Mental health law Flashcards
when is the MHA not needed?
The majority of patients with mental disorders are assessed and treated in circumstances where the MHA 1983 (2007) does not (usually*) apply:
Competent patients who voluntarily consent to assessment and treatment [common law]
Incompetent patients where treatment is in their best interests [Mental Capacity Act 2005]*
what does the MHA allow?
MHA 1983 (2007) allows for compulsory admission and treatment of patients who have a mental disorder and who have capacity and are refusing assessment & treatment
What does section 2 of the MHA allow
28 day detention
Application made by nearest relative or AMHP and supported by 2 Drs (1 a specialist)
Patient must be suffering from a “mental disorder of a nature or degree” warranting admission for assessment and this must be in the “interests of his own health or safety or the protection of others”
Appeal via MHRT
what does section 3 of the MHA allow?
6 month detention period (renewable and reviewable at 6 months and then every 12 months)
Application made by nearest relative or AMHP and supported by 2 Drs (1 a specialist)
Patient must be suffering from mental disorder for which they need Rx in hospital and it is necessary for health or safety of patient or others that Rx be given and appropriate medical treatment is available
Appeal via MHRT
what does section 4 of the MHA allow?
72 hours detention period
Admitted on the recommendation of 1 doctor (who need not be specialist but (ideally) knows the patient) if there is “urgent necessity”
Patient must be suffering from a mental disorder
Time spent in hospital under s4 counts towards compulsory periods of detention
what does section 5.2 of the MHA allow?
Detention of a patient who is already in hospital voluntarily (usually psychiatric hospital) who then changes his/her mind and wants to leave
72 hours detention (maximum
what does section 5.4 of the MHA allow
Detention by a nurse
6 hours detention (maximum)
give 5 examples of a mental disorder
Delusional disorders and schizophrenia
Affective disorders (depression, manic depression)
Neurotic disorders (anxiety, PTSD, OCD)
Eating disorders (anorexia nervosa, bulimia)
Personality disorders
Organic Mental Disorder (Dementia/Delirium)
2 exceptions to mental disorder
Learning Disability / Autistic Spectrum Disorder:
On the list but can only be detained if disability/disorder is accompanied by “aggressive or seriously irresponsible conduct”
Alcoholism & Drug dependency:
If mental disorder is caused by alcohol/drugs then detention allowed, but alcoholism and drug dependency not classified as mental disorder in their own right
can patients who are admitted deny treatment?
Once admitted competent patients who refuse treatment can be treated against their will under Part IV of the MHA 1983 (2007)
Section 2: Compulsory treatment is lawful
Section 3: Compulsory treatment is lawful
Section 4: Only voluntary treatment is lawful
law surrounding ECT
Due to 2007 amendments there are now separate rules for ECT / psychosurgery
Consent of patient and second opinion is now needed for psychosurgery
ECT may not (unless urgently needed) be given to a capacitous patient who refuses ECT. If patient is not capacitous then second opinion needed from a special panel
does support need to be provided on discharge?
If a patient is discharged after being detained under the MHA 1983 (2007) certain forms of after-care / support must be provided
The 2007 amendment also now allows for a “Community Treatment Order” which is a form of “conditional discharge”
what is a community treatment order
Community Treatment Order: for patients who are sufficiently well to be conditionally discharged (after detention under MHA) but require on-going treatment – Section 17a
Patients permitted to remain in the community if “compliant” with treatment
If non-adherent patients will be returned to hospital
Compulsory treatment can only take place in community if it is an emergency
role of independent mental health advocate
IMHAs will help qualifying patients understand the legal provisions to which they are subject under the MHA, and the rights and safeguards to which they are entitled
summarise th key changes to the MHA 2007
Single definition of mental disorder
Modified the treatability criterion for detention
Introduced supervised community treatment
Replacement of ASW role with AMPH
Permitted refusal of ECT
Redefined roles of nearest relative and acknowledges civil partnerships
Introduced IMHA
Hospital managers must refer cases to the MHRT
