Mental health legislation Flashcards
Why do you trigger involuntary treatment for mental illness?
Treatment of small group of patients who are severely unwell, psychotic, and a risk to themself or others
What are criticisms of involuntary treatment of mental health disorders?
Seen as ill-liberal
May be poorly compatible with international human rights norms
Unnecessary for most patients
Counterproductive for some patients
Practical problems in administering treatments
What mental health act is used in scotland?
Mental Health (Care & Treatment) (Scotland) Act 2003
What are purposes of mental health law?
Power to provide compulsory care and treatment for people with a mental disorder
Rights and safeguards to make sure those powers are used appropriately
What are the Millan principles of the mental health act?
Non-discrimination Equality Respect for diversity Reciprocity Informal care Participation Respect for carers Least restrictive alternative Benefit Child welfare
How is mental disorder defined under the mental health act?
Any mental illness
Personality disorder
Learning disability
By any cause or manifestation
Who can determine when someone can be given involuntary treatment under the mental health act?
Approved medical practitioner
Mental health officer
The court
Who can be detained under the mental health act?
> 18yrs
<18 - can be detained but required child/adolescent specialist
What is an emergency detention certificate?
Authorises detention for up to 72 hours
What is a short term detention certificate?
Authorises detention for up to 28 days
What is a compulsory treatment order?
Authorises detention for up to six months
What is nurses holding power?
Authorises detention for up to 2 hours
When is emergency detention certificate used?
Patient has a likely mental disorder and that there is significant risk of harm to self or others
Granting short term detention certificate has an undesirable delay
What is general criteria for detention?
Mental disorder
Significant impairment of decision making for medical treatment about mental disorder
Significant risk to health, safety, or welfare of person or of other persons
Treatment available
Order necessary
What is SIDMA?
Significant Impairment of Decision Making Ability
What is involved in SIDMA?
Lack of insight Cognitive impairment Presence of psychosis Severe depressive symptoms Learning disability
What involuntary treatment can be given under the mental health act?
Only treatment for the disorder - not any other disorders
How is an adult with incapacity defined?
Incapable of: Acting Making decisions Communicating decisions Understanding decisions Retaining memory of decisions
What are principles when applying the adults with incapacity act to provide treatment?
Intervention must benefit adult
Intervention will be least restrictive to freedom of adult
Account must be taken of past and present wishes
Account should be taken of views of relatives, carers, and guardians
Can you have capacity for some decisions but not others?
Yes - decision specific
What information can we gather to determine whether somebody has capacity?
Info from history and evidence before the court
Consult notes
Has decision about certain aspects of capacity already been made?
Ask carers/family
Any previous assessments
Any previous power of attorney
Any previously stated views
What is the CUR criteria for assessment of capacity?
Communication
Understanding
Retention of information
Decision
What is done assess communication?
Assess if the person can communicate
Can communication deficit be overcome - sign language, written communication, makaton, hearing aid, etc
How is understanding assessed for capacity?
Do they have adequate info
Can they interpret pros and cons
Ability to weigh evidence
Can lack of understanding be overcome with more info
What questions can you ask to assess retention in capacity?
What did I want you to do?
What did I tell you?
Can you explain it to me?
How is making decisions assessed for capacity?
Is it clear what the decision is
Is it consistent
What 3 areas are covered for adults with incapacity?
Property
Welfare (medical)
Financial
What is not authorised under adults with incapacity (Scotland) act 2000?
Use of force or detention unless it is immediately necessary and only for so long as is necessary in circumstances
Action which would be inconsistent with any decision by a competent court
Placing an adult in a hospital for the treatment of mental disorder against his will
How do you decide which act to use between AWIA and MHA?
Aetiology - psychiatric, physical, or both
What is encompassed in AWIA?
Welfare
Financial and property
Physical illness
What is encompassed in MHA?
Psychiatric - can encompass secondary physical issues
How is an adult at risk defined in the Adult Support and Protection (Scotland) Act 2007?
Unable to safeguard own well-being, property, rights, or other interests
At risk of harm
Because they are affected by a condition, they are more vulnerable to harm than adults who are not so affected
How is risk of harm defined under the ASP(S)A 2007?
Another person’s conduct is causing (or is likely to cause) the adult to be harmed
The adult is engaging (or is likely to engage) in conduct which causes (or is likely to cause) self harm
How is harm defined under the ASP(S)A 2007?
Conduct which causes physical harm
Conduct which causes psychological harm such as fear, alarm, or distress
Unlawful conduct which appropriates or adversely affects property, rights, or interests ie theft, fraud
Conduct which causes self-harm
What should be done if you suspect an adult is at risk?
Discuss with a senior
Document concerns
Report to the relevant local authority
