Psych Laws

Question 1

For someone to have capacity, they must be able to:

Answer 1

1. Understand and retain relevant information.
2. Use and weight that information to make a decision.
3. Communicate that decision

Question 2

What are the principles of using the adults with incapacity act Scotland?

Answer 2

1. Intervention must benefit the adult
2. Such benefit cannot reasonable be achieved without the intervention
3. Take account of past and present wishes
4. Consult with other relevant persons
5. Encourage the adult to use residual capacity

Question 3

What does the AWI section 47 certificate not allow you to do?

Answer 3

You cannot use force unless immediately necessary for only as long as is necessary
Cannot authorise transport to place of treatment

Question 4

What does the AWI section 47 certificate allow you to do?

Answer 4

Authorise treatment of a physical disorder in someone without capacity to consent to that treatment

Question 5

What can a welfare guardian not do?

Answer 5

Cannot place the adult in hospital for treatment of mental disorder against their will

Question 6

If power of attorney/welfare guardian comes to a decision the patient doesn’t agree with, what do they need to enforce it?

Answer 6

A compliance order from the sheriff

Question 7

What is the purpose of the mental health act?

Answer 7

Allows for treatment of mental disorder or physical consequences of mental disorder in someone without capacity to consent to treatment.

Question 8

What is the criteria for emergency detention under the mental health act?

Answer 8

1. Likely to have a mental disorder.
2. Significantly impaired decision-making ability regarding treatment, due to mental disorder.
3. Detention in hospital is necessary as a matter of urgency to determine what treatment is needed.
4. Risk to health, safety or welfare of the person or safety of others.
5. Making arrangements for short term detention would involve undesirable delay

Question 9

What is the criteria for short term detention under the mental health act?

Answer 9

1. Likely to have a mental disorder.
2. Significantly impaired decision-making ability regarding treatment, due to mental disorder.
3. Detention in hospital is necessary for assessment or treatment.
4. Risk to health, safety or welfare of the person, or safety of others.
5. Cannot be treated voluntarily.

Question 10

If a young person has incapacity, what should you do (from the children’s act in Scotland)?

Answer 10

Ask one parent for consent (best practice to include both parents in discussion).
If parents disagree, seek legal advice.

Question 11

Does the mental health act have an age limit?

Answer 11

No

Question 12

When would you use the mental health act with young people?

Answer 12

Use of force
Use of IM injection
Certain treatments e.g. NG feeding, ECT
Detrimental impact on relationship with carer

Question 13

What is SIDMA and is it the same as incapacity?

Answer 13

Significantly impaired decision making ability (SIDMA).

No as it is only when caused by mental disorder alone.

Question 14

How long does an emergency detention order last for?

Answer 14

72 hours (can let them go sooner)

Question 15

Does an emergency detention order authorise treatment?

Answer 15

No

Question 16

Who can do emergency detention orders and do 2 people need to agree to it?

Answer 16

Fully registered doctor (FY2 and above).

Where possible a mental health officer should agree to it.

Question 17

How long does a short detention order last for and can you do treatment with it?

Answer 17

Up to 28 days

Yes 28 days of treatment also authorised

Question 18

Who needs to do a short term detention order?

Answer 18

Approved medical practicioner (psych reg or consultant with extra training in MHA) AND a mental health officer.

Question 19

Can a short term detention order be appealed?

Answer 19

Yes by the patient and their named person

Question 20

How long can a short term detention order be prolonged and why?

Answer 20

3 days if extra time needed to apply for CTO

5 days if CTO application submitted

Question 21

How long does a compulsory treatment order last for and how much treatment can be given?

Answer 21

Up to 6 months

Treatment for 2 months

Question 22

Who needs to request a compulsory treatment order and how is the application assessed?

Answer 22

Approved medical practitioner and mental health officer

MHO submits it to mandatory tribunal

Question 23

When can a compulsory treatment order be renewed?

Answer 23

At 6 months, then yearly

Question 24

When can treatment be given on an emergency detention and what certificate needs to be completed after?

Answer 24

To save patient’s life
To prevent serious deterioration in patient’s condition
To alleviate serious suffering
To prevent patient from being a danger to themselves or others
T4 certificate

Question 25

After 2 months of treatment on short term detention/compulsory treatment order, what do you need to do to provide further treatment?

Answer 25

Get a second opinion doctor to come along and authorise the treatment.

Question 26

What are the treatments that need a second opinion doctor to give under a short term detention/compulsory treatment order?

Answer 26

ECT (unless emergency)
Nutrition by artificial means
Vagus nerve stimulation
Transcranial magnetic stimulation
Any medicine to reduce sex drive
Neurosurgery (need patient consent or additional protections)

Question 27

What systems are in place to protect patient’s rights and safeguards?

Answer 27

Advance statements (can be overruled)
Named person
Independent advocacy
Mental health tribunal (psychiatrist, convenor and third person with other experience)

Question 28

What is the nurses holding power?

Answer 28

Registered mental health or intellectual disability nurse
Can hold patient for up to 3 hours if necessary for protection of health, safety or welfare of patient or safety of others

Question 29

What holding powers do the police have?

Answer 29

Removal from public place to place of safety
If someone appears to have a mental disorder needing care and treatment
Up to 24 hours