Mental Health And Law Flashcards
Why can’t people with mental disorders be treated under the Mental Capacity Act in their best interest?
Mental illness can affect people’s value
Even though their cognitive function may not be impaired, the process of decision making can be affected
Mental health act 1983
To ensure that people with serious mental disorders shchi threaten their health or safety of the public can be treated irrespective of their consent where it is necessary to prevent them from harming themselves or others
- only for mental health. Not physical illness
- detention/treatment without consent
- 3 professionals decisions
Section 2
Assessment order
Cannot institute long term treatment, but can give treatment as part of assessment process
Last up to 28 days
Two doctors must agree and one of them must be section 12 doctor
Section 3
Treatment order
Can initially last up to 6 months
Each subsequent order lasts up to 1 year
Cannot be detained under section 3 if Nearest Relative object
Most treatment can be given under section 3 including psychotropic medication (on psychiatric ward)
After 3 months of detention, either person has to consent to treatment or SOAD doctor must confirm treatment is in best interests
Safeguards for ECT
Two doctors have to agree
Renewable
ECT
A person must consent to ECT
Where they lack capacity, a second doctor must give authorization
Section 4
Emergency order -seldom used as good practice is to hold full MHA assessment and consider for 2 or 3
Allows emergency detainment for the purpose of assessment for a duration of up to 72 hours
The application can be made by the nearest relative or an Approved Mental Health Professional and must be supported by one doctor. The doctor must have examined the patient within the previous 24 hours
During the 72 hour period, second doctor has to review
Community treatment order
For patients on section 3
Enforce treatment in community
Power to bring patient back to hospital of does not comply with treatment plan
Section 5 (2)
•Doctor's holding power (72 hours) •When an informal inpatient tries to leave -any registered doctor -any ward (not A&E) •Further assessment must occur within 72 hours -can be released from 5(2) -MHA assessment >>discharge if not detainable or >>detention under section 2 or 3
S5(4)=Nurse’s holding power 6 hours
*must be a hospital inpatient
Section 135
Magistrate’s order
Applied for by AMHP where person refusing to allow mental health professionals into their residence
Gives police warrant to enter property and take person to “place of safety”
Section 136
Applies to person found in public place suspected by police of having mental disorder conferring an immediate risk
Taken to “place of safety”
Assessment by Duty psychiatrist
-discharge or
-MHA assessment
»admit under S2 or 3 or discharge of not detainable
Sarah -took overdose, history of physical and sexual abuse, history of depression.
refusal of treatment
Section 2 for assessment due to high risk of suicide, possible mental illness, refusal to engage
- Medics have to assess the capacity (understand,weight, retain and communicate)
- If no capacity, treat overdose under MCA
She might have BPD. Her refusal of treatment might be due to her ex showed up
She might be delirium due to the overdose
Chris -paranoid schizophrenia Become withdrawn after mother's death Disengage from mental health service Disturbing neighbours Religious delusion Threats to burn down his flat
Section 3 (treatment order) is appropriate.
He has an established diagnosis and recognized pattern of relapse. No further assessment is needed as we know what treatment he needs.
Chris-admitted to hospital
Develop gangrene in his leg
Surgeon advise an amputation
He refuse
Has to assess if Chris has capacity (understand, believe, weight, retain, communicate)
Just because he has paranoid schizophrenia, it doesn’t mean he doesn’t have capacity
Since gangrene is not the result of mental illness, it cannot be treated under the MHA.
49 yo man with severe autism, learning disability, mute
Increasingly agitated at day centre
Admitted informally for assessment
Carers not allowed to visit while he was being assessed
Detained in hospital under common law- he wasn’t refusing,but hadn’t actually consented
Common law based on case law-was how all cases of incapacitated persons were dealt with, based on doctrine of “best interests”
Common law based on precedent- no formal procedures or criteria; subjective, arbitrary,
Common law (informal, more arbitrary, based on precedence) vs statutory law (formal, by parliamentary act)
MCA’s deprivation of liberty safeguards (DoLS)
Provides legal safeguards for mental ill patients deprived of liberty when MHA not applicable
-amendment to the MHA which allows restraint and restriction to be used but only if they are in a person’s best interest
