow? [4]
- Deprivation of liberty
- Restraint (physical & chemical)
- Imposition of treatment agaisnt someones will
- Performance of acts on others without their consent
When was the MHA act last revised and what was added? [1]
Revised in 2007 to add CTOs (A community treatment order (CTO) is an order made by your responsible clinician to give you supervised treatment in the communit)
What is section 136 of the MHA? [1]
Police officers can remove someone from public place if deemed at risk to selves of others
What are the differences between the MHA and MCA? [4]
What are the key features of the mental health act [
Does NOT specify what constitute what a mental disorder is
But does exlude:
- Dependence on alcohol or drugs
- Learning disability unless associated with abnormally aggressive or seriously irresponsible conduct
No age restriction
Principles of least restriction
Application is guided by Code of Practise
Mental health act: what are the criteria for detention? [4]
The patient must be suffering from a mental disorder of a nature and/or degree that makes it appropriate and necessary for them to be detained in hospital, in the interests of their own health, own safety, protection of others
Appropriate treatment is available
Degree is the extent to which the illness is currently manifesting
Describe the different sections (2-5) that need to know for MHA with regards to:
- Where
- Who
- How long
- Renewable
- Compulsory treatment
What are the MHA 1983 Safeguards?
Two doctors & AMHP (independent) to detain
Right of appeal to First Tier Tribunal
* Completely independent panel
* Burden of proof is on the detaining authority
* Bound to order the patient’s discharge if not found to be detainable
Hospital Managers’ meetings
Consent to treatment after 3/12 Second Opinion Approved Doctor (SOAD)
CQC oversight
NR discharge
Tribunal (judge, independent pyschiatrist and lay person) is majority decision whereas hospital managers (3 lay people) is unaninmous
MHA 1983 Safeguards
When can you apply for hospital managers review or tribunal review? [2]
Any patient can apply for hospital managers review at any point during their stay
Tribunal: have to appeal within first 14 days of stay
Can apply to both
What are the key features of the mental capacity act 2005? [6]
- Aims to protect the rights and freedoms of individuals who lack capacity to make their own decisions
- Applies to people 16 years+
- Applies in hospitals and care homes (MHA only in hospitals)
- Applies to interventions undertaken for service users on a daily basis (“duty of care” acts)
- Attending to their personal care
- Providing healthcare treatment
- Shopping or paying their bills
- S5 MCA provides protection to staff carrying out acts
What do you need to think about with regards to MCA 2005 Act? [1]
Capacity tests are decision specific
You assume capacity is present unless it is shown to be absent
Assist - should provide all practiable help for people to decide for themselves
Unwise decisions
- doesn’t mean lacks capacity
Best interest for those who lack capacity
Least restrictive
- person making a decision for someone else should aways consider less restrictive option
How do you decide incapacity? [2]
Need to do both:
One - Status test
- ID if there is impairment of or a disturbance in the functioning of the mind or brain (mental illness / learning disability / dementia / confusion)
Can they make the decision?
Two - Must be able to
1. Understand information relevant to the decision
2. Retain that information long enough to make a decision
3. Weigh up the information as part of the process of making the decision
4. Communicate the decision
Lacking any one of these = lacks capacity
When is someone assigned a independent mental capacity advocate? [1]
is appointed where a person lacks capacity and has no friends, relatives or appointed decision-makers to speak for them
Who are deputies appointed by? [1]
Court of Protection
Describe what is meant by a deprivation of their liberty (DoLS) [3]
DoLS principles
* Applied when the MCA is used in such a way that the person is deprived of their liberty
1. Subject to continuous supervision & control
2. Not free to leave
Person must be provided with a representative and given the right to challenge the deprivation of liberty
* Doesn’t apply to people already under the MHA
What do you absolutely need to know about the MCA? / what would you do if someone asked you to assess someones capacity? [+]
What does the MHA assessment involve and who needs to recommend this decision? [1]
A Mental Health Act assessment involves a detailed evaluation to determine whether to detain someone under the Mental Health Act.
The decision needs to be recommended by two registered medical practitioners (doctors):
* A Section 12 doctor
* Another doctor (e.g., their GP)
A Mental Health Act assessment can result in compulsory admission under which sections? [2]
A Mental Health Act assessment can result in compulsory admission under Section 2 or Section 3.
Describe what section 2 and 3 involves? [2]
Section 2
- Section 2 involves compulsory admission for assessment following a Mental Health Act assessment, with a maximum period of 28 days.
- It cannot be renewed. It ends in either discharge or further detention under Section 3.
Section 3
- Section 3 involves compulsory admission for treatment. The maximum period is six months, after which the Responsible Clinician can arrange to renew it for further treatment.
- Detention under Section 3 requires a Mental Health Act assessment. Patients that are well-known to mental health services may be detained under Section 3 straight from the community. Alternatively, patients may be detained under Section 3 following assessment under Section 2.
Describe what section 4, 5(2) and 5(4) ? [2]
Section 4
- Section 4 is used to detain patients for up to 72 hours in urgent scenarios where other procedures cannot be arranged in time. It requires an AMHP and one doctor. It is followed by a Mental Health Act assessment.
Section 5(2)
- Section 5(2) is used in an emergency to detain patients who are already in hospital voluntarily.
- It lasts up to 72 hours and requires only one doctor. It is followed by a Mental Health Act assessment.
Section 5(4)
- Section 5(4) is used in an emergency to detain patients who are already in hospital voluntarily. It lasts up to 6 hours and requires only one nurse. It is followed by a Mental Health Act assessment.
Describe what the MHA and MCA are based on [2]
The Mental Capacity Act is based on a functional test
- Can they function in this way?
The Mental Health Act is inherently status based
- On the basis of the person having a mental health dx
