Law And Mental Health

Question 0

Mental Capacity act 2005 covers

Answer 0

Consent and capacity

Question 1

Mental health act 2007 covers

Answer 1

Compulsory admission and treatment of mental illness

Question 2

Mental health act is concerned with those who…

Answer 2

Are considered to be a risk to themselves or others

And suffer from a ‘mental disorder’

Question 3

MHA defines ‘mental disorder’ as

Answer 3

Any disorder or disability of the mind

Quite broad

Question 4

MHA key points

Answer 4

Can only be detained if appropriate medical treatment available
Do not apply for treating physical illness
Those under sections 2&3 can appeal against decisions

Question 5

How many inpatients in mental health units are admitted under MHA?

Answer 5

10-15%

Question 6

Section 2

Answer 6

Admission for assessment
Max 28 days
Need 2 Drs to recommend - one section 12 approved

Question 7

Section 3

Answer 7

Admission for treatment
Maximum 6 months
2 Drs, at least one section 12 approved

Question 8

Section 5(2)

Answer 8

Holding order for patient already on ward
Maximum 72 hours
One doctor to recomend

Question 9

Section 136

Answer 9

Police can remove person appearing to suffer from ‘mental disorder’ from public place to ‘place of safety’

Question 10

Capacity

Answer 10

Ability to make decisions
Presumed intact
Related to specific decisions

Question 11

To have capacity must be able to…

Answer 11

Understand the relevant information
Retain that information
Use that information to make decision
Communicate that decision

Question 12

If a person lacks capacity..

Answer 12

Steps may be taken in their best interests
Least restrictive, allow maximum participation in decision
Take into account personal beliefs

Question 13

To give valid consent one needs

Answer 13

Mental capacity
Sufficient information
Lack of coercion

Question 14

Mental capacity act - 2 stage test for capacity

Answer 14

1. Impairment/disturbance in functioning of mind/brain

2. Does this mean they are unable to make a specific decision when they need to?

Question 15

Capacity of patients admitted acutely to general medical beds:

Answer 15

40% lack capacity for treatment decisions if subjected to detailed assessment
Most go along with treatment and understand they are in hospital

Question 16

Key cause of mental incapacity is:

Answer 16

Cognitive impairment

Question 17

What percentage of patients without capacity are recognised as such?

Answer 17

25%

Question 18

Psychiatric patients and capacity

Answer 18

60% acute inpatients lack capacity
25% lack capacity and NOT under MHA
Main reason is major disorder - mania/schizophrenia

Question 19

If lacking capacity, consider…

Answer 19

Advance decision
Lasting power of Attorney / Court Deputy
Independent mental capacity advocate

Question 20

Physical illness can only be treated on MHA when…

Answer 20

Mental disorder is caused by physical illness

Physical illness is direct result of mental disorder (eg overdose)

Question 21

Detention under Mental Health Act ends when…

Answer 21

Patient/family can apply to tribunal to review Section
Pt/family can apply to court
Responsible clinician can end Section
Time lapse

Question 22

Section 5.4

Answer 22

Register nurse can detain a patient for 6 hours
In hospital
If considering section 2 or 3

Question 23

Section 135

Answer 23

Police can enter someone’s house and bring them to a place of safety
For 72 hours, for assessment
Need to apply to a magistrate

Question 24

Section 17

Answer 24

Can give patients leave from the ward
Subject to conditions deemed necessary
No limit of duration

Question 25

Consequences of being ‘sectioned’

Answer 25

Under section 3 - get section 117 aftercare
May need to declare on visa applications
Equality act so should not be discriminated against regarding work

Question 27

MHA or capacity act - which takes precedence?

Answer 27

Mental health act.

Risk before best interests

Question 28

Young people in forensic mental health

Answer 28

50% of all offenders are under 21, and 90% of 16-20yrs in prison have some mental health issue and 10% had functional psychosis

Question 29

Section 117 of the MHA

Answer 29

doctors have a duty of aftercare for patients discharged from section 3

Question 30

Section 7 of the MHA

Answer 30

Guardianship – requires the patient to live at a place decided by the guardian and attend for treatment. Access is given to a responsible clinician

Question 31

Advance directives

Answer 31

To be valid needs to be made by a person over 18, with capacity, specific situations where it applies and not have been modified.

Question 32

In order to refuse life saving treatment an advance directive must

Answer 32

Be in writing
Be signed and witnessed
Include the statement that the decision stands even if life is at risk

Question 33

Advance directives cannot

Answer 33

Ask for life to be ended
Force doctors to act against their better judgement
Be used to deny treatment for a mental disorder

Question 34

To make a will a person must be

Answer 34

Aware of the nature and effect of a will
Aware of the extent of their estate
The claims of those included and excluded
Have no mental disorder or be lacking in capacity or be under undue influence by third parties

Question 35

Driving

Answer 35

If the patient has a condition which impacts their ability to drive they must inform the DVLA – if they refuse the doctor must be only after having informed the patient