Psychiatry - Mental health legislation

Question 1

What is the criteria for detention under the MHA?

Answer 1

1) Person must be over 16, not admitted voluntarily and suffering from a mental disorder. Detention solely on the basis of dependence of alcohol or drugs is not permitted
2) Nature and degree of the mental disorder warrants detention in hospital (for assessment or treatment)
3) Must be necessary for the health or safety of the patient or the protection of others
4) Appropriate medical treatment (section 3) must be available - alleviate and prevent worsening of the disorder

Question 2

What individuals are involved in the MHA assessment?

Answer 2

Section 12(2) approved doctor - certified to have special expertise in mental health. Provide medical recommendation for detention

Second medical recommendation, independent from the first, ideally someone who has prior knowledge of the patient (patients GP)
- if not possible, section 12(2) doctors recommendation used

Approved Mental Health Practitioner (AMHP), can be social workers or other healthcare professionals. AHMPs make the application for detention to the hospital based on medical recommendation

Responsible clinician (RC) is the approved clinician in charge of the patients care, most often psychiatrists

Question 3

Mental health review tribunals

Answer 3

Patients may appeal their detention under MHA
Tribunal consists of independent panel of a psychiatrist, a lawyer and a lay person
They may decide to discharge the patient from hospital if they are satisfied that the criteria for detention are not met

Question 4

What is a section 5(2)?

Answer 4

A patient who is a voluntary patient can be detained for a maximum of 72 hours by a doctor. Requires recommendation by the RC or nominated deputy.
Full MHA assessment should take place

Question 5

Section 2

Answer 5

Requires two medical recommendations and the recommendation of an AMHP
Maximum duration is 28 days
Is for ASSESSMENT of a mental disorder (and treatment if required)

Question 6

What is section 3?

Answer 6

Requires two medical recommendations and the recommendation of an AMHP (both doctors must have seen the patient in the last 72 hours)
Initial duration is 6 months and can be extended by a further 6 months and then for periods of 1 year at a time
Is for TREATMENT of a mental disorder

Question 7

What is section 4 of the MHA?

Answer 7

72 hour assessment order
Used as an emergency when a section 2 would involve and unacceptable delay
A GP and an AMHP or nearest relative
Often changed to a section 2 on arrival at hospital

Question 8

Community treatment orders

Answer 8

Used for patients who have been detained under section 3 or 37
Allow patients to live in the community whilst still being subject to the powers of the MHA for the purpose of receiving medical treatment and they can be recalled to hospital

(Section 37 is similar to section 3, it is imposed by a court instead of a prison sentence based on two medical recommendations)

Question 9

Section 135

Answer 9

Court order can be obtained to allow police to break into a property to remove a patient and bring them to a place of safety

Question 10

Section 136

Answer 10

Someone found in a public place, who appears to have a mental disorder can be taken to a place of safety by the police