Psychiatric Law Flashcards
what counts as a mental disorder under the MHA
mental illness (including dementia)
learning disability
personality disorder
what are the criteria for an emergency detention
- patient likely has a mental disorder
- the mental disorder is impairing their ability to make decisions regarding their treatment
- matter of urgency to detain them to decide on treatment
- if they werent detained there would be a risk to themselves or others
- Short term detention would add undesirable delays
can you treat someone under the emergency detention
no
- unless life saving, to alleviate serious suffering, to prevent serious deterioration or to prevent risk to patient or others
how long does an ED let you detain a patient
72 hours for further assessment
who can carry out an ED
FY2 and above
who should ideally be informed of an ED
MHO
can an ED be legally appealed
no
what law is used to detain and treat patients in scotland with a mental disorder however caused or manifested
mental health care and treatment act 2003
what is the criteria for a short term detention
- patient has a mental disorder
- mental disorder is impairing ability to make decisions regarding treatment
- necessary to detain patient to decide treatment
- not detaining patient would pose a risk to patient or others
- short term detention is necessary
how long does a short term detention last
28 days
does a short term detention allow treatment
yes
can a short term detention be extended
yes - by 3 days to put together an application for CTO
by 5 days once CTO is submitted
who can apply for a short term detention
approved medical practitioner - trained psychiatrist (ST4+)
can a short term detention be appealed
yes by the patient and a named person
in front of a tribunal or mental health welfare commission
what treatments are not covered by short term detention
ECT artificial nutrition vagus nerve stimulation transcranial magnetic stimulation hormonal medicine to reduce sex drive neurosurgery
does a short term detention require consent of MHO
yes absolutely
what is the criteria for a CTO
- patient has a mental disorder
- mental disorder is impairing patients ability to make decisions regarding treatment
- there is treatment available for the mental disorder
- not treating the patient would pose a risk to patient or others
- CTO is necessary
who sits on the tribunal panel when applying for a CTO
(i) A lawyer
(ii) A psychiatrist
(iii) A person with other skills and experience, e.g. a nurse, social worker or someone with personal experience of mental disorder
who can apply for a CTO
MHO with supporting letters from 2 approved medical practitioners, both of whom have examined the patient and one of whom is the psychiatrist in charge of the patients care
how is a CTO decided
heard in front of a tribunal where patient is entitled to legal representation
if granted what can a CTO impose
treatment and residence conditions
how long does a CTO last
6 months initially
reviewed at 6 months then yearly
can a CTO be appealed
yes by patient or named person
what is an advanced statement
written by the patient when they are deemed to have capacity outlining how they wish to be treated should they become unwell and lose capacity
does a CTO have to abide by advanced statement
has to regard it but can be overruled - need to explain why it has been
what is a named person
someone who will look after the persons interests if they have to be treated under the MHA
what is an independent advocate
everyone under the MHA with a mental disorder is entitled to an IA who will support patient and help them ot explain their own views about treatment
what is capacity
the ability to use and understand information to make a decision and be able to communicate this decision
does capacity depend on the decision
yes - may have capacity for one decision but not another
what is consent
permission for something to happen or agreement to do something
assessment of capacity can be carried out by who
FY2 and above
in order to have capacity what must a patient be able to do
- understand the treatment with regard to nature, purpose and requirement
- understand risks, benefits and alternatives
- understand the risk of declining treatment
- retain information long enough to use it, weigh it up and come to a decision and be able to communicate it
how is capacity assessed (acronym)
BURPCCC
- believes
- understands
- retains
- processes
- communicates
- consistency
- coercion (none of this)
can treatment be given without assessing capacity
yes in an emergency
what powers do the police have with regard to detaining someone with a mental disorder
removal to a safe place from a public place
detain for up to 24 hours for assessment
what section of the AWIA is a certificate of incapacity
section 47
does a certificate of incapacity allow use of force
only if immediately necessary and only for as long as necessary
certificate of incapacity allows who to make the decision on behalf of the patient
doctor or by appointed proxy
who has power of attorney (named person)
individual who is appointed by the patient when they have capacity to have authority to make decisions for them
what is a guardianship order
when there is no power of attorney so the court appoints an individual to act and make decisions on behalf of someone with incapacity
who grants a guardianship order
sheriff
can a welfare guardian place an adult in hospital for tx of MHD against their will
no
what is an intervention order
order that authorises a person to act and make one off decision for an adult with incapacity
what can be issued if adult doesnt comply with wishes of welfare guardian
sheriff can issue a compliance order
children under the age of what are deemed to not have capacity
12
do ages 12-16 have capacity
may do, depends on understanding
over what age are you assumed to have capacity
16
who makes the decision if a child lacks capacity
parents
can a parent overrule decision by child deemed to have capacity
no
what happens if a doctor disagrees with parents decision
doctor can seek to over rule decision of parent
how long can a nurse holding power detain someone
up to 3 hours
what is the criteria for treating patients under the AWIA 2000
intervention is in the best interest of the patient, will benefit them and such benefit couldn’t be achieved without the intervention
what is first line in tranquilising a patient
oral lorazepam
what is 2nd line in tranquilising a patient
haloperidol - IM/PO
