Mental Health Legislation

Question 1

When was the Mental Health Act created and amended?

Answer 1

• 1983

- 2007

Question 2

Who assesses a patient under the MHA?

Answer 2

2 Drs and 1 AMHP

Question 3

Role of the AMHP

Answer 3

• 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

Question 4

Under what section must 1 Dr be approved by

Answer 4

12

Question 5

What are the criteria for detention under the MHA?

Answer 5

• Suffering from mental disorder warranting detention in hospital
• AND risk to self/others
• AND unwilling to go voluntariy

Question 6

What is Section 2?

Answer 6

Warrants detention in hospital for assessment

Question 7

How long does Section 2 last?

Answer 7

Up to 28 days

Question 8

Who is required for a section 2?

Answer 8

2 Drs and 1 AMHP

Question 9

Can a section 2 be appealed

Answer 9

Within first 14 days

Question 10

What is Section 3?

Answer 10

Warrants medical treatment in hospital

Question 11

Who is required for a section 3?

Answer 11

2 Dr’s and an AMHP

Question 12

How long does a section 3 last?

Answer 12

Up to 6 months

Question 13

Can a section 3 be appealed?

Answer 13

Twice within the 1st 6 months then yearly after this

Question 14

What is treated under section 3?

Answer 14

• Mental disorder
• Cause of the mental disorder
• Consequences of the mental disorder

Question 15

What is Section 5?

Answer 15

• 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

Question 16

How long does a section 5(2) last?

Answer 16

Up to 72 hours

Question 17

Who can apply for a section 5(2)?

Answer 17

• Application by consultant in charge of care or nominated deputy
• Must be a registered medical practitioner - FY2 and above

Question 18

What is a Section 135?

Answer 18

Warrant to search for and remove patient and take to a place of safety for the purpose of an assessment

Question 19

What is a Section 136?

Answer 19

• Detainment of person who is not in a private dwelling
• Taken to a place for assessment
• Lasts up to 24hours

Question 20

What are the 5 statutory principles of the MCA?

Answer 20

1. A person is assumed to have capacity
2. All practicable steps must be taken to help the person to make a decision
3. Do not treat people as unable to make decisions if they make an unwise decision
4. Any actions or decisions made on behalf of a person who lacks capacity must be in that person’s best interests
5. Before acting in a persons best interests, it must be established there us no other less restrictive way to achieve the outcome

Question 21

How is Mental Capacity assessed?

Answer 21

1. Diagnostic Test

2. Functional Test

Question 22

What is a diagnostic test?

Answer 22

At the time of the decision, the person has an impairment of, or disturbance in function of the mind or brain

Question 23

What is a functional test?

Answer 23

• 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

Question 24

What is a Lasting Power of Attorney?

Answer 24

• Allows a person to stipulate who they would wish to manage their health and welfare decisions
• Decisions about their property and finances

Question 25

What is the court of protection?

Answer 25

Can be used to make declarations concerning capacity and can appoint deputies on behalf of others

Question 26

What is the IMCA?

Answer 26

• 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

Question 27

What are DoLS?

Answer 27

• Deprivation of Liberty Safeguards

- Apply to anyone who lacks capacity and is deprived of their liberty in their best interests

Question 28

If primarily assessing or treating a mental disorder what would you use?

Answer 28

MHA

Question 29

If treating a physical illness what would you use?

Answer 29

MCA

Question 30

If the illness is the result of a mental disorder, what would you use?

Answer 30

MHA

Question 31

If you need to treat a physical illness in someone who is detained under the MHA what would you use?

Answer 31

MCA

Question 32

Unconscious person brought in to the Emergency Department

following a car crash, requiring urgent, life-saving treatment

Answer 32

MCA

Question 33

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”

Answer 33

MCA

Question 34

Man with a long history of schizophrenia, frequent admissions to
psychiatric hospital, refusing prescribed treatment; hallucinations
worsening, history of self harm when unwell

Answer 34

MHA

Question 35

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

Answer 35

MHA

Question 36

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

Answer 36

MCA

Question 37

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.

Answer 37

Give time to allow for capacity assessment as non-urgent otherwise use MCA

Question 38

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.

Answer 38

No need for detainment