Psychiatry and Law Flashcards
The mental health act (2007) matches which of the following:
1 - civil law of compulsory admission for up to 28 days for assessment and treatment
2 - civil law relating to the involuntary treatment and admission of patients with mental health disorders
3 - civil law relating to consent, capacity and deprivation of liberty
4 - criminal law as it relates to mental health
2 - civil law relating to the involuntary treatment and admission of patients with mental health disorders
The mental health act (2007) relates to the civil law relating to the involuntary treatment and admission of patients with mental health disorders. It has 3 purposes, which of the following is NOT one of these purposes?
1 - ensure essential treatment
2 - protect individuals from going to prison
3 - protect other people
4 - protect individuals from wrongful detention
2 - protect individuals from going to prison
Ensuring essential treatment is one of the 3 key purposes of the mental health act. Which of the following criteria are used to decide if a treatment is essential for a patient?
1 - safety of the patient
2 - safety of others
3 - prevent deterioration in health that could lead to unsafe for the patient or others
4 - all of the above
4 - all of the above
According to the mental health act (2007), what is the definition of a mental disorder?
1 - impaired ADLs
2 - unable to work
3 - disorder or disability of the mind
4 - all of the above
3 - disorder or disability of the mind
- dependence on alcohol and drugs is NOT included
- learning difficulty, UNLESS accompanied by abnormal aggression is NOT included
Typically what % of patients with mental health disorders are sectioned under the mental health act (2007)?
1 - 1-5%
2 - 10-15%
3 - 20-30%
4 - >55%
2 - 10-15%
Are the majority of mental health patients admitted under MHA (2007) or admitted voluntarily?
- voluntarily
The mental capacity act (2005), including deprivation of safeguarding (DoLS) matches which of the following?
1 - civil law of compulsory admission for up to 28 days for assessment and treatment
2 - civil law relating to the involuntary treatment and admission of patients with mental health disorders
3 - civil law relating to consent, capacity and deprivation of liberty
4 - criminal law as it relates to mental health
3 - civil law relating to consent, capacity and deprivation of liberty
Is the mental capacity act generic that covers everything?
- no
- questions must be specific to time and decision specific
- e.g. do you want some cake = yes
- do you want a bypass? This is much more complex and requires further brain function
What is section 2 of the MHA (2007)?
1 - treatment for up to 6 months
2 - admitting/assessing a patient for 28 days
3 - police can remove a patient with mental health disorder form public area and take to place of safety
4 - patient can be detained for up to 6 hours by a psychiatric nurse
2 - admitting/assessing a patient for 28 days
At the end of a section 2 of the MHA, do patients automatically get discharged?
- some can
- OR the section 2 is converted to a section 3 for treatment
Who is required to apply for a section 2 of the MHA (2007)?
1 - approved mental health professional (AMHP)
2 - a doctor with section 12 approval (special expertise in diagnosing mental health disorders)
3 - one clinical doctor with experience in mental health disorders (MHD)
4 - all of the above
4 - all of the above
- patient must be suffering with MHD and warrant assessment for MHD
- person is detained for their own and/or others safety
What is section 3 of the MHA (2007)?
1 - treatment for up to 6 months
2 - admitting/assessing a patient for 28 days
3 - police can remove a patient with mental health disorder form public area and take to place of safety
4 - patient can be detained for up to 6 hours by a psychiatric nurse
1 - treatment for up to 6 months
- can be extended to a year following this
- BUT if no longer requiring voluntary treatment, patients can be discharged
Who is required to apply for a section 3 of the MHA (2007)?
1 - approved mental health professional (AMHP)
2 - a doctor with section 12 approval (special expertise in diagnosing mental health disorders) who has seem the patient in last 24h
3 - one clinical doctor with experience in mental health disorders (MHD) who has seem the patient in last 24h
4 - appropriate medial treatment must be available to keep the patient admitted
5 - all of the above
5 - all of the above
In a section 3 (detention for treatment for 6 months), can patients bet treated against their own will?
- yes for 1st 3 months
- after 1st 3 months the patient must provide consent, OR a second doctor csan review and override this
- Electro-convulsive therapy has its own separate guidelines
Can patients appeal against a section 2 or 3?
- yes
- referred to a mental health review tribunal
- needs a lawyer, psychiatrist and lay member
Advocacy is a part of the MHA (2007). What is this?
1 - patients have a right to appeal against a section 2 or 3
2 - a civil servant who acts on behalf of the patient
3 - member of the medical team who acts in the best interests of the patient
4 - all of the above
2 - a civil servant who acts on behalf of the patient
- makes sure human rights are ok
- ensures the patient understands everything
- can help the patient appeal against a section 2 or 3
A section 4 of the MHA (2007) allows for emergency admission of patients, without all the logistics of section 2. How long can a section 4 last for?
