Mental health and law Flashcards
What does the Mental Health Act 2007 apply to?
admission and discharge of people suffering from
a ‘mental disorder’ who are considered to be a risk
to themselves or others
when can people be detained under the Mental Health Act 2007
if appropriate medical treatment is available
NOT for the treatment of physical disorders.
what % of all inpatients in mental health units are
admitted under the MHA?
10-15
most there voluntarily
To have capacity, a person must be able to do which 4 things?
• understand the information relevant to the decision;
• retain that information;
• use or weigh that information as part of the process of
making the decision;
• communicate their decision (whether by talking,
using sign language or any other means).
Capacity is lacking if any of these abilities are missing.
when should capacity be assessed?
should be assessed separately
for each decision.
what are the principles of section 2 of the mental health act?
an approved mental health professional puts in the application
purpose; Admission for Assessment
max period; 28 days
what are the principles of section 3 of the mental health act?
an approved mental health professional puts in the application
purpose; Admission for treatment
max period; 6 months
what are the principles of section 5(2) of the mental health act?
“Dcotor’s holding power”
Holding order for a patient already on the ward
max period; 72 hours
– 1 doctor; the doctors looking after the patient NOT just psych. not F1s
what are the principles of section 136 of the mental health act?
Police order to remove a person appearing to
suffer from a ‘mental disorder’ from a public
place to a ‘place of safety’
72 hours –
under the mental capacity act, how should a doctor proceed whena. patient is deemed to lack capacity?
steps may be taken in their best interests.
These steps should be the least restrictive of their rights and freedoms,
should allow them to participate as much as possible in the decision-making process,
and should take into account their personal beliefs.
what is the diagnostic pyramid trying to convey?
the diagnoses higher up ‘the pyramid’ take precedence over those below, so;
clinicians need to exclude organic causes of symptoms (denoted O on the pyramid) before diagnosing anything else.
what are the components of the diagnostic pyramid in order?
Organic PSYCHOTIC AFFECTIVE NEUROTIC PERSONALITY DISORDERS
give example of situation where you cant use section 5(2) to admit a patient?
it can only be used on inpatients
so you cant use on a patient you are trying to admit from A&E
section 135(1) gives which powers?
how to obtain?
the power to remove a person from a dwelling if it is considered they have a mental disorder and that they may be in need of care and attention for this.
With the agreement of the person they can be assessed at the dwelling or removed to the place of safety for the assessment to take place there.
approved mental health professional presents evidence at magistrates to get warrant. the amhp then goes with police and medical practitioner to assess patient in their house or safe place.
section 4 gives which powers?
emergency assessment
holding power for 72 hours
section 4 gives which powers?
how to obtain?
emergency assessment/detention
holding power for 72 hours
application is usually done by
an Approved Mental Health Professional OR nearest relative
+ Doctor; section 12 approved or previous rapport with patient
what is section 37?
Hospital order
The criminal courts can use section 37 of The Mental Health Act if they think you should be in hospital instead of prison.
You must have a mental disorder and need treatment in hospital and have been convicted of a crime that is punishable with imprisonment
Duration: The hospital can treat you without your permission for up to 3 months.
It is a sentence and does not have a fixed end date
Will be in hospital for 6 months+. can be renewed for 6 months again. then 12 months.
two doctors must first assess
what is section 41?
restriction order aka conditional discharge
you can live in the community with a number of conditions imposed on you.
may include that you live at a specified place and accept treatment for your mental illness. appointments with (AMHP) or probation officer and also with your responsible clinician.
treatment can only be given with your consent.
If you fail to comply with the conditions the Ministry of Justice will be informed and you could be recalled to hospital and reinstatement of section 37/41.
usually given with section 37 as 37/41
can be for fixed period of time (6 months +) or it may be indefinite.
list some behavioural management techniques in PICU?
One to one nursing sessions
Verbal de- escalation
Care Planning
list some EMERGENCY management techniques in PICU?
Rapid Tranquillisation
Acuphase Physical Restraint Seclusion
list some therapy techniques used in PICU?
Brief Psychology
Art therapy
Music Therapy
Gardening/Reading
what are precautions to observe before rapid tranquillisation ?
Always consider ORAL medications first.
Check medical history, allergies and ECG before administering.
Requires close physical health monitoring after RT.
how do you plan rapid tranquillisation?
Neuroleptic naive/ no antipsychotics previously:
- PO Lorazepam
unsuccessful:
- IM Lorazepam (onlanzepine if dont work)
Taken antipsychotics before:
- PO Lorazepam or onlanzapine
or
- PO haloperidol + promethazine
unsuccessful:
- IM haloperidol + promethazine (no cardiac disease)
- IM Lorazepam (if cardiac disease/unkown)
when is seclusion used?
last resort
Seclusion is only used when a person poses an immediate risk to others and all other therapeutic approaches have been exhausted.
1 to 1 nursing
