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Year 4 - Psych > MHA, MCA, and Risk > Flashcards

MHA, MCA, and Risk Flashcards

1
Q

MCA and MHA
- Years

A

MCA and MHA
- Years

  • MCA 2005
  • MHA 1983 (2007)
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2
Q

Medicine

  1. Can 16yo consent for blood test
  2. Can 16yo consent for operation
  3. What can child not do?
  4. Needle phobic caesarian?
A

Medicine

  1. Can 16yo consent for blood test
    - Yes
  2. Can 16yo consent for operation
    - Yes
  3. What can child not do?
    - Refuse life saving treatment
  4. Needle phobia
    - Ask high court judge to restrain on MCA
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3
Q

Capacity
- Three conditions for validity

A

Capacity
- Three conditions

  1. Informed
  2. Competent
  3. Voluntary
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4
Q

Advanced decisions
- ADRTs

  1. Age
  2. Capacity
A

Advanced decisions
- ADRTs

  1. Age
    - 18+
  2. Capacity
    - Must have capacity when making
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5
Q

MHA
- 4 Principles of use

A

MHA
- 4 Principles

  1. Minimise illness effects
  2. Least restrictive
  3. Patient and NoK participation
  4. Equity, effectiveness, efficiency
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6
Q

MHA
- Criteria for use

A

MHA
- Criteria

  1. Mental disorder as defined by law
  2. Disorder of certain nature or degree
  3. Significant risk to person’s health, safety, or safety of others
  4. No alternative to hospital admission as a safeguard
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7
Q

MHA
- Section 5(4)

A

MHA
- Section 5(4)

  1. RMNs detain inpatient
    - up to 6 hours
    - not ED
  2. Pink paper form
  3. Submitted to hospital managers
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8
Q

MHA
- Section 5(2)

  1. Persons
  2. Length
  3. Appeal process
A

MHA
- Section 5(2)

  1. RMO (consultant) or nominated deputy
    - 72 hours
    - Not ED
  2. No appeal
  3. Legal form for managers
  4. To allow MHA assessment
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9
Q

MHA
- Section 2

  1. Length
  2. Persons
  3. Appeal
A

MHA
- Section 2

  1. For assessment (and treatment)
    - 28 days
  2. 2 doctors
    - 1 is Section 12(2) approved
  3. 1 AMHP
    - Not just a SW
  4. Community or inpatient
    - not prison
  5. Appeal within first 14 days
    - Heard within 7 days
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10
Q

MHA
- Oral medication

A

MHA
- Oral medication

  1. Cannot be force fed
  2. IM alternatives can be used
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11
Q

MHA
- Section 3

A

MHA
- Section 3

  1. Treatment
    - 6 months
  2. 2 doctors
    - 1 approved 12(2)
  3. 1 AMHP
  4. Community or inpatient
    - not prison
  5. 1 Appeal
    - Hospital managers panel
    - Tribunal
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12
Q

MHA
- Section 136

A

MHA
- Section 136

  1. Assessment
    - 72 hours
  2. Place of Safety
    - From public
    - includes police cell
    - includes ED
    - not from own home
  3. Police stay with person
  4. Can do MHA assessment
    - section 2/3
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13
Q

MHA
- Section 135

A

MHA
- Section 135

  1. Assessment
    - 36 hours
  2. Magistrates warrant
  3. Taken from home
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14
Q

MHA
- Section 17

A

MHA
- Section 17

  1. Leave arrangements
    - S2, S3
  2. Several hours, overnights, longer
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15
Q

MHA
- Section 117

A

MHA
- Section 117

  1. S3 entitles patient to aftercare
  2. Local authority
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16
Q

MHA S3
- CTO

A

MHA S3
- CTO

  1. Well enough to leave
    - Treatment is necessary
    - Conditions in place
  2. Can be recalled
    - Conditions broken
    - Unwell
  3. Can still appeal
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17
Q

Risks to self

A

Risks to self

  1. Suicide
  2. Para-suicide
    - Survival of suicide
  3. DSH
18
Q

Suicide
- Prevalence

A

Suicide
- Prevalence

  1. 3M:1F
  2. Top 10 cause of death
  3. Young people
    - Suicide 2nd most common cause of death
  4. Highest
    - Men 40-44
    - Women 50-54
19
Q

Suicide
- MH Contact

  1. MH services
  2. GP within 1 year
  3. GP within 1 month
  4. MH services within 1 month
A

Suicide
- MH Contact

  1. MH services
    - 33%
  2. GP within 1 year
    - 75%
  3. MH services within 1 month
    - 20%
  4. GP within 1 month
    - 45%
20
Q

