MHA_flashcards

Question 1

What is the Mental Health Act 1983?

Answer 1

A law amended by the Mental Health Act 2007 and further in 2012, used for individuals with no capacity regarding mental health conditions, providing powers to admit people to hospital by force for all ages.

Question 2

What is the principle of sectioning?

Answer 2

Sectioning is always a last resort and should aim for an informal admission where possible. If they do not agree and pose an immediate risk to themselves or others, sectioning may be applied.

Question 3

What is Section 2 of the MHA?

Answer 3

Section 2 is for admission for assessment (and treatment if deemed appropriate), usually used for first admission, lasts 28 days, and cannot be renewed.

Question 4

Who can apply for Section 2?

Answer 4

An Approved Mental Health Professional (AMHP) or nearest relative (NR) on behalf of two doctors, one of whom should be Section 12 approved and one who knows the patient professionally.

Question 5

What are the discharge routes for Section 2?

Answer 5

One application by the nearest relative to the Mental Health Review Tribunal within the first 14 days of detention or discharge by the responsible clinician at any time.

Question 6

What is Section 3 of the MHA?

Answer 6

Section 3 is for admission for treatment with diagnosis stated, lasts 6 months, and can be renewed for 6 months initially and then for 12 months thereafter.

Question 7

Who can apply for Section 3?

Answer 7

An AMHP or NR on behalf of two doctors, one Section 12 approved and one who knows the patient professionally. The NR should be consulted unless in urgent circumstances.

Question 8

What are the discharge routes for Section 3?

Answer 8

Patient can apply to the Mental Health Review Tribunal, leave can be granted under Section 17, and the NR can apply for discharge to the hospital but it can be barred by the responsible clinician.

Question 9

What is Section 4 of the MHA?

Answer 9

Section 4 is for emergency treatment, lasts 72 hours, preferred over Section 2 for immediate admission, requires only one doctor, and can be converted into a Section 2.

Question 10

Who can apply for Section 4?

Answer 10

Usually an AMHP or rarely a nearest relative on behalf of one doctor who does not need to be Section 12 approved.

Question 11

What is Section 5(2) of the MHA?

Answer 11

Section 5(2) allows the detention of an inpatient for 72 hours by one doctor in charge of the case or a nominee.

Question 12

What is Section 5(4) of the MHA?

Answer 12

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

Question 13

What is Section 17 of the MHA?

Answer 13

Section 17 allows leave for a specified period from a current section with conditions to be met, such as returning at a certain time or staying with a particular person.

Question 14

What is Section 35 of the MHA?

Answer 14

Section 35 applies if the patient is accused of committing a crime, allowing the Magistrates Court to remand them in hospital if one doctor has evidence of a mental health disorder, lasts 28 days, and can be extended.

Question 15

What is Section 37 of the MHA?

Answer 15

Section 37 is for admission for medical treatment in a patient who has committed a crime, lasts 6 months, and can be extended for another 6 months and then 1 year at a time thereafter.

Question 16

What is Section 41 of the MHA?

Answer 16

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

Question 17

What is Section 47 of the MHA?

Answer 17

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 18

What is Section 48 of the MHA?

Answer 18

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

Question 19

What is Section 135 of the MHA?

Answer 19

Section 135 allows a magistrate to issue 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 (can be extended to 36).

Question 20

What is Section 136 of the MHA?

Answer 20

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, lasting 24 hours (can be extended to 36).

Question 21

What do Sections 26 and 29 cover?

Answer 21

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

Question 22

What is the purpose of the Tribunal in the MHA?

Answer 22

The Tribunal decides whether it is lawful to continue detention or Community Treatment Order (CTO) and determines if the statutory criteria for detention or CTO are met.

Question 23

What are the Tribunal’s options?

Answer 23

The Tribunal can uphold detention, discharge at once, discharge at a later date, reconvene at a later date, or issue directions/make recommendations.

Question 24

What is a Community Treatment Order (CTO)?

Answer 24

A CTO allows a patient discharged from a section to live in the community under certain conditions, and if these are broken, the patient can be taken back to hospital for up to 72 hours for assessment.

Question 25

Who is an Approved Mental Health Professional (AMHP)?

Answer 25

An AMHP is a mental health professional approved by a local social services authority to carry out certain duties under the MHA, usually a social worker or someone with appropriate qualifications.

Question 26

What is an Independent Mental Health Advocate (IMHA)?

Answer 26

An IMHA is an advocate trained to help patients understand their rights under the MHA and provide support while detained, available to those under most sections of the MHA.

Question 27

What is Guardianship under the MHA?

Answer 27

Guardianship involves appointing a ‘guardian’ to help the patient live independently in the community instead of being sectioned and kept in hospital.

Question 28

What are Deprivation of Liberty Safeguards (DoLS)?

Answer 28

DoLS are used when a person is deprived of their liberty within a care home or hospital, necessary if restraints and restrictions used under the MCA deprive a person of their liberty.

Question 29

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

Answer 29

The ECtHR provides everyone the right to liberty under Article 5 of the Human Rights Act 1998, with MHA limitations challengeable by an MHA tribunal.

Question 30

Who is a Section 12 approved clinician?

Answer 30

A clinician with post-MRCPsych membership and specific MHA training.

Question 31

Who is the Responsible Clinician?

Answer 31

The consultant in charge of the patient’s care, also known as the Approved Clinician (AC) usually on-call cover.

Question 32

What is the role of a Nominated Deputy?

Answer 32

Any other doctor involved in the patient’s care, e.g., a paediatric SHO on call who may have detained a patient.

Question 33

What is the Mental Capacity Act 2005?

Answer 33

A framework for decision-making on behalf of people who lack capacity, applying to those aged 16 and over, covering medical treatment decisions for both physical and mental disorders.

Question 34

What are the key principles of the Mental Capacity Act 2005?

Answer 34

Time and decision specific, presumption of capacity, clearly defined capacity test, respecting unwise decisions if capacity is present, reasonable steps for decision-making assistance, least restrictive intervention, and best interests principles.