Mental Health Legislation

Question 1

What are the two main acts that set out mental health legislation in the UK?

Answer 1

Mental Health Act (1983)

Mental Capacity Act (2005)

Question 2

What are the criteria that must be met for detention under the Mental Health Act?

Answer 2

1. Must be suffering from a mental disorder of a nature or degree warranting admission;

AND

2. Must be a risk to their own health and/or safety and/or the safety of others;

AND

3. Must be unwilling to be admitted voluntarily or lack the capacity to make this decision.

Summary:
Mental disorder + Risk + Unwilling/Unable

Question 3

Who can make the assessment to detain a person under the Mental Health Act?

Answer 3

2 doctors + 1 AMHP

Two doctors make recommendations that the person be detained.

• Each determines if the person meets the criteria in their own opinion.
• One must be Section 12 approved.
• One should have prior knowledge of the patient.

One AMHP (approved mental health professional) makes the application to the receiving hospital.
- Independent and makes the final decision.

Question 4

What can be treated under the Mental Health Act?

Answer 4

1. The cause of the mental disorder.
   (e. g. encephalopathy or other organic illness)
2. The mental disorder.
   (i. e. psychotropic medication, ECT)
3. Direct consequence(s) of the mental disorder.

(Self-neglect/harm, overdose, feeding in eating disorder)

Question 5

Which MHA section governs admission for assessment?

Answer 5

Section 2

Question 6

Which MHA section governs admission for treatment?

Answer 6

Section 3

Question 7

Which MHA section governs holding powers for informal patients?

Answer 7

Section 5

Question 8

Which MHA section governs police powers?

Answer 8

Sections 135 and 136

Question 9

MHA Section 2

Answer 9

Used for assessment

Up to 28 days

2 doctors + 1 AMHP

Can treat

Can appeal

No renewal

At the end of the term, must be revoked or a section 3 detention put in place.

Question 10

MHA Section 3

Answer 10

Used for treatment

Up to 6 months

2 doctors + 1 AMHP

Can treat

Can appeal

Can renew: another 6 months and then yearly

At the end of term must be revoked or renewed

Question 11

MHA Section 5(2)

Answer 11

Used for doctors holding power

Up to 72 hours

Fully registered doctor

No treatment

No appeal

No renewal

At expiry, triggers MHA assessment for ?section 2 or 3.

Question 12

MHA Section 5(4)

Answer 12

Used for nurses holding power

Up to 6 hours

Mental health nurse

No treatment

No appeal

No renewal

Triggers a section 5(2) assessment

Question 13

MHA Section 136

Answer 13

Used for police holding power

Up to 24 hours

Police

No treatment

No appeal

No renewal (can be extended upto 12 hours)

Triggers MHA assessment

Question 14

True or false: A section 136 allows police to detain and move anyone appearing to suffer from a mental disorder to a place of safety.

Answer 14

Sort of true.

Only applies in public places.

If the person is in a private dwelling, must obtain a Section 135 magistrate warrant.

Question 15

Which form is completed when detaining a patient under Section 5(2) of the MHA?

Answer 15

Form H1

Question 16

Which of the following is not true of the Mental Capacity Act?

A) Never assume a person has capacity
B) All practicable steps must be taken to enable decision making
C) People are able to make unwise decisions
D) Decisions made on behalf of someone lacking capacity must be in their best interests
E) Decision made on behalf of someone lacking capacity must be the least restrictive option

Answer 16

A) Never assume a person has capacity

Under the MCA a person is assumed to have capacity

Question 17

How is capacity assessed under the Mental Capacity Act?

Answer 17

Step 1. Diagnostic test:
- Does the person have an impairment or disturbance of the mind or brain?

Step 2: Functional test:

• Can they (a) understand, (b) retain, (c) weigh up the information relevant to the decision?
• Can they communicate their decision?

Question 18

For each of these of these statements, decide if they are true or false with regards to an Advanced Directive:

A) Must be witnessed
B) Must have capacity at the time it is written
C) Allows refusal of specific treatments

Answer 18

All true!

An Advanced Directive:

A) Must be witnessed
B) Must have capacity at the time it is written
C) Allows refusal of specific treatments

Question 19

What might an advanced statement contain?

Answer 19

Details of the person’s wishes, feelings, beliefs and values.

Question 20

How do you test whether someone has been deprived of their liberty?

Answer 20

1. Are they under continuous supervision and control?

2. Are they not free to leave?

Question 21

True or false: Deprivation of Liberty Safeguards can be applied to anyone lacking capacity.

Answer 21

False.

Must meet other criteria, including:

• 18 years or older
• Mental Health Act wouldn’t be more suitable
• Is in a care home or hospital

Question 22

True or false: An emergency DoLS lasts for 7 days and a standard DoLS lasts for 1 year.

Answer 22

True.

An emergency DoLS lasts for 7 days and a standard DoLS lasts for 1 year.

Question 23

True or false: DoLS confers the right for doctors to treat in the patient’s best interests.

Answer 23

False.

DoLS give no right to treatment. If treatment is required then we must assess capacity and if they lack capacity provide treatment in their best interests