Psych - MCA And MHA Flashcards
How do you assess someone’s capacity? What must they be able to do?
• Understand information relevant to the decision
• Retain, use and weigh that information to come to a decision
• Communicate that decision
*People have the right to make bad decisions!
What is lasting power of attorney?
- Allows a person with capacity to appoint an attorney to make decisions on their behalf if they lose capacity
- The attorney can be directed by person appointing them to make decisions about property, finances, health
What are advance decisions?
- Anybody with capacity can made an advance decision/directive about treatment the do not want to receive in future if they lose capacity
- Can include life-saving treatment as long as is specifed bu person making advance decision
- Permits person to refuse treatment but not demand it
What is a DoLS? Who does it apply to and what conditions must be met in order for it to be granted?
Deprivation of liberty safeguards (DoLS)
Apply to people in hospitals/homes who:
- Are deprived of liberty
- Lack capacity to make decisions about care and tx
- Not sectioned on Mental Health Act
Can only be granted if assessors agree that:
- Pt is over 18
- Would not conflict with a valid decision by a lasting power of attorney, advance direction, deputy
- Person lacks capacity whether to be admitted to, or remain, the hospital or care home
- Person suffering from a mental disorder
- Not detained under the MHA
- Not to enable mental health treatment in hospital of someone who objects to being in hospital or to the treatment (MHA should be considered then)
- Authorisation must be renewed annually
- *Patient or representative may appeal
What is the MHA? What are the requirements for sectioning someone?
MHA: concerned with the care and treatment of patients compulsorily detained in hospital, and those under community treatment order
Requirements:
- Patient is judged to have a mental disorder sufficiently severe to need detention in hospital in the interest of their own health/safety or for the protection of others
- People cannot be detained b/c of a learning disability alone, unless it is associated with abnormally aggressive or seriously irresponsible conduct
- *Mental disorder: any disorder/disability of the mind - includes mental illness, personality disorder, learning disability and disorders of sexual preference but not dependence on alcohol or drugs
What is a section 2?
- Admission for assessment for up to 28 days
- Not renewable
- Approved Mental Health Professional (AMHP) or rarely they nearest relative (NR) makes the application on recommendation of 2 doctors
- Treatment can be given against a patient’s wishes
What is a section 3?
- Admission for treatment for up to 6 months
- Can be renewed
- Need AMHP + 2 doctors, both of which must have seen the patient in last 24h
- Treatment can be given against patient wishes
What is a section 4?
- 72h assessment order
- Used as emergency, when a section 2 would involve an unacceptable delay
- Can be done by GP, AMHP or NR
- Often changed to section 2 on arrival to hospital
What is a section 5(2)?
- Used for patients already voluntarily in hospital (any ward but A&E) - can be legally detained by a doctor for 72h
- On recommendation of RC or nominated deputy
- People placed on this section must be assessed for sections 2 or 3 or discharged from 5(2) to become informal
What is a section 5(4)
- Similar to section 5(2) but can be done by a nurse
- Allows to detain a patient who is voluntarily in hospital for 6h
What is a section 17a?
- Supervised community treatment order
- Can be used to recall a patient to hospital for treatment if they do not comply with conditions of the order in the community (ie not taking their medication)
What is a section 135?
-Court order that can be obtained to allowed police to a property to remove a person (who is believed to be suffering from a mental disorder) to a place of safety
What is a section 136?
-Empowers a police officer who finds a person in a public space appearing to suffer from a mental disorder to remove them a place them in a place of safety for assessment
