Psych Laws Flashcards
For someone to have capacity, they must be able to:
- Understand and retain relevant information.
- Use and weight that information to make a decision.
- Communicate that decision
What are the principles of using the adults with incapacity act Scotland?
- Intervention must benefit the adult
- Such benefit cannot reasonable be achieved without the intervention
- Take account of past and present wishes
- Consult with other relevant persons
- Encourage the adult to use residual capacity
What does the AWI section 47 certificate not allow you to do?
You cannot use force unless immediately necessary for only as long as is necessary
Cannot authorise transport to place of treatment
What does the AWI section 47 certificate allow you to do?
Authorise treatment of a physical disorder in someone without capacity to consent to that treatment
What can a welfare guardian not do?
Cannot place the adult in hospital for treatment of mental disorder against their will
If power of attorney/welfare guardian comes to a decision the patient doesn’t agree with, what do they need to enforce it?
A compliance order from the sheriff
What is the purpose of the mental health act?
Allows for treatment of mental disorder or physical consequences of mental disorder in someone without capacity to consent to treatment.
What is the criteria for emergency detention under the mental health act?
- Likely to have a mental disorder.
- Significantly impaired decision-making ability regarding treatment, due to mental disorder.
- Detention in hospital is necessary as a matter of urgency to determine what treatment is needed.
- Risk to health, safety or welfare of the person or safety of others.
- Making arrangements for short term detention would involve undesirable delay
What is the criteria for short term detention under the mental health act?
- Likely to have a mental disorder.
- Significantly impaired decision-making ability regarding treatment, due to mental disorder.
- Detention in hospital is necessary for assessment or treatment.
- Risk to health, safety or welfare of the person, or safety of others.
- Cannot be treated voluntarily.
If a young person has incapacity, what should you do (from the children’s act in Scotland)?
Ask one parent for consent (best practice to include both parents in discussion).
If parents disagree, seek legal advice.
Does the mental health act have an age limit?
No
When would you use the mental health act with young people?
Use of force
Use of IM injection
Certain treatments e.g. NG feeding, ECT
Detrimental impact on relationship with carer
What is SIDMA and is it the same as incapacity?
Significantly impaired decision making ability (SIDMA).
No as it is only when caused by mental disorder alone.
How long does an emergency detention order last for?
72 hours (can let them go sooner)
Does an emergency detention order authorise treatment?
No
Who can do emergency detention orders and do 2 people need to agree to it?
Fully registered doctor (FY2 and above).
Where possible a mental health officer should agree to it.
How long does a short detention order last for and can you do treatment with it?
Up to 28 days
Yes 28 days of treatment also authorised
Who needs to do a short term detention order?
Approved medical practicioner (psych reg or consultant with extra training in MHA) AND a mental health officer.
Can a short term detention order be appealed?
Yes by the patient and their named person
How long can a short term detention order be prolonged and why?
3 days if extra time needed to apply for CTO
5 days if CTO application submitted
How long does a compulsory treatment order last for and how much treatment can be given?
Up to 6 months
Treatment for 2 months
Who needs to request a compulsory treatment order and how is the application assessed?
Approved medical practitioner and mental health officer
MHO submits it to mandatory tribunal
When can a compulsory treatment order be renewed?
At 6 months, then yearly
When can treatment be given on an emergency detention and what certificate needs to be completed after?
To save patient’s life
To prevent serious deterioration in patient’s condition
To alleviate serious suffering
To prevent patient from being a danger to themselves or others
T4 certificate
After 2 months of treatment on short term detention/compulsory treatment order, what do you need to do to provide further treatment?
Get a second opinion doctor to come along and authorise the treatment.
What are the treatments that need a second opinion doctor to give under a short term detention/compulsory treatment order?
ECT (unless emergency) Nutrition by artificial means Vagus nerve stimulation Transcranial magnetic stimulation Any medicine to reduce sex drive Neurosurgery (need patient consent or additional protections)
What systems are in place to protect patient’s rights and safeguards?
Advance statements (can be overruled)
Named person
Independent advocacy
Mental health tribunal (psychiatrist, convenor and third person with other experience)
What is the nurses holding power?
Registered mental health or intellectual disability nurse
Can hold patient for up to 3 hours if necessary for protection of health, safety or welfare of patient or safety of others
What holding powers do the police have?
Removal from public place to place of safety
If someone appears to have a mental disorder needing care and treatment
Up to 24 hours
