Mental health legislation

Question 1

Guiding principles of MHA

Answer 1

Least restrictive option and maximising independence

Empowerment and involvement

Respect and dignity

Purpose and effectiveness

Efficiency and equity

Question 2

What is needed for a MHA assessment for detainment?

Answer 2

1. assessed by 2 Dr’s and 1 AMHP (ideally all attend to see the patient at the same time)
2. each Dr must determine their own opinion regarding whether the person meets the criteria for detention
3. the AMHP is always responsible for making the
   application to the receiving hospital (and can disagree with the assessing Dr’s recommendations)

Question 3

What are the requirements for the doctors in assessing under MHA?

Answer 3

1 Dr MUST be Section 12 approved

1 Dr should “have prior knowledge” of the patient (eg: GP)

Question 4

Very rarely who can make the final decision in place of the AMHP

Answer 4

Pt’s nearest relative

Question 5

Patient criteria for detention under MHA

Answer 5

Must be suffering from Mental Disorder (= “any disorder or disability of mind”), of a nature or degree, which warrants detention in hospital

AND

Must be at risk to own health AND/OR own safety AND/OR risk to others

AND

Must be unwilling to go to hospital voluntarily (when have capacity)

Question 6

Is learning disability alone grounds for sectioning?

Answer 6

No, must be associated with abnormally aggressive or seriously irresponsible conduct

Question 7

Section 2 is for what

Answer 7

Assessment and treatment

Question 8

Section 2 lasts how long

Answer 8

up to 28 days

Question 9

Section 2 can be appealed when?

Answer 9

first 14 days

Question 10

Sect 3 is for what

Answer 10

treatment

Question 11

Sect 3 lasts how long

Answer 11

up to 6m

Question 12

Sect 3 can be appealed when?

Answer 12

twice in first 6m then yearly

Question 13

what can be treated under the MHA?

Answer 13

Mental disorder

Causes of mental disorder

Consequences of mental disorder

Question 14

What is section 5(2) for?

Answer 14

Doctor’s holding power- in patients only, to assess under MHA in the next 72hrs

Question 15

Can 5(2) be used in A&E?

Answer 15

No

Question 16

Can FY1s use 5(2)?

Answer 16

No

Question 17

Can you treat a patient under 5(2)?

Answer 17

No

Question 18

Can you use 5(2) in the community?

Answer 18

No in patients only

Question 19

what are the two police powers?

Answer 19

Sect 135 and 136

Question 20

A section 135 does what?

Answer 20

Warrant to search for and remove a patient to a place of safety for MH assessment

Question 21

Who grants a sect 135?

Answer 21

Magistrate

Question 22

What is sect 136 for?

Answer 22

Mentally disordered person not in a private dwelling

Police can take them to a place of safety for assessment if they need immediate care.

Police must have discussed with a MH professional first.

Question 23

How long do sects 135 and 136 last?

Answer 23

24h (or 36 exceptionally)

Question 24

Can a section 136 be used to keep someone in A&E?

Answer 24

Yes

Question 25

Five principles of MCA

Answer 25

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 is no other less restrictive way to achieve the outcome

Question 26

Two stages of MCA assessment

Answer 26

1. diagnostic test

2. functional test

Question 27

What is involved in the diagnostic test in a MCA assessment?

Answer 27

At the time of the decision does the person have an impairment of, or disturbance in functioning of, the mind or brain?

Question 28

What is involve din the functional test in a MCA assessment?

Answer 28

1. understand
2. retain
3. weigh up
4. communicate

Question 29

What should be considered in ‘best interests’?

Answer 29

Consider:
The person’s past and present wishes and feelings

Beliefs and values

Views of anyone named by the person

Anyone engaged in caring for the person or interested in
their welfare

Any donee of a lasting power of attorney

Any deputy appointed for the person by the court

IMCA (if appointed)

Question 30

To have legal weight an advanced decision must?

Answer 30

Specify which treatments they are refusing

Question 31

What is an LPA?

Answer 31

Who they want to manage their health and welfare and/or finances and property

Question 32

What can the court of protection do?

Answer 32

Appoint a deputy

Question 33

When must an IMCA be involved?

Answer 33

‘serious medical treatment’ or DoLS

Question 34

What is a DoLS?

Answer 34

Lack capacity

and

need to be ‘deprived of liberty’ (stay in their location) for their best interests

Question 35

Two types of DoLS application

Answer 35

Urgent (for up to 7 days)

Standard (for up to 1y)