MHA + MCA

Question 1

What is the Mental Capacity act 2005?

Answer 1

Used when a patient lacks capacity
Allows doctors to make decisions regarding a patients best interests

Question 2

Principals of the MCA?

Answer 2

• Capacity is presumed unless proven otherwise
• Capacity is decision specific
• Patients have the right to make unwise decisions
• If a patient lacks capacity, decisions should be taken in their best interest

Question 3

How do you assess if someone has capacity?

Answer 3

They must be able to understand,weigh up, retain and communicate a decision

Question 4

What is an advanced decision?

Related to OPIC too!

Answer 4

• Only relates to medical treatments
• Only in the negative- so only to REFUSE a treatment
• Patient must be above 18 and have capacity
• E.g. patient can have an advanced decision to refuse antibiotics if they have a life-threatening infection

Question 5

What is Lasting Power of Attonery?

Answer 5

• Enabled a mentally incapacitated person to plan for incapacity
• Can extend to property, welfare, healthcare
• They appoint an LPA

From Gov website:
Lasting power of attorney (LPA) is a legal document that lets you (the ‘donor’) appoint one or more people (known as ‘attorneys’) to help you make decisions or to make decisions on your behalf.
- gives you more control over what happens to you if you have an accident or an illness and cannot make your own decisions (you ‘lack mental capacity’).
- You must be 18 or over and have mental capacity (the ability to make your own decisions) when you make your LPA

Question 6

Principals of the Mental Health Act?

Answer 6

• Patient must have a disoder of the mind
• Must be using the least restrictive means possible
• Patient must be a risk to themselves or others

Question 7

What is the definition of mental disorder in law?

Answer 7

Any disorder or disability of the mind

Question 8

What treatment are you able to give under the MHA?

Answer 8

The MHA only permits the treatment of mental health problems, UNLESS a patient’s physical problem is a result of or a cause of their mental disorder (e.g. refeeding in anorexia).

Question 9

Outline Section 5 (4)

Answer 9

• Power granted to RMNs to detain an inpatient for up to 6 hours for medical assessment where mental illness is suspected
• EMERGENCY DEPT DOES NOT COUNT AS INPATIENT

Question 10

Outline Section 5(2)

Answer 10

RMO or nominated deputy can detain an inpatient for up to 72 hours
ED DOES NOT COUNT AS INPATIENT

Question 11

Outline Section 2

Answer 11

• 2 doctors at least 1 of whom should be a psychiatrist ( section 12 (2) approved) and one Approved Mental Health Practioner (AMHP)
• Patient can be in community or inpatient (anywhere except prison)
• Section for a mx of 28 days for Assessment and treatment of mental disorder
• Appeal within first 14 days

Question 12

Outline Section 3

Answer 12

• 2 doctors at least 1 of whom should be a psychiatrist ( section 12 (2) approved) and one Approved Mental Health Practioner (AMHP)
• Community or inpatient (anywhere except prison)
• Section for maximum of 6 months for treatment of mental disorder
• After the 6 months, the consultant can fill out a form to extend it for another 6 months

Question 13

Outline Section 136

Answer 13

• Police power to remove to a place of safety from a PUBLIC PLACE for an assessment by an AMHP and 1 doctor
• Held up to 72 hours to allow assessment
• Police to stay with the person
• If needed, second doctor attends for a MHA assessment for section 2 or 3

Question 14

What is Section 17?

Answer 14

• While detained in hosp under S2, S3, a patient may leave under S17
• Leave to walk outside, go home, fo several hours or overnight

Question 15

Outline Section 117

Answer 15

Anyone who has been on section 3 is entitled to S117 aftercare from local authority

Question 16

Who do you need to safegaurd?

Answer 16

Often to under 18s, but also to vulnerable older adult and those who lack capacity

Question 17

What are examples of safeguarding concerns?

Answer 17

Direct e.g. reported abuse, domestic violence
Indirect e.g. single mother to young children being hospitilised

Question 18

What do you ask when assessing the need to safeguard someon

Answer 18

Risk assessment
Dependents
Discuss any concerns with safeguarding team

Question 19

Descirbe DoLs?

Answer 19

The Deprivation of Liberty Safeguards (DoLS) is the procedure prescribed in law when it is necessary to deprive of their liberty a resident or patient who lacks capacity to consent to their care and treatment in order to keep them safe from harm.