MHA and Law

Question 1

what is consent and what comprises valid consent

Answer 1

permission for something to happen

given freely, legally capable, covers intervention, informed and enduring

Question 2

what is capacity and what is required to have capacity

Answer 2

abiity to make a decision

understand and retain information, use of info to make decision and ability to communicate decision

Question 3

true/false- capacity should be assumed until proven otherwise

Answer 3

true

Question 4

important factors to consider for use of the Adults with incapacity (Scotland) Act 2000

Answer 4

intervention must benefit adult 
such cannot be achieved without intervention 
account of past and present wishes 
consult with relevant others 
encourage to use residual capacity

Question 5

what is guardianship under Adults with incapacity (Scotland) Act 2000 and what can they do

Answer 5

welfare/financial
makes specific decision over long term but cannot place adult in hospital for tx of a mental disorder against their will
if there is not compliance, sherriff can issue compliance order

Question 6

what is power of attorney in Adults with incapacity (Scotland) Act 2000

Answer 6

granted whilst patient has capacity to have power to act as continuing financial or welfare attorney
in case capacity is lost

Question 7

what is a section 47 under Adults with incapacity (Scotland) Act 2000

Answer 7

practitioner can provide reasonable intervention related to tx
doesn’t authorise force unless immediately necessary
doesn’t specifically allow transport for tx

Question 8

outline consent and capacity in children

Answer 8

> 16 presumed to have capacity to consent

<16 can be involved as much as possible and ability to make decisions

Question 9

What does the Children (scotland) act outline

Answer 9

if person lacks capacity then ask parent for consent

if parents have disagreement seek legal advice

Question 10

when to consider MHA instead of children (scotland) act

Answer 10

more safeguarding
no lower age limit
need use of force, IM injection, NG feed or ECT or detrimental impact on parent with carer

Question 11

criteria to detain under MHA

Answer 11

probable/likely mental disorder 
SIDM 
determine tx or to give emergency tx 
informal/voluntary care inappropriate 
significant risk to pt or others

Question 12

true/false - alcohol or drug dependence warrants detention under MHA as a probable mental disorder

Answer 12

false

Question 13

what is section 5(2), how long can patients be detained, who can it be done by, what tx is authorised

Answer 13

emergency detention for 72 hours assessment
doesnt authorise tx unless life saving or prevents serious deterioration
needs to be FY2 or above
no right of appeal

Question 14

what is section 2, how long can patients be detained, who can it be done by, what tx is authorised

Answer 14

short term detention 
<28 days assessment and tx 
approved medical practitioner and an MHO
right of appeal 
can be extended to put application for CTO but only if mental state deteriorated

Question 15

what is section 3, how long can patients be detained, who can it be done by, what tx is authorised

Answer 15

Compulsory tx order
up to 6m, can be extended by 6m then yearly
approved medical practitioner and MHO
mental disorder must be present and needs reports from 2 independent doctors

Question 16

what tx cannot be given under MHA unless there is special authority to do so

Answer 16

ECT
Artificial nutrition 
vagus nerve stimulation 
transcranial magnetic stimulation 
medication to reduce libido 
neurosurgery

Question 17

what is section 5(4), how long can patients be detained, who can it be done by, what tx is authorised

Answer 17

nurses holding power for mental health nurse to hold pt for up to hrs
only if pt is in hospital and receiving tx

Question 18

what is an advance statement

Answer 18

written statement signed when well
how would like tx in future
must be regarded, but can be overruled