Mental Health Legislation Flashcards
Why may some treatment for mentally ill people be involuntary?
Severely unwell
Lost touch with reality
Risk to self or others
What are some general criticisms of involuntary treatment?
Ill-liberal
Poorly compatible with human rights norms
Unnecessary for most patients
Counterproductive for some patients
Practical problems in administering treatments
What are some ethical problems with involuntary treatment?
Non-maleficence
Autonomy
Paternalism
Non-discrimination
What legislation governs mental health in Scotland?
Mental Health (Care & Treatment) (Scotland) Act 2003, modified in 2015 "MHA" Public Health (Scotland) Act 2008
What is the purpose of mental health law?
Power to provide compulsory care
Rights and safeguards to make sure those powers are used appropriately
What are the principles of the MHA?
Non-discrimination Equality Respect for diversity Reciprocity Informal care Participation Respect for carers Least restrictive alternative Benefit Child welfare
How does the MHA define mental disorder?
Any mental illness, personality disorder or learning disability however caused or manifested
What are the 3 main pieces of legislation for mental disorders?
Adults with Incapacity Act (Scotland) 2000
MHA
Adult Support & Protection (Scotland) Act 2007
What powers does the MHA give?
Civil compulsory powers
To detain
To assess
To treat
What are MHA powers determined by?
An approved medical practitioner
Mental Health Officer (MHO)
The court
Can patients under the age of 18 years still be detained?
Yes
Need child/adolescent specialist
What are some civil compulsory powers?
Emergency detention certificate (EDC)
Short-term detention certificate (STDC)
Compulsory treatment order (CTO)
Nurses holding power
How long does an EDC allow detention for?
Up to 72 hours
How long does an STDC allow detention for?
Up to 28 days
How long does a CTO allow detention for?
Up to 6 months
How long does a Nurses holding power allow detention for?
Up to 2 hours
What are some criteria for detention?
Mental disorder
Ability to make decisions impaired
Can detain in hospital to determine appropriate treatment
Significant risk to health, safety or welfare of patient or other
Treatment available
Order necessary
What is SIDMA?
Significant Impairment of Decision Making Ability
What may cause SIDMA?
Lack of insight Cognitive impairment Presence of psychosis Severe depression Learning disability
What powers do police have under the MHA?
Removal from a public place
Appears to be in immediate need of care
Detain for up to 24 hours
Designed to allow assessment and make arrangement for care and treatment
What is an adult with incapacity according to the adults with incapacity act?
Aged 16 years or older
Incapable of making, communicating, understanding or retaining memory of their decisions
What are the principles which must be considered when applying the adults with incapacity act?
Intervention must benefit the adult
Least restrictive intervention to adult’s freedom
Past and present wishes of the adult must be recorded
I capacity assumed to be present until proven otherwise?
Yes
What are the criteria for capacity?
Communication
Understanding
Retention of Information
Decision
What are the 3 areas of capacity?
Property
Welfare (medical)
Financial
How is a guardianship order be instated?
Two doctors approve MHO application Needs to specify powers Can be financial or welfare or both Registered with the office of the public guardian
What is adult protection?
Law, policies & procedures that dictate and influence responses in situations where it is suspected, or known, that certain adults are experiencing harm or abuse
What is an “adult at risk” according to the Adult Support and Protection (Scotland) Act 2007?
Unable to safeguard own well-being, property, rights or other interests
At risk of harm
More vulnerable to being harmed as a result of disability, mental disorder, illness or physical/mental infirmity
How does the Adult Support and Protection Act define “harm”?
Physical harm
Psychological harm
Unlawful conduct which appropriates or adversely affects property, rights or interests
Self harm
What do you do if you suspect an adult is at risk?
Discuss with a senior
Document concerns
Report to the relevant local authority
