Violence and aggression- with laws Flashcards

1
Q

What is violence?

A

The intentional use of physical force or power, threatened or actual, or against a group or community, which either results in or has the high likelihood of causing injury, death, psychological harm, maldevelopment or deprivation.

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2
Q

Does having a mental health disorder predispose you to violence?

A

Not necessarily. If you have a mental health disorder, have been previously violent and partake in substance abuse then yes, but just the mental disorder alone isn’t that much more likely.

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3
Q

How might you manage aggressive behaviour?

A

Predict it- this is the best way to avoid it. Look at body language.
Prevent it- de-escalation, try and talk to the patient.
Intervention- restraint, seclusion, rapid tranquillisation.

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4
Q

What prophylactic techniques can help to manage aggressive behaviour?

A

Room layout- always stand closer to the door than the patient
Observations- having them observed by nurses
Locked or open ward setting
Stimulating environment may cause further confusion

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5
Q

To detain someone (in any form) the person has to be:

A

Appear to have a mental disorder
Cannot make decisions clearly
A danger to themselves/others

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6
Q

When is a person not mentally disordered? (which disorders mean you cannot detain someone)

A

Alcohol or substance misuse.
Behaviour that is likely to cause harassment, alarm or distress to another
Sexual orientation, sexual deviancy, transsexualism etc.

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7
Q

Who can use an emergency detention order?

A

Any doctor above the stage of FY2.

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8
Q

Who can use a short term detention and compulsory treatment order

A

Approved medical practitioners. These are people with at least 4 years training in psychiatry or a member of the royal college of psychiatry.

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9
Q

What order can the police put in place? What are the conditions?

A

Place of safety order.
The person must be in a public place and the police have to take them somewhere safe to be assessed. This is usually A and E or a psychiatric hospital.

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10
Q

What can nurses do if someone needs detaining and there is no doctor present?

A

Holding power
It allows them to hold someone for up to a few hours until a doctor arrives. This could be in a scenario where someone tries to leave hospital to commit suicide and there are no doctors around to do an emergency detention.

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11
Q

When might you use an emergency detention?

A

As a matter of necessity to assess the patients mental state. And if the patient were not admitted- there would be significant risk to others or themselves.

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12
Q

How long does an emergency detention last?

A

Up to 72 hours

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13
Q

Can a patient appeal an emergency detention?

A

No

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14
Q

Do you need consent from a mental health officer or AMP to carry out an emergency detention?

A

Usually there is consent from a MHO but you don’t need it. It must be reviewed by an AMP as soon as possible.

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15
Q

Can you treat a patient under an emergency detention?

A

No- you can’t treat them without their consent. Unless in an emergency situation.

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16
Q

Who applies short term detentions?

A

Approved medical practitioners.

17
Q

Can patients appeal a short term detention?

A

Yes

18
Q

How long does a short term detention last?

A

Up to 28 days.

19
Q

Can you treat under a short term detention?

A

Yes.

20
Q

When should you use a short term detention?

A

If the approved medical professional considers it

  • likely the patient has a mental disorder
  • the patients ability to make decisions is impaired
  • it is necessary to detain the patient to give the patient treatment or decide what treatment needs to be given.
  • significant risk to themselves or others.
21
Q

When would you use a compulsory treatment act?

A

Around 2 weeks into the STD you have to decide whether you want to apply for a CTO to continue treatment.

22
Q

How long does a CTO last for?

A

Up to 6 months

23
Q

Can the patient appeal against a CTO?

A

Yes.

24
Q

Who applies for the CTO?

A

A mental health officer makes the application, which needs to be supported by two medical reports.

25
Q

Can you give treatment under a CTO?

A

Yes.

26
Q

When should you use rapid tranquillisation?

A

First of all consider non-drug approaches
Then check the past medical history for any contraindications
First try oral therapy- oral lorazepam
If oral unsuccessful try injection therapy. Still use lorazepam.