The Mental Health Act and Mental Capacity Act Flashcards
What can the mental health act be used for?
Enforcing treatment for mental health conditions to minimise undersirable effects of the condition on the individual
What must be the case in order to section a patient?
The disorder must be of a certain nature or degree, and there must be significant risk to self/others if left
What is Section 2 for?
Admission to hospital for assessment
How long does section 2 work for?
Up to 28 days
Who has to approve a section 2?
An approved MHA professional and an approved Doctor
Can a section 2 be appealed?
Yes
What is section 3 for?
Admission to hospital for treatment
How long does section 3 work for?
Up to 6 months
Who has to approve a section 3?
2 AMHPs (1 must be independant of the patients treatment)
Can a section 3 be appealed?
Yes
What happens after 3 months under section 3?
A consent to treatment form must be filled in to review the patients treatment plan vie Second opinion appointed doctor (SOAD)
What is a section 5(2)?
An act allowing detention of patients already in hospital
How long does section 5(2) work for?
Up to 7 hours
What does section 5(2) allow?
The pt to be seen by 2 doctors to assess them for further treatment or sectioning
Can you appeal a section 5(2)?
No
What is a section 5(4)?
Nurses’ power to detain a person being treated for a mental disorder as a hospital in-patient
How long does section 5(4) work for?
Up to 6 hours
What does section 5(4) allow?
A patient to be assessed for staying in hospital or further MH disorder treatment
Can you appeal a section 5(4)?
No
What is section 136?
The police can take someone from a public place to a place of safety (eg ward, A&E, police cells) for 72 hours until assessment
What is a community treatment order?
A legal order made by the Mental Health Review Tribunal or by a Magistrate. It sets out the terms under which a person must accept medication and therapy, counselling, management, rehabilitation and other services while living in the community
What is capacity?
The ability to make a decision based on information given, remembered, and retrieved
What should be the case with capacity?
It should be assumed, incapacity should be proven
WRT capacity, what do patients have the right to do?
Make bad decisions
What is in place for the incapacitated adult?
Legal safeguards to prevent ill treatment or willful neglect
Can lack of capacity be short term?
Yes
What must decisions made for the patient without capacity be?
In the patients best interest and should be the least restrictive of their basic rights and freedoms
What does the MCA allow patients to do before losing capacity?
Designate someone to make decisions on their behalf for when they lose capacity
What is the definition of a mental disorder under the MHA?
“Any disorder or disability of the mind’. This covers a range of disorders including schizophrenia, depression, anxiety disorders and eating disorders.
NB Suffering from one of these disorders by itself does not mean that a person is subject to the provisions of the Act.
How does the MHA view learning disabilities?
A disability will only fall within the definition of a mental disorder if it is associated with abnormally aggressive or seriously irresponsible conduct.
What is section 17?
Allows a S2 or S3 pt leave if they are assessed as safe to do so
When a pt is under level 1a monioring on the wards, what does that mean?
Constant oservation within an arms length, including full sight
When a pt is under level 1b monioring on the wards, what does that mean?
Constant observation within close proximity including full sight
When a pt is under level 2 monioring on the wards, what does that mean?
Intermittent observations, usually every 15 minutes
When a pt is under level 3 monioring on the wards, what does that mean?
Hourly checks
If we have done everything we can to help a patient make a decision, but they are still unable to, can we then treat them as incapacitated?
Yes
Before we make a decision on behalf of the pt, what must we consider?
If there is another way to achieve what we are trying to achieve which is less restrictive of the person’s rights and freedoms
What are the 4 steps to making an informed decision?
- Understand information given
- Retain information
- Weigh up/use the information to make a decision
- Communicate that decision back
If a patient seems likely to regain capacity soon, what should you consider?
Can this decision/action wait until they have capacity again?
If a pt draws up an advanced decisions document, what can it contain?
Their preference of a range of treatments, and treatments they would specifically not want to have if they lose capacity.
What is the name for when a pt under 16 can give consent?
Gillick competence
For Gillick competence, what must the pt demonstrate?
The ability to make an informed decision and understand their choices relating to treatment
Can a demented person give consent?
Yes - if they can make the decision in the moment, but forget later on, they still have capacity because they made an informed choice.
What is important about capacity and they types of decisions the pt can make?
Capacity is not a catch-all. A pt can have capacity for certain things, and not others.
What must the pt not have in order to be placed under section?
Capacity!!!
If a pt walks into A&E and is clearly having a manic episode, but can demonstrate capacity, and tells you they don’t want treatment, what do you do?
You have to let them walk away, because they had capacity so you can’t section them
When is a section 4 used?
When using a section 2 would cause undesirable delay.
How long does a section 4 last?
72 hours
What is required to place a pt under section 4?
Only 1 doctor needs to make the recommendation. A second order can then be made within the 72 hours to upgrade to section 2.
Why would a doctor or nurse put a pt under section 5?
To secure the health and safety of a pt who is trying to leave, or to secure the safety of other pts on the ward
What is a section 135 and who uses it?
Police - can take a person from a private place to a place of safety. Lasts 72 hours so a MH assessment can be carried out.
What is a section 136 and who uses it?
Police - can take a person from a public place to a place of safety. Lasts 72 hours so a MH assessment can be carried out.
What counts as a place of safety?
A hospital or police station
Who else can request an assessment of a pt?
The pts nearest relative
If the nearest relative who referred a pt pbjects to their relative being put nder section 3, what happens?
That pt cannot be sectioned unless the county court overrules the decision.
