Mental Health Legislation Flashcards
When was the Mental Health Act created and amended?
- 1983
- 2007
Who assesses a patient under the MHA?
2 Drs and 1 AMHP
Role of the AMHP
- Responsible for making the application to the receiving hospital
- Can disagree with assessing Dr
- Independent and makes the final decision regarding the detention of patient
Under what section must 1 Dr be approved by
12
What are the criteria for detention under the MHA?
- Suffering from mental disorder warranting detention in hospital
- AND risk to self/others
- AND unwilling to go voluntariy
What is Section 2?
Warrants detention in hospital for assessment
How long does Section 2 last?
Up to 28 days
Who is required for a section 2?
2 Drs and 1 AMHP
Can a section 2 be appealed
Within first 14 days
What is Section 3?
Warrants medical treatment in hospital
Who is required for a section 3?
2 Dr’s and an AMHP
How long does a section 3 last?
Up to 6 months
Can a section 3 be appealed?
Twice within the 1st 6 months then yearly after this
What is treated under section 3?
- Mental disorder
- Cause of the mental disorder
- Consequences of the mental disorder
What is Section 5?
- Detention of informal patients already in hospital who demonstrate a mental disorder
- Risk to self or others
- Holding power so that a MHA assessment can be carried out
- Cannot be used to treat physical health problem
How long does a section 5(2) last?
Up to 72 hours
Who can apply for a section 5(2)?
- Application by consultant in charge of care or nominated deputy
- Must be a registered medical practitioner - FY2 and above
What is a Section 135?
Warrant to search for and remove patient and take to a place of safety for the purpose of an assessment
What is a Section 136?
- Detainment of person who is not in a private dwelling
- Taken to a place for assessment
- Lasts up to 24hours
What are the 5 statutory principles of the MCA?
- A person is assumed to have capacity
- All practicable steps must be taken to help the person to make a decision
- Do not treat people as unable to make decisions if they make an unwise decision
- Any actions or decisions made on behalf of a person who lacks capacity must be in that person’s best interests
- Before acting in a persons best interests, it must be established there us no other less restrictive way to achieve the outcome
How is Mental Capacity assessed?
- Diagnostic Test
2. Functional Test
What is a diagnostic test?
At the time of the decision, the person has an impairment of, or disturbance in function of the mind or brain
What is a functional test?
- 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 his decision
What is a Lasting Power of Attorney?
- Allows a person to stipulate who they would wish to manage their health and welfare decisions
- Decisions about their property and finances
What is the court of protection?
Can be used to make declarations concerning capacity and can appoint deputies on behalf of others
What is the IMCA?
- Independent Mental Capacity Advocates
- If the person who lacks capacity does not have anyone else to advocate for them, IMCA gets involved if decision is about serious medical treatment
What are DoLS?
- Deprivation of Liberty Safeguards
- Apply to anyone who lacks capacity and is deprived of their liberty in their best interests
If primarily assessing or treating a mental disorder what would you use?
MHA
If treating a physical illness what would you use?
MCA
If the illness is the result of a mental disorder, what would you use?
MHA
If you need to treat a physical illness in someone who is detained under the MHA what would you use?
MCA
Unconscious person brought in to the Emergency Department
following a car crash, requiring urgent, life-saving treatment
MCA
Elderly person with delirium, requires IV antibiotics but is refusing
to remain on the medical ward as needs to “get back to school for
class”
MCA
Man with a long history of schizophrenia, frequent admissions to
psychiatric hospital, refusing prescribed treatment; hallucinations
worsening, history of self harm when unwell
MHA
21 year girl with 1st episode of psychosis; at risk of
severe self neglect, does not believe she is
unwell, refusing community support or admission
MHA
Surgical ward, 25 year old man admitted 2 days ago
with acute abdominal pain. No history of any mental
health problems, heavy alcohol use (over 15 units/day).
Develops sudden onset of persecutory delusions and
hallucinations – wanting to leave ward as feels unsafe
there
MCA
Medical admissions unit. 80 year old lady with
suspected bowel cancer; needs a non-urgent
colonoscopy to rule this out as cause of PR
bleeding (not immediately life threatening). Believes
she is “dead” inside and refuses all treatments
because of this.
Give time to allow for capacity assessment as non-urgent otherwise use MCA
50 year old man, post operative, unable to
communicate verbally due to tracheotomy. No history of
any mental health problems. Family describe him as an
obstinate character and there no changes in mental
state compared to his norm. Some minor risks of
complications if he leaves ward. Refuses to stay on
ward for monitoring.
No need for detainment