Suicide
- Highest time of risk

A

Suicide
- Highest time of risk

  1. Inpatient stay
    - forensic history
    - previous suicide
    - violence to property
    - bereavement
    - delusions
  2. 14 days post-discharge
    - Unplanned, unemployment, suicidality prior to admission
21
Q

Bipolar and schizophrenia
- Suicide risk

A

Bipolar and schizophrenia
- Suicide risk

  1. Bipolar
    - 1/3 will attempt
    - 1/20 will die
  2. Schizophrenia
    - 1/20 will die
22
Q

Chronic physical illness
- Suicide risk

A

Chronic physical illness
- Suicide risk

  1. Neurological, GI, CVS, Cancer
  2. Chronic pain
  3. Disfigurement
  4. Limited life
    - job, family, finance
23
Q

Deliberate self harm

  1. Definition
  2. Main types
A

Deliberate self harm

  1. Definition
    - intended
    - results in harm
  2. Main types
    - self-poisoning
    - self-injury
24
Q

DSH
- Risk of suicide within 1 year

A

DSH
- Risk of suicide within 1 year

M: 1.1%
F: 0.5%

25
Q

DSH
- Substance use at time

A

DSH
- Substance use at time

M 40-75%
F 12-50%

26
Q

MH
- Risk Assessment

A

MH
- Risk Assessment

  1. Psych exam
  2. Hx
    - RFs
    - Modifiable RFs
    - Protective factors
    - Suicide screening
  3. Risk level
    - Low, medium, high
27
Q

MH
- DSH/Para-suicide Hx

A

MH
- DSH/Para-suicide Hx

  1. Triggers
  2. Preparation
  3. Circumstances
  4. After the act
  5. MSE
  6. Psych history
  7. Collateral history
28
Q

DSH/Para-suicide
- Mx

A

DSH/Para-suicide
- Mx

  1. Discharge
    - GP tomorrow
  2. Crisis team
  3. Admit
    - Informal
    - Section
29
Q

Homicide
- Male
- Known to killers
- Age

A

Homicide

  • Male
    69%
  • Known to killers
    M 50%
    F 75%
  • Age
    Under 1yo
30
Q

Homicide
- Psychotic risks

A

Homicide
- Psychotic risks

  1. Specific persecutory
    - delusions
    - hallucinations
  2. Auditory commands
    - hallucinations
31
Q

MH Risk Assessment

  • Community considerations
A

MH Risk Assessment
- Community considerations

  1. Previous violence
    - Psych influence
    - Circumstances
  2. Modified by treatment?
  3. MDT views
  4. Potential victims
32
Q

MH Risk Assessment
- Child protection

A

MH Risk Assessment
- Child protection

  1. Types of abuse
  2. CAMHS
  3. Adult patient
    - Children, grandchildren
  4. Documentation
    - Name
    - DOB
    - Residence
    - Nature of relationship
33
Q

Child protection
- Disclosure as adult

A

Child protection
- Disclosure as adult

  1. Contact SW
  2. Contact police if current threat
34
Q

Suicide
- RA

A

Suicide
- RA

  1. Final acts
    - Writing note
    - Feeding pets
  2. Ongoing thoughts
  3. Previous behaviour
    - Biggest predictor
  4. Avoid asking why early on
35
Q

MH disorders
- Occult risks

A

MH disorders
- Occult risks

  1. LT health
    - smoking
    - diet
    - alcohol
  2. Disinhibition
    - debt
    - pregnancy
    - STI
36
Q

Mental capacity when under MHA
- Mental disorders
- Medical conditions

A

Mental capacity when under MHA

  • Mental disorders
    MHA
  • Medical conditions
    MCA
37
Q

MCA
- Threshold of probability

A

MCA
- Threshold of probability

  1. More likely than not
38
Q

MH impact on MCA

A

MH impact on MCA

  1. Understand and retain
    - Beliefs and delusion
    - Retention and dementia
  2. Weigh up
    - Pessimism
    - Delusion
  3. Communicate
    - Psychotic
    - Inability to communicate
    - Unwilling to communicate
39
Q

MHA
- Three criteria

A

MHA
- Three criteria

  1. Evidence of mental health disorder
  2. Risk to self or others
    - Nature or degree of illness
  3. Treatment is intended
40
Q

MHA
- Forensic Sections

A

MHA
- Forensic Sections

  1. Diagnosed in prison
  2. Questions before trial
  3. Questions after trial
41
Q

MHA
- Tribunal Types

A

MHA
- Tribunal Types

  1. Hospital managers
  2. Mental Health Tribunal
    - CQC governed

Year 4 - Psych (11 decks)

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