R11: Guide To Mental Health Act Pp75-108

Question 0

Forensic patients who are found to be unfit to be tried: (3)

Answer 0

Tribunal must review the case ASAP and decide:

• person likely to become fir to be tried over the next 12 months?
• detain in hosp. For treatment?
• safety of public endangered by release?

Question 1

Electro-Convulsive Therapy

Answer 1

• 2 diffs present (1 must be experienced in ECT and one exp in anaethesia and a psychiatrist)
• need to explain procedure, risks, benefits and alternatives for informal patients consent
• for involuntary patients you must apply to the Mental Health Review Tribunal

Question 2

Forensic patients found not guilty by reason of mental illness:

Answer 2

Tribunal must meet and make recommendations to the minister for health concerning the person’s:

• detention, care and treatment
• whether it is appropriate to release the person either conditionally or unconditionally

Also note that those who become mentally ill in prison can be transferred to hosp if determined by 2 doctors.

Question 3

Forensic patients must be reviewed every 6 months to assess:

Answer 3

• continued detention, care or treatment
• the current status of their fitness to be tried for an offence
• whether they can be appropriately released

Question 4

Enacting a schedule (5)

Answer 4

Police assistance:

• should not be routinely sought in these situations
• should only be requested after consultation b/w the GP and mental health team

When police assistance is required they should:

• in most cases accompany the person in an ambulance
• use a police vehicle only where there is a risk to the safety of ambulance officers and/or their vehicle

N.B. MH staff and GPs should not give police a schedule and expect them to enact it w/o assistance

Question 5

Community orders actioning their breaching

Answer 5

Where police assistance is required to take a person to a hospital or health care agency as a result of breaching their CTO, MH staff should:

• contact police and inform them their assistance will be necessary
• discuss the precise requirements with duty officer including the degree of urgency
• provide background info on the expected situation
• arrange to meet at a time and location which enables the officers to be fully briefed
• hand the relevant documentation to the police

Question 6

YP can be admitted as involuntary patients in the same way as adults and always have the same rights and threshold for informed consent. Informal admission of children has some provisions: (5)

Answer 6

• a child may request voluntary admission
• if the child is under 16, the p/g must be notified ASAP
• if 14/15 they may choose to continue as a voluntary patient even where a p/g objects
• if under 14 parental consent is essential for the admission to proceed
• if child under 14, where a p/g objects to the care or treatment, the medical superintendent must discharge them.

Question 7

Older ppl

Answer 7

• no specific provisions under Act but Act can be used to provide for them. I.e. Alzheimer’s doesn’t qualify as mental illness but delirium and risk of serious harm
• similarly older males have highest rate of suicide esp schizophrenia or bipolar so need to be monitored

Question 8

Nesb clients have higher rates of

Answer 8

• involuntary admission
• police involvement
• ECT
• CTOs

Thus the use of interpreters and cross-cultural consultants important though out the entire process.