Mental health legislations

Question 1

What are the four parts of the mental health act?

Answer 1

1) The application and extent of the act plus a definition of mental disorder
2) Compulsory admission to hospital and guardianship
3) Patients concerned with criminal proceedings
4) Consent to treatment

Question 2

What things alone, which may seem like they could fall under the mental health act (MHA) but do not?

Answer 2

1) drugs and alcohol

2) learning disability

Question 3

What are the four types of mental disorder described in part 1 of the MHA?

Answer 3

1) Mental illness (not defined by the MHA but left as a matter of clinical judgement. It should be of a degree as to warrant detention in the interests of health, safety or protection of others)
2) Mental impairment (a state of arrested or incomplete development of the mind which includes significant impairment of intelligence and social functioning and is associated with abnormally aggressive or seriously irresponsible conduct)
3) Severe mental impairment (as for above but with severe impairment of social functioning and intelligence)
4) Psychopathic disorder (a persistent disorder or disability of mind (may or may not include a significant impairment of intelligence) which results in abnormally aggressive or seriously irresponsible conduct)

Question 4

What are sequence of events by which Part 2 of the MHA usually follows when executing a section 2 or 3?

Answer 4

1) An approved social worker (ASW) or nearest relative will make an application for assessment after having seen the patient within the last 14 days
2) The application must then be supported by two doctors, one of whom should be section 12 approved. It is recommended that one doctor knows the pt.

Question 5

Under what section are patients allowed temporary leave from hospital?

Answer 5

Section 17

Question 6

What % of inpatients on a psych ward are NOT on a section?

Answer 6

90%

Question 7

Describe a Section 2

Answer 7

28 days - for assessment and may be converted to a section 3.

Application is by an approved social worker or nearest relative and must be approved by two doctors, one who is section 12 approved.

Question 8

Describe a Section 3

Answer 8

6 months - for treatment,

usually when the diagnosis and treatment response is established.

This can be extended later.

An ASW or nearest relative must apply and two doctors should approve it (one with section 12 approval).

Question 9

Describe a Section 4

Answer 9

72 hours – emergency admission to hospital for assessment when there is not time to wait for a section 2.

Applicants are an ASW or nearest relative and only one doctor is needed to approve it.

Question 10

Describe a Section 5(2)

Answer 10

72 hours – detention of a hospital in-patient who is receiving any form of treatment in order to give time to convert to a section 2/3.

The doctor responsible for their care usually does this.

It is not valid in A+E

Question 11

Describe a Section 5(4)

Answer 11

6 hours – urgent detention of an in-patient receiving treatment for a mental disorder when a doctor is unable to attend.

A registered nurse trained in mental health may do this.

It is not valid in A+E

Question 12

What is part 3 of the MHA related to?

Answer 12

Mentally ill patients involved in criminal proceedings or under sentence.

The sections relating to this are 35, 36, 37 and 41.

Question 13

Patients on a section 3 may be treated without their consent for how long? (what happens after this amount of time)

Answer 13

3 months, after 3 months and in other special cases, an extra section is required to continue treatment

Question 14

Describe a Section 135

Answer 14

72 hours - An approved social worker (ASW) can apply to a magistrate for a warrant to allow police to enter and remove someone with a mental disorder from their home and transfer them to a place of safety.

Question 15

Describe a Section 136

Answer 15

72 hours - Police who find a person in a public place appearing to suffer from a mental disorder may remove him/her to a place of safety.

Question 16

What is common law?

Answer 16

Law that is based on court decisions (case law) or customs

Question 17

What is statute law?

Answer 17

Laws made in parliament

Question 18

What type of law is the MHA?

Answer 18

Statute law

Question 19

What type of law is used when instituting lifesaving treatment on an unconscious patient?

Answer 19

Common law

Question 20

What are the two main pieces of mental health legislation?

Answer 20

1) 1983 Mental health act

2) 2005 Mental capacity act

Question 21

What is capacity based on?

Answer 21

Whether a person is able to:

1) Understand the information relevant to the decision
2) Retain the information
3) Use or weight the information as part of the process of making a decision
4) To communicate their decision (any means)

If any one of these is lacking then it can be said that a patient is lacking capacity.

It should be noted that a patient only has to retain the information long enough to make a decision and can forget it after the decision has been made.

Question 22

A patients best interests (part of the mental capcity act (MCA)) includes what guidance?

Answer 22

1) The persons past and present wishes (also any relevant written statements from when they had capacity)
2) Their beliefs and values that would influence the situation if they had capacity
3) The wishes of any family and friends or those appointed with power of attorney.
4) Whether the patient will regain capacity in the future

Question 23

What piece of legislation covers whether a person is competent to make a will?

Answer 23

Testamentary capacity

Question 24

How does the mental health act define mental illness?

Answer 24

It is not defined by the MHA but left as

a matter of clinical judgement

It should be bad enough as to warrant detention in the interests of

health,

safety or

protection of others

Question 25

How does the mental health act define mental impairment?

Answer 25

a state of incomplete development of the mind which includes significant impairment

of intelligence and social functioning

and is associated with abnormally aggressive or

seriously irresponsible conduct

Question 26

How does the mental health act define severe mental impairment?

Answer 26

mental impairment

with severe impairment of social functioning and intelligence

Question 27

How does the mental health act define psychopathic disorder?

Answer 27

a persistent disorder or disability of mind

(may or may not include a significant impairment of intelligence)

which results in abnormally aggressive or

seriously irresponsible conduct

Question 28

Who can discharge a patient from a section 2 or 3?

Answer 28

The responsible medical officer

hospital manager

mental health tribunal or

nearest relative (the last one may be blocked by psychiatrist and 72 hours notice is needed)

Question 29

What are the four categories that must be met to have testamentary capacity?

Answer 29

1) The testator understands that he is giving his property, after his death
2) He understands the nature of, and is able to recollect the extent of, his property
3) He is aware of who might have a reasonable claim to his estate
4) He is able to weigh up each relatives claims and make rational judgements about allocation.

Question 30

Can a person with dementia or psychosis have testamentary capacity?

Answer 30

Yes they can provided they meet the criteria