Psychiatric Law

Question 1

what counts as a mental disorder under the MHA

Answer 1

mental illness (including dementia)
learning disability
personality disorder

Question 2

what are the criteria for an emergency detention

Answer 2

• patient likely has a mental disorder
• the mental disorder is impairing their ability to make decisions regarding their treatment
• matter of urgency to detain them to decide on treatment
• if they werent detained there would be a risk to themselves or others
• Short term detention would add undesirable delays

Question 3

can you treat someone under the emergency detention

Answer 3

no
- unless life saving, to alleviate serious suffering, to prevent serious deterioration or to prevent risk to patient or others

Question 4

how long does an ED let you detain a patient

Answer 4

72 hours for further assessment

Question 5

who can carry out an ED

Answer 5

FY2 and above

Question 6

who should ideally be informed of an ED

Answer 6

MHO

Question 7

can an ED be legally appealed

Answer 7

no

Question 8

what law is used to detain and treat patients in scotland with a mental disorder however caused or manifested

Answer 8

mental health care and treatment act 2003

Question 9

what is the criteria for a short term detention

Answer 9

• patient has a mental disorder
• mental disorder is impairing ability to make decisions regarding treatment
• necessary to detain patient to decide treatment
• not detaining patient would pose a risk to patient or others
• short term detention is necessary

Question 10

how long does a short term detention last

Answer 10

28 days

Question 11

does a short term detention allow treatment

Answer 11

yes

Question 12

can a short term detention be extended

Answer 12

yes - by 3 days to put together an application for CTO

by 5 days once CTO is submitted

Question 13

who can apply for a short term detention

Answer 13

approved medical practitioner - trained psychiatrist (ST4+)

Question 14

can a short term detention be appealed

Answer 14

yes by the patient and a named person

in front of a tribunal or mental health welfare commission

Question 15

what treatments are not covered by short term detention

Answer 15

ECT
artificial nutrition
vagus nerve stimulation
transcranial magnetic stimulation
hormonal medicine to reduce sex drive 
neurosurgery

Question 16

does a short term detention require consent of MHO

Answer 16

yes absolutely

Question 17

what is the criteria for a CTO

Answer 17

• patient has a mental disorder
• mental disorder is impairing patients ability to make decisions regarding treatment
• there is treatment available for the mental disorder
• not treating the patient would pose a risk to patient or others
• CTO is necessary

Question 18

who sits on the tribunal panel when applying for a CTO

Answer 18

(i) A lawyer
(ii) A psychiatrist
(iii) A person with other skills and experience, e.g. a nurse, social worker or someone with personal experience of mental disorder

Question 19

who can apply for a CTO

Answer 19

MHO with supporting letters from 2 approved medical practitioners, both of whom have examined the patient and one of whom is the psychiatrist in charge of the patients care

Question 20

how is a CTO decided

Answer 20

heard in front of a tribunal where patient is entitled to legal representation

Question 21

if granted what can a CTO impose

Answer 21

treatment and residence conditions

Question 22

how long does a CTO last

Answer 22

6 months initially

reviewed at 6 months then yearly

Question 23

can a CTO be appealed

Answer 23

yes by patient or named person

Question 24

what is an advanced statement

Answer 24

written by the patient when they are deemed to have capacity outlining how they wish to be treated should they become unwell and lose capacity

Question 25

does a CTO have to abide by advanced statement

Answer 25

has to regard it but can be overruled - need to explain why it has been

Question 26

what is a named person

Answer 26

someone who will look after the persons interests if they have to be treated under the MHA

Question 27

what is an independent advocate

Answer 27

everyone under the MHA with a mental disorder is entitled to an IA who will support patient and help them ot explain their own views about treatment

Question 28

what is capacity

Answer 28

the ability to use and understand information to make a decision and be able to communicate this decision

Question 29

does capacity depend on the decision

Answer 29

yes - may have capacity for one decision but not another

Question 30

what is consent

Answer 30

permission for something to happen or agreement to do something

Question 31

assessment of capacity can be carried out by who

Answer 31

FY2 and above

Question 32

in order to have capacity what must a patient be able to do

Answer 32

- understand the treatment with regard to nature, purpose and requirement - understand risks, benefits and alternatives - understand the risk of declining treatment - retain information long enough to use it, weigh it up and come to a decision and be able to communicate it

Question 33

how is capacity assessed (acronym)

Answer 33

BURPCCC - believes - understands - retains - processes - communicates - consistency - coercion (none of this)

Question 34

can treatment be given without assessing capacity

Answer 34

yes in an emergency

Question 35

what powers do the police have with regard to detaining someone with a mental disorder

Answer 35

removal to a safe place from a public place | detain for up to 24 hours for assessment

Question 36

what section of the AWIA is a certificate of incapacity

Answer 36

section 47

Question 37

does a certificate of incapacity allow use of force

Answer 37

only if immediately necessary and only for as long as necessary

Question 38

certificate of incapacity allows who to make the decision on behalf of the patient

Answer 38

doctor or by appointed proxy

Question 39

who has power of attorney (named person)

Answer 39

individual who is appointed by the patient when they have capacity to have authority to make decisions for them

Question 40

what is a guardianship order

Answer 40

when there is no power of attorney so the court appoints an individual to act and make decisions on behalf of someone with incapacity

Question 41

who grants a guardianship order

Answer 41

sheriff

Question 42

can a welfare guardian place an adult in hospital for tx of MHD against their will

Answer 42

no

Question 43

what is an intervention order

Answer 43

order that authorises a person to act and make one off decision for an adult with incapacity

Question 44

what can be issued if adult doesnt comply with wishes of welfare guardian

Answer 44

sheriff can issue a compliance order

Question 45

children under the age of what are deemed to not have capacity

Answer 45

12

Question 46

do ages 12-16 have capacity

Answer 46

may do, depends on understanding

Question 47

over what age are you assumed to have capacity

Answer 47

16

Question 48

who makes the decision if a child lacks capacity

Answer 48

parents

Question 49

can a parent overrule decision by child deemed to have capacity

Answer 49

no

Question 50

what happens if a doctor disagrees with parents decision

Answer 50

doctor can seek to over rule decision of parent

Question 51

how long can a nurse holding power detain someone

Answer 51

up to 3 hours

Question 52

what is the criteria for treating patients under the AWIA 2000

Answer 52

intervention is in the best interest of the patient, will benefit them and such benefit couldn't be achieved without the intervention

Question 53

what is first line in tranquilising a patient

Answer 53

oral lorazepam

Question 54

what is 2nd line in tranquilising a patient

Answer 54

haloperidol - IM/PO