Legal & Ethics

Question 1

What is the Mental Health Act (2007)?

Answer 1

legal framework for informal and compulsory care/treatment of people with a mental disorder in England and Wales.

Question 2

What is a Mental disorder?

Answer 2

includes mental illness, personality disorder, learning disability (with “abnormally aggressive behaviour” or “seriously irresponsible conduct”), and disorders of sexual preference (e.g. paedophilia).

Question 3

People under the influence of ________ cannot be detained under the MHA.

Answer 3

drugs and/or alcohol

Question 4

Which individuals are involved in the application of the MHA ?

Answer 4

Section 12 doctor
Approved mental health professional (AMHP)
Responsible clinician
Nearest relative

Question 5

Section 12 doctor

Answer 5

a doctor approved to make specific medical recommendations.

Question 6

Approved mental health professional (AMHP)

Answer 6

mental health worker (e.g. social worker, psychologist, mental health nurse, occupational therapist) who has additional mental health training and is approved by the local authority.

Question 7

Responsible clinician

Answer 7

an approved clinician with the overall responsibility of patient care, they are responsible for renewing sections and discharging patients from a section.

Question 8

Nearest relative

Answer 8

first relative in the MHA list.

Question 9

What is Section 131 of the MHA?

Answer 9

Section 131 of the Mental Health Act is a section of the legislation which covers the informal admission of patients.

This means that patients can be admitted for care and treatment without formal restrictions, and they are free to leave at any time.

Question 10

To be admitted under section 131, patients must meet the following criteria:

Answer 10

The patient must have capacity
The patient must consent to the admission
The patient must not resist the admission

Question 11

Section 2 of the Mental Health Act is used for

Answer 11

compulsory detention for assessment

Question 12

A person can be detained under section 2 only if both of the following apply:

Answer 12

The person suffers from a mental disorder that warrants detention in hospital for assessment for at least a limited period.
The person ought to be detained in the interests of their own health or safety or the protection of others.

Question 13

What is the maximum period a person can be detained for assessment under section 2 of the MHA?

Answer 13

The maximum period a person can be detained for assessment is 28 days, which cannot be renewed.

Question 14

Under section 2 of the MHA, you can also apply for admission - what is needed for this?

Answer 14

The application for admission can be made by an approved mental health professional (AMHP) or the nearest relative. This application must be supported by two doctors, one of which must be an approved section 12 doctor.

Question 15

Section 3 of the Mental Health Act is used for

Answer 15

compulsory detention for treatment.

Question 16

A person can be detained under section 3 only if all the following apply:

Answer 16

The person suffers from a mental disorder of a nature or degree that makes it appropriate for them to receive treatment in hospital.
It is necessary for the health or safety of the person or the protection of others, that the person should receive treatment which cannot otherwise be provided unless the patient is detained.
Appropriate medical treatment is available for them.

Question 17

What is the maximum period a person can be detained for assessment under section 3 of the MHA?

Answer 17

The maximum period a person can be detained under this section is 6 months, which can be renewed.

Question 18

Under section 3 of the MHA, you can also apply for admission - what is needed for this?

Answer 18

The application for admission can be made by an AMHP or the nearest relative. The nearest relative can oppose this and/or request it is rescinded (unlike section 2).

This application must be supported by two doctors, one of which must be an approved section 12 doctor. Both doctors must have seen the patient in the last 24 hours.

Question 19

Section 4 of the Mental Health Act is used for

Answer 19

admission for assessment in cases of emergency.

Question 20

When is section 4 of MHA used

Answer 20

It is primarily used in outpatient services when it is not possible to wait for a section 2 to be arranged. An application can be made by an AMHP or nearest relative and only requires the support of one doctor.

Question 21

What is the maximum period a person can be detained for assessment under section 4 of the MHA?

Answer 21

This section allows patients to be detained for a maximum of 72 hours, after which it often changed to a section 2

Question 22

Section 5(2)

Answer 22

an emergency order where an inpatient who is a voluntary patient in hospital can be detained for up to 72 hours for a mental health act assessment.

Question 23

who is required to make a section 5(2) application?

Answer 23

Only one doctor (usually the one in charge of the patient’s care) is required to make an application for this section.

Question 24

Section 5(4)

Answer 24

This is similar to section 5(2), but a patient can be detained by a nurse for up to 6 hours to allow further assessment by medical staff.

Question 25

The application for Section 5(4) can be made by a nurse if:

Answer 25

The patient is suffering from a mental disorder to such a degree that it is necessary for their health or safety or the protection of others, that they are immediately restrained from leaving hospital. It is not feasible or practical for a clinician to be immediately available to detain the patient under Section 5(2).

Question 26

Section 135

Answer 26

Section 135 is a court order that allows police officers to enter private property, by force, to remove a person suffering from a mental health disorder and place them in a place of safety (usually an Emergency Department or police station) if there is reasonable cause to suspect that they: Have been ill-treated or neglected Is unable to care for themselves and are living alone

Question 27

What is the maximum period a person can be detained for assessment under section 135 of the MHA?

Answer 27

The patient can be detained under this court order for up to 24 hours (although this can be extended by 12 hours).

Question 28

Section 136

Answer 28

Section 136 allows police officers to detain someone suspected of suffering from a mental health disorder, from a public place to a place of safety without a warrant, for up to 24 hours to allow them to be assessed by a medical practitioner.

Question 29

Section 17a

Answer 29

Under section 17a, patients who are on a section 3 can leave hospital for treatment in the community if they are well enough.

Question 30

Under section 17a: The decision to release a patient from hospital is made by the responsible clinician in agreement with the AMHP if the following criteria are met:

Answer 30

The patient is suffering from a mental health disorder to a degree that is appropriate for them to receive medical treatment It is necessary for the patient’s health or safety or the protection of others, that they should receive treatment Treatment can be provided to the patient without the need to continue to detain them in hospital Appropriate medical treatment is available to the patient