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Year 3 - Ethics and Law > Mental Health Law > Flashcards

Mental Health Law Flashcards

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1
Q

When is involuntary treatment used?

A

Within mental illness:

  • When someone poses a risk to themselves or others
  • Severely unwell, lost touch with reality (psychotic)
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2
Q

How can involuntary treatment be approved?

A

There Mental Health Legislation which provides a legal mechanism

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3
Q

What criticism is there to involuntary treatment?

A
  • Seen as ill-liberal
  • Poorly compatible with international human rights norms
  • Unnecessary for most patients
  • Counterproductive to some patients
  • Practical problems in administration
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4
Q

What ethical issues surround involuntary treatment?

A
  • Non-maleficience
  • Loss of autonomy
  • Paternalism – > Hard = Ignores patients views
  • Non-discrimination –> Physical versus mental illness e.g. diabetes
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5
Q

What ethical justifications surround involuntary treatment?

A
  • Beneficence
  • Autonomy –> May promote reasoned autonomy
  • Right to treatment
  • Paternalism –> Soft = Shaping
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6
Q

What legislations surround involuntary treatment in the UK

A
  • Scotland = Mental Health (Care & Treatment) (Scotland) Act 2003, “MHA”
  • England = Mental Health Act 1983 [Amended by Mental Health Act 2007]
  • Northern Ireland = Mental Health (Northern Ireland) Order 1986
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7
Q

What legislations surround involuntary treatment in Scotland?

A

Scotland = Mental Health (Care & Treatment) (Scotland) Act 2003, “MHA”

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8
Q

What legislations surround involuntary treatment in England?

A

England = Mental Health Act 1983 [Amended by Mental Health Act 2007]

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9
Q

What legislations surround involuntary treatment in Northern Ireland?

A

Northern Ireland = Mental Health (Northern Ireland) Order 1986

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10
Q

What is the role of the mental health acts?

A
  • Allows involuntary treatment
  • Provide rights and safeguards
  • Duties on NHS Boards and local authorities
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11
Q

What is the role of safeguards?

A
  • Explicit criteria
  • Multiple professional views
  • Lay and career perspectives
  • Legal oversights
  • Right of appeal (Article 5 ECHR)
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12
Q

What are the Millan Principles?

A
  • Non-discrimination
  • Equality
  • Respect for diversity
  • Reciprocity
  • Informal care
  • Participation
  • Respect for carers
  • Least restrictive alternatives -
  • Benefit
  • Child welfare
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13
Q

What are the 5 criteria for MHA?

A

All must be met:

1) Mental disorder
2) Treatment available
3) Condition cause impaired ability to makes decisions about psychiatric treatments
4) Risk to self or others
5) Necessity
6) Least restrictive treatments

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14
Q

What is nurse holding power?

A

Authorises detention for 2 hours, fewer safeguards

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15
Q

What is emergency detention certificate?

A

Authorises detention for 72 hours, fewer safeguards

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16
Q

What is short-term detention certificate?

A

Authorises detention for 28 days

Requires 5 criteria, 1 doctor and 1 MHO

17
Q

What is compulsory treatment order?

A

Authorises detention for up to 6 months, more safeguards

18
Q

What is a mental health disorder?

A

Mental illness, personality disorder or learning disability

19
Q

What exclusions are there in mental disorders?

A
  • Sexual orientation
  • Sexual deviancy
  • Transsexualism
  • Transvestism
  • Dependance on, or use of, alcohol or drugs
  • Behaviour that cause, or is likely to cause, harassment, alarm or distress to any other person
  • Actin as no prudent person would
20
Q

What differences are there in mental health laws in the UK?

A

Impaired decision making ability in Scotland

Versus

Need for hospitalisation in UK

Also procedural matters, durations etc

21
Q

What is mental capacity?

A

Ability to make decisions about finances, welfare and medical treatments

22
Q

What is required for mental capacity?

A
  • Reason and deliberate
  • Values and goals
  • Appreciate one’s circumstances
  • Understand information
  • Communicate a choice
23
Q

What is legal capacity?

A
  • The ability to hold right and duties (legal standing) and to exercise these rights and duties (legal agency)
  • Making legally-valid decisions
24
Q

When is capacity assessed?

A
  • Impaired mental capacity (Dementia, intellectual disability etc) –> May lead to loss of legal capacity
  • Legal matter –> But relies on medical evidence
25
Q

What is the legislation surrounding mental capacity in Scotland?

A

Adults with Incapacity Act (Scotland) Act 2000, AWIA

26
Q

What is the legislation surrounding mental capacity in England and Wales?

A

Mental Capacity Act 2005 [Amended by Mental Health Act 2007]

27
Q

What is the legislation surrounding mental capacity in Northern Ireland?

A

Mental Capacity Act (Northern Ireland) 2016

28
Q

What is the role of the mental capacity legislation?

A

1) Allows legally-valid decisions to be made for those who lack mental capacity
2) Transfers decision-making right from impaired individual to another

Typical outcome AWIA = Guardianship

29
Q

How can doctors shortcut the AWIA to attain guardianship for an individual with loss of capacity?

A

Certificate of Incapacity under Section 47 of the Adults with Incapacity (Scotland) Act 2000

30
Q

How can social workers shortcut the AWIA to attain guardianship for an individual with loss of capacity?

A

Housing

31
Q

What safeguards are in place in terms of capacity ?

A
  • Multiple professionals
  • Explicit criteria
  • Procedures
  • Legal oversight
32
Q

What is the criteria for the Adults with Incapacity Act, Scotland, 2000 (AWIA)?

A

Needs only to have significant impairment in one area:

  • Acting; or
  • Making decision; or
  • Communicating decisions; or
  • Understanding decisions; or
  • Retaining the memory o decisions
33
Q

Differences between AWIA and MHA?

A

AWIA = Fiances, welfare treatment for physical conditions

MHA = Treatment for psychotic conditions

34
Q

Which ethical issues surround capacity law?

A

Autonomy:

  • In theory, promotes (principles)
  • In practice, may diminish (Mechanisms)

Non-discrimination:

  • Allows legally-valid decisions for disabled people
  • Transfers powers away from disabled people
35
Q

What is the Adult Support and Protection (Scotland) Act 2007?

A
  • Defines “adults at risk”
  • Risk of harm
  • Harm includes
36
Q

What is the Adult Support and Protection (Scotland) Act 2007 - in terms of adults art risk?

A

Defines “adults at risk” as:

1) Unable to safeguard their own well-being, property, rights or other interests;
2) At risk of harm; and
3) Because they affected by disability, mental disorder, illness or physical or mental infirmity, are more vulnerable of being harmed than adults who are not so affected

37
Q

What is the Adult Support and Protection (Scotland) Act 2007 - in terms of risk of harm?

A

Risk of harm:

  • Another person’s conduct is causing (or is likely to cause) the adult to be harmed, or
  • The adult is engaging (or is likely to engage) in conduct which causes (or is likely to cause) self-harm
38
Q

What is the Adult Support and Protection (Scotland) Act 2007 - Harm includes?

A

Harm includes:

  • Physical harm
  • Psychological harm
  • Unlawful conduct
  • Self-harm
39
Q

What should you do if you suspect an adult is at risk of harm?

A
  • Discuss with a senior
  • Document concerns
  • Report to the relevant authority

Year 3 - Ethics and Law (14 decks)

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