MHA_Assessment_Flashcards

Question 1

What is the Mental Health Act (MHA) and when is it used?

Answer 1

The Mental Health Act (MHA) 1983, amended by the Mental Health Act 2007 and further in 2012, is used when a person has no capacity and only regarding mental health conditions. It provides powers to admit people living in the community to hospital by force, for all ages.

Question 2

What is the principle of sectioning under the MHA?

Answer 2

Sectioning is always a last resort and should aim for informal admission where possible. Sectioning occurs if the patient does not agree to admission and poses an immediate risk to themselves or others.

Question 3

What is Section 2 of the MHA and what does it involve?

Answer 3

Section 2 involves admission for assessment and treatment if appropriate. It is usually used for the first admission, lasts for 28 days, and cannot be renewed. It requires approval by an AMHP or nearest relative and two doctors, one of whom is Section 12 approved.

Question 4

What is Section 3 of the MHA and what does it involve?

Answer 4

Section 3 involves admission for treatment with a diagnosis stated, lasts for 6 months, and can be renewed. It requires approval by an AMHP or nearest relative and two doctors, one of whom is Section 12 approved. Patients can be forcibly medicated and must consent to treatment after 3 months.

Question 5

What is Section 4 of the MHA and what does it involve?

Answer 5

Section 4 involves admission for emergency treatment for 72 hours and is preferred over Section 2 if admission is more immediate. It requires one doctor and can be converted into Section 2.

Question 6

What is Section 5(2) of the MHA and what does it involve?

Answer 6

Section 5(2) involves the detention of an inpatient for 72 hours and can be done by one doctor in charge of the case.

Question 7

What is Section 5(4) of the MHA and what does it involve?

Answer 7

Section 5(4) involves the detention of an inpatient enforced by a nurse for 6 hours until a doctor or clinician with authority arrives.

Question 8

What is Section 17 of the MHA and what does it involve?

Answer 8

Section 17 allows leave for a specified period from a current section with certain conditions.

Question 9

What is Section 35 of the MHA and what does it involve?

Answer 9

Section 35 involves the Magistrates Court remanding a patient accused of committing a crime to a hospital for 28 days, extendable up to 12 weeks.

Question 10

What is Section 37 of the MHA and what does it involve?

Answer 10

Section 37 involves admission for medical treatment for 6 months for a patient who has committed a crime, extendable for another 6 months, and then 1 year at a time thereafter.

Question 11

What is Section 41 of the MHA and what does it involve?

Answer 11

Section 41 is a restriction order made by the Crown Court, affecting leave of absence, discharge, and transfer between hospitals. No appeal is allowed within the first 6 months.

Question 12

What is Section 47 of the MHA and what does it involve?

Answer 12

Section 47 is used to transfer a serving prisoner to hospital and can add a Section 49 which adds the restrictions of Section 41.

Question 13

What is Section 48 of the MHA and what does it involve?

Answer 13

Section 48 is used for the transfer of an unsentenced prisoner to hospital for detention.

Question 14

What is Section 135 of the MHA and what does it involve?

Answer 14

Section 135 involves a magistrate issuing a warrant for a police officer (with a doctor and AMHP) to enter any premises to take the patient to a place of safety for 24 hours, extendable to 36 hours.

Question 15

What is Section 136 of the MHA and what does it involve?

Answer 15

Section 136 allows police to take a patient from a public place to a place of safety for examination by a doctor and interview by an AMHP for 24 hours, extendable to 36 hours.

Question 16

What are Sections 26 and 29 of the MHA and what do they involve?

Answer 16

Section 26 defines who the patient’s nearest relative is, and Section 29 covers the patient’s rights to change the nearest relative.

Question 17

How can a patient appeal against the MHA?

Answer 17

A patient can appeal against the MHA through a Tribunal, which decides the lawfulness of continued detention or Community Treatment Order (CTO) and determines whether the statutory criteria are met.

Question 18

What is a Community Treatment Order (CTO) under the MHA?

Answer 18

A Community Treatment Order (CTO) allows a patient discharged from a previous section to live in the community under certain conditions. If conditions are broken, the patient can be taken back to hospital for up to 72 hours for assessment.

Question 19

Who is an Approved Mental Health Professional (AMHP) under the MHA?

Answer 19

An Approved Mental Health Professional (AMHP) is a mental health professional approved by a local social services authority to carry out duties under the MHA, usually a social worker with the appropriate qualifications.

Question 20

What is an Independent Mental Health Advocate (IMHA) under the MHA?

Answer 20

An Independent Mental Health Advocate (IMHA) is trained to help patients understand their rights under the MHA and provide support while detained. Patients have a right to an IMHA under specific sections of the MHA.

Question 21

What is guardianship under the MHA?

Answer 21

Guardianship involves appointing a guardian to help a patient live as independently as possible in the community instead of being kept in hospital.

Question 22

What are Deprivation of Liberty Safeguards (DoLS) under the MHA?

Answer 22

Deprivation of Liberty Safeguards (DoLS) are used if a person is deprived of their liberty within a care home or hospital, needed if restraint and restrictions used to safeguard a person under the MCA will deprive them of their liberty.

Question 23

What is the European Convention on Human Rights (ECtHR) in relation to the MHA?

Answer 23

The European Convention on Human Rights (ECtHR) gives everyone rights to liberty under Article 5 of the Human Rights Act (HRA) 1998. The MHA limits these rights for the assessment and treatment of mental disorders, and these limitations can be challenged by an MHA tribunal.

Question 24

What is a Section 12 approved Clinician under the MHA?

Answer 24

A Section 12 approved Clinician has post-MRCPsych membership and specific MHA training.

Question 25

Who is the Responsible Clinician under the MHA?

Answer 25

The Responsible Clinician is the consultant in charge of the patient’s care, and an Approved Clinician (AC) usually covers on-call duties before becoming the Responsible Clinician.

Question 26

What is the Mental Capacity Act (MCA) 2005 and what does it cover?

Answer 26

The Mental Capacity Act (MCA) 2005 provides a framework for decision-making on behalf of people who lack capacity, identifying how best interests are determined and applies to people aged 16 and over.

Question 27

What is the 4-step process for assessing capacity under the MCA?

Answer 27

The 4-step process for assessing capacity under the MCA includes understanding the risks, benefits, and alternatives related to the decision, retaining that information long enough to make the decision, weighing up that information, and communicating the decision through any means.

Question 28

What are the key principles of the MCA?

Answer 28

The key principles of the MCA include being time and decision-specific, presumption of capacity, clearly defined test of capacity, respecting decisions if the person has capacity, taking reasonable steps to help a person make their decision, and ensuring the least restrictive intervention in the person’s best interests.