1 - 24h
2 - 48h
3 - 72h
4 - 96h
3 - 72h
- non-renewable
- needs 1 doctor (not section 12 approved)
- generally converted to a section 2 upon arrival at hospital
Which 2 of the following can request an application of section 4 of the MHA (2007)?
1 - nearest relative
2 - section 12 doctor
3 - approved mental health professional (AMHP)
4 -police
2 - section 12 doctor
3 - approved mental health professional (AMHP)
Which of the following are important in a section 5 (2) of the MHA (2007)?
1 - any doctor has capacity to detain a patient
2 - patient can be in any type of hospital
3 - does not include emergency department
4 - can detain the patient for up to 72 hours
5 - all of the above
5 - all of the above
- doctor should liaise with a psychiatrist within the 72 hour window
Which of the following are important in a section 5 (4) of the MHA (2007)?
1 - any psychiatric nurse has capacity to detain a patient
2 - approved mental health professional (AMHP) can detain a patient
3 - patient is attempting discharge
4 - can detain the patient for up to 6 hours
5 - all of the above
5 - all of the above
What is section 136 of the mental health act?
1 - treatment for up to 6 months
2 - admitting/assessing a patient for 28 days
3 - police can remove a patient with mental health disorder form public area and take to place of safety
4 - patient can be detained for up to 6 hours by a psychiatric nurse
3 - police can remove a patient with mental health disorder form public area and take to place of safety
What is section 135 of the mental health act?
1 - treatment for up to 6 months
2 - admitting/assessing a patient for 28 days
3 - police can remove a patient with mental health disorder form public area and take to place of safety
4 - approved mental health professional (AMHP) requests warrant for police to enter premises and detain individual at a safe location
4 - approved mental health professional (AMHP) requests warrant for police to enter premises and detain individual at a safe location
The MHA (2007) states that patients can only be treated for their mental health problems, and not physical problems. However, there are 2 exceptions to this rule, which 2 of the following?
1 - enforced feeding for anorexia nervosa
2 - if a police warrant is issued
3 - treatment following suicide if attempt is linked to mental health disorder
4 - if patient is on a section 3
1 - enforced feeding for anorexia nervosa
- this is deemed to be a mental health disorder
3 - treatment following suicide if attempt is linked to mental health disorder
Which of the following are important aspects of consent?
1 - must be voluntary
2 - given voluntarily without undue force
3 - consent must be informed
4 - all of the above
4 - all of the above
The mental capacity act (2005) relates to whether all patients can provide consent. Which of the following underpin this act?
1 - adult is assumed to have capacity until proven otherwise
2 - patient should not be treated until all practical steps have been taken to help them
3 - unwise decisions should not be misunderstood with lack of capacity
4 - treatment is based on the patients best interests
5 - treatment should be the least restrictive option for the patient
6 - all of the above
6 - all of the above
To have capacity a patient must have how many of the following:
- understand the information they have been given
- retain information they have been given
- weight up information given to make a decision
- communicate their decision
1 - all 4
2 - >3
3 - >2
4 - 1
1 - all 4
What is an advance decision to refuse treatment?
1 - a legal document giving a name individual power over their healthcare
2 - acting in the best interest of the patient, regardless of what they want
3 - decision make when patient had capacity to decline further treatment
4 - all of the above
3 - decision make when patient had capacity to decline further treatment
What is a lasting power of attorney?
1 - a legal document giving a name individual power over their healthcare
2 - acting in the best interest of the patient, regardless of what they want
3 - decision make when patient had capacity to decline further treatment
4 - all of the above
1 - a legal document giving a name individual power over their healthcare
- can relate to health, welfare, financial and property
In criminal law there is something called the defence of insanity. Which of the following must be true for a patient to be acquitted of their crimes under insanity?
1 - patient must have disease of the mind
2 - disease of mind must be present prior to offence
3 - disease of the mind led to offence and defect of reason
4 - patient is unaware what they were doing was wrong
5 - all of the above
5 - all of the above
In criminal law there is diminished responsibility. Which of the following is the only time this can be used?
1 - homicide
2 - assault
3 - assisted suicide
4 - armed robbery
1 - homicide
- jury need to be convinced that an underlying mental health disorder led to crime
- charge can then be reduced to manslaughter
Common law essentially means that touching a patient without valid consent may constitute the civil or criminal offence of battery. Does this always hold true?
- no
- common law doctrine of necessity states that in urgent settings that a patient can receive treatment if there is not time for a MHA or MCA assessment
If a patient is injured and as a result of their injuries they have developed delirium and they are refusing treatment, would this require a MHA or MCA assessment?
- mental capacity act
- this is because the patients delirium and therefore ability to give consent is caused by the patients injuries and needs treating
