Risk and mental health act

Question 1

When can you use the mental health act?

Answer 1

When patients are unwilling or lacking capcaity to consent

Question 2

3 main criteria for the mental health act

Answer 2

Mental disorder of a nature or degree which makes it appropriate for them to receive treatment in hospital
Risk to self or others
Appropriate treatment is available

Question 3

Notable exclusions form the mental health act

Answer 3

If in isolation, with no addition mental disorder or risk:
Dependence on drug and alcohol
Learning disability (unless ruled at risk to self or others)

Question 4

Which section of MHA stops patients leaving hospital if they thus har have been in hospital voluntarily?

Answer 4

Section 5

Question 5

Who is responsible for making the decision whether someone needs an assessment?

Answer 5

Nominated deputy - doctor available at time
F2 responsible for their care

Question 6

Where can u have a mental health assessment?

Answer 6

Section 2
136 (public place)
Police station

Question 7

Whenare police holding powers required?

Answer 7

for use by police if a mental illness is suspected and the person needs ‘care or control’

Question 8

What is section 136 used for?

Answer 8

Take someone to place of safety - friends/relatives home, hospital or police station
24 hours can be kept, and can be extended for 12 hours

Question 9

What is section 135 MHA?

Answer 9

Access to private address without permission - incl necessary property damage
Requires magistrate permission and address specific
Again used to take place of safety Can be kept on this section for up to 36 hours

Question 10

When should section 5 be used and not be used?

Answer 10

Any patient voluntarily on a locked ward must either be allowed to leave when asking to or be stopped using section 5
Section 5 should only be used when sections 2, 3 or 4 are not possible/safe to be used

Question 11

What is Nurses holding power?

Answer 11

Section 5(4)
Only used by trained mental health or learning disability nurses if no doctor available only in psychiatric hospital
Can hold a patient for up to 6 hours - cannot be renewed
Terminates as soon as doctor arrives

Question 12

Doctors holding power - who can use, how long for

Answer 12

Section 5(2)
ONly usable by fully registered doctor eg FY2
Can hold patient for up to 72 hours
Written report must be submitted to hospital managers

Question 13

Section 4 when use

Answer 13

When only one doctor availabel
No treatment powers

Question 14

Which sections have treatment powers?

Answer 14

Sections that require 2 doctors
eg section 2 and 3

Question 15

What does section 2 allow?

Answer 15

Assessing of patient - doctors determine:
Type of mental disorder
Whether treatment is required
What treatment this will be and impact on overall health

Question 16

How long can section 2 last?

Answer 16

28 days

Question 17

Who does section 2 require to be passed?

Answer 17

One doctor must have seen patient within 14 days
One doctor must be section 12 approved
AMHP is usually a social worker

Question 18

Order of closest relative

Answer 18

Partner
Older parent
Ypunger parent
Older children
Younger children

Question 19

Who can object to section 3?

Answer 19

Closest relative if deeemed objectionable by court

Question 20

Whn is section 2 chosen over section 3?

Answer 20

Section 2 is chosen over section 3 by AMHP if never been assessed, or been a long time since last assessment

Question 21

When can treatment against will be given?

Answer 21

Section 2 and 3 (assuming criteria for treatment is met)
Any medication or procedure for mental disorder or consequences
Restraint
Expert nursing

Question 22

What is the purpose of section 3?

Answer 22

Treating patient

Question 23

How long can section 3 keep a patient in hospital for?

Answer 23

6 months
Can be renewed for 6 months if required
If this surpassed renewed annually

Question 24

Exclusions for MHA treatment

Answer 24

Cant be used for
-ECT
-Brain surgery
-Medical treatment after first 3 months
unless its a serious life or limb saving) saving emergency
Or with a second opiniion

Question 25

What does renewal of section 3 require?

Answer 25

Renewal requires assessment by the clinician in the 2 months before the section ends

Question 26

How long can patient be treated without consent in section 3?

Answer 26

Patient may be treated without their consent for 3 months – after this requires approval by a ‘second opinion approved doctor’ (SOAD)

Question 27

5 principles of capacity

Answer 27

1. A Presumption of Capacity
   Every Adult has the right to make his or her own decisions and must be assumed to have capacity to do so unless it is proved otherwise
2. Individuals being supported to make their own decisions
   People must be given all practicable help before anyone treats them as not being able to make their own decisions
3. Unwise Decisions
   Just because a person makes what might seem as an unwise decision, they should not be treated as lacking in capacity to make that decision
4. Best Interests
   An act done or decision made under the Act for or on behalf of a person who lacks capacity, must be done in their best interests
5. Least Restrictive Option
   Anything done for, or on behalf of a person who lacks capacity, should be the least restrictive of the basic rights of freedoms

Question 28

2 stage assessment of capacity

Answer 28

Does the person have an impairment of the mind or brain, or is there some sort of disturbance affecting the way their mind works? (It does not matter whether the impairment or disturbance is permanent or temporary)
If yes does that impairment or disturbance mean that the person is unable to make the decision in question at the time it needs to be made?

Question 29

When is someone unable to make a decision or themselves?

Answer 29

Understand the information relevant to the decision
Retain that information
Use or weigh that information as part of the process of making the decision
Communicate their decision (whether by talking, using sign language or any other means)

Question 30

When is the mental capacity act important?

Answer 30

Detainment somwhere that isnt a hopsital
Treating a physical disease eg antibiotics for severe dementia

Question 31

When can end life sustaining treatment?

Answer 31

If futile or more harm than good
Try and be as unrestricitve as possible

Question 32

When can you use section 5(2)?

Answer 32

In patients that have been admitted

Question 33

What does section 135 require that makes it rare?

Answer 33

magistrates approval

Question 33

What does section 135 require that makes it rare?

Answer 33

magistrates approval

Question 34

What does section 2 allow doctors to assess

Answer 34

Type of mental disorder
Whether treatment is required
What treatment this will be and impact on overall health

Question 35

Who required for section 2?

Answer 35

2 doctors and an AMHP