Mental Health Act (1983) Flashcards
What is the Mental Health Act (MHA)?
Main piece of legislation that covers the assessment, treatment and rights of people with a mental disorder (excluding alcohol/drugs use alone)
Allows people to be detained in hospital or police custody and have their disorder assessed or treated against their wishes, officially known as “sectioning”
People detained under the MHA need urgent treatment for a mental health disorder as they are at risk of harming themselves or others
What is Section 135 used for?
On private premises, police have powers to enter your home, if need be by force, under this warrant
Individual may then be taken to a place of safety ie hospital/police station, for an assessment by an approved mental health professional and a doctor
Individual can be kept there until the assessment is completed, up to a maximum of 72 hours
Police should remain present for time it takes to assess under section 2 or 3, dont let them leave
What is Section 136 used for?
Functions as a 135 but for when an individual is found and detained from a public place (including GP practices and A+E)
What is a Section 5(4) used for?
If you are already in hospital - certain nurses can stop patients leaving under Section 5(4) until the doctor in charge of your care or treatment, or their nominated deputy, can make a decision about whether to detain the individual there under Section 5(2)
Can detain an individual for up to 6hrs; cant coercively treat
What is a Section 5(2) used for?
Gives doctors the ability to detain someone in hospital for up to 72 hours, during which time the individual should receive an assessment that decides if further detention under the Mental Health Act is necessary
Cant be coercively treated under this section
What is a Section 2 used for?
Admission for assessment:
allows admission and assessment of a patient for up to 28 days, not typically renewed - treatment can be given for mental disorder without consent
Application is made by the Approved Mental Health Professional (AMHP) and two doctors make written recommendations
What is the role of an AMHP?
The AMHP is takes the lead role in a Mental Health Act Assessment
Before ‘07 - was done by social worker, now extended to other clinicians ie community psychiatric nurses that have undergone specialist training
AMHP will act on behalf of nearest relative by coordinating the assessment and making formal section application
What are the role of the other 2 doctors (involved in a Section 2)?
One doctor (usually psychiatrist, also GP) should have approval from the secretary of state under Section 12 (will have had 6m-1yr psychiatric experience)
The second doctor (F2 and above) should be someone who has previous knowledge of the patient, usually GP
What is a Section 3 used for?
Admission for treatment
For patients who are already known to the service or who have already been assessed under Section 2
Lasts for up to 6 months - can be renewed thereafter
Application is made by the same professionals as in a section two
What is a Section 4 used for?
Emergency admission
Used to admit a patient when only one doctor can be found - this doctor may be the GP
The AMHP makes the application and the doctor makes the recommendation
detention is limited to 72 hours
The purpose of the detention is so that a full Mental Health Act assessment can be undertaken
What are the underlying principles of the
MHA?
Respect for patients past and present wishes and feelings
Respect for diversity generally
Minimising restrictions on liberty - psychiatrists are the only people who can restrict liberties indefinitely (unlike courts)
Involvement of patients in planning, developing, delivering care appropriate to them - discuss your plans to section patient and your reasons why (even though they may lack insight to understand)
Avoidance of unlawful discrimination
Effectiveness of treatment
Views of carers and other interested parties
Patient well being and safety
Public safety
What evidence is required for a Section 2?
1) Patient is suffering from a mental disorder of a nature/degree that warrants detention in hospital for assessment AND
2) Patient ought to be detained for his or her own health or safety (more common) or the protection of others
Information provided must be explicit and specific
What additional information is required for a section 3?
Appropriate treatment must be available for the patient - again, made explicitly clear - what is the treatment plan, beds available etc
What is a CTO?
Community treatment order
Made by patients responsible clinician to allow treatment in the community under the MHA
Can also recall to hospital to give emergency treatment if necessary
Various conditions patient has to follow - have to go to certain places/appointments for treatment
Only if on a section 3 (also section 37 hospital order) NOT 2, 4, 5
Again lasts 6months and can be renewed by clinician indefinitely
