Mental health legislation

Question 1

Section 5.2 of Mental Health Act

Answer 1

Type of Order: Emergency
How long it lasts: Up to 72 hours
Staff required: 1 Doctor

Question 2

When and what can be done under 5.2 of Mental health act

Answer 2

If the patient is an in-patient with a mental illness
If the patient is at risk
If informal admission is no longer appropriate, i.e. the patient wants to leave
If the patient needs an assessment for Section 2 or 3

Hold the patient for Mental Health Act assessment.
Cannot give treatment
Cannot do another 5(2) back-to-back
Cannot let it lapse
Cannot use in A&E or Outpatients
Cannot have leave
Cannot get into trouble for doing it in good faith.

Question 3

Who can sign a 5.2

Answer 3

In a General Hospital it is done by thephysicians/surgeons - Not the psychiatrist!
Most senior member
Only a fully registered medical practitioner can sign the form so a Pre-registration house officer, such as an F1, can NOT do it.
If the physician does report the patient under Section 5(2) then the psychiatrist should see the patient as soon as possible.
Section 5(2) only applies to in-patients in a general hospital — therefore not in A&E or Outpatients!

Question 4

4 components of the process of capacity

Answer 4

Understand
Retain
Deliberate
Communicate

Question 5

2 stages of capacity assessment

Answer 5

Stage 1: a person lacks capacity if he/she is unable to make a specific decision due to a disturbance in the functioning of the mind or brain.

Stage 2: a person is unable to make a decision if they are unable to:

Understand
Retain
Deliberate
Communicate

Question 6

What should be considered when making decisions for somebody else under the MCA

Answer 6

Is the person likely to regain capacity & when?
Maximise the person’s participation in process
Past and present wishes of person
Their beliefs, values and other factors
Views of carers and other nominated or appointed persons

Question 7

What is lasting power of attorney

Answer 7

This is a legal mechanism that allows someone to specify another adult to look after their affairs - financial and/or medical should they lack capacity in the future.

Question 8

What is a written advance directive?

Answer 8

Legal document that is signed by the patient before they lose capacity.
It can make advanced decisions, including the refusal of a treatment that may be life-saving