Risk and mental health act Flashcards
When can you use the mental health act?
When patients are unwilling or lacking capcaity to consent
3 main criteria for the mental health act
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
Notable exclusions form the mental health act
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)
Which section of MHA stops patients leaving hospital if they thus har have been in hospital voluntarily?
Section 5
Who is responsible for making the decision whether someone needs an assessment?
Nominated deputy - doctor available at time
F2 responsible for their care
Where can u have a mental health assessment?
Section 2
136 (public place)
Police station
Whenare police holding powers required?
for use by police if a mental illness is suspected and the person needs ‘care or control’
What is section 136 used for?
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
What is section 135 MHA?
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
When should section 5 be used and not be used?
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
What is Nurses holding power?
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
Doctors holding power - who can use, how long for
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
Section 4 when use
When only one doctor availabel
No treatment powers
Which sections have treatment powers?
Sections that require 2 doctors
eg section 2 and 3
What does section 2 allow?
Assessing of patient - doctors determine:
Type of mental disorder
Whether treatment is required
What treatment this will be and impact on overall health
How long can section 2 last?
28 days
Who does section 2 require to be passed?
One doctor must have seen patient within 14 days
One doctor must be section 12 approved
AMHP is usually a social worker
Order of closest relative
Partner
Older parent
Ypunger parent
Older children
Younger children
Who can object to section 3?
Closest relative if deeemed objectionable by court
Whn is section 2 chosen over section 3?
Section 2 is chosen over section 3 by AMHP if never been assessed, or been a long time since last assessment
When can treatment against will be given?
Section 2 and 3 (assuming criteria for treatment is met)
Any medication or procedure for mental disorder or consequences
Restraint
Expert nursing
What is the purpose of section 3?
Treating patient
How long can section 3 keep a patient in hospital for?
6 months
Can be renewed for 6 months if required
If this surpassed renewed annually
Exclusions for MHA treatment
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
What does renewal of section 3 require?
Renewal requires assessment by the clinician in the 2 months before the section ends
How long can patient be treated without consent in section 3?
Patient may be treated without their consent for 3 months – after this requires approval by a ‘second opinion approved doctor’ (SOAD)
5 principles of capacity
- 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 - 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 - 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 - 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 - 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
2 stage assessment of capacity
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?
When is someone unable to make a decision or themselves?
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)
When is the mental capacity act important?
Detainment somwhere that isnt a hopsital
Treating a physical disease eg antibiotics for severe dementia
When can end life sustaining treatment?
If futile or more harm than good
Try and be as unrestricitve as possible
When can you use section 5(2)?
In patients that have been admitted
What does section 135 require that makes it rare?
magistrates approval
What does section 135 require that makes it rare?
magistrates approval
What does section 2 allow doctors to assess
Type of mental disorder
Whether treatment is required
What treatment this will be and impact on overall health
Who required for section 2?
2 doctors and an AMHP
