The Mental Health Act and Mental Capacity Act

Question 1

What can the mental health act be used for?

Answer 1

Enforcing treatment for mental health conditions to minimise undersirable effects of the condition on the individual

Question 2

What must be the case in order to section a patient?

Answer 2

The disorder must be of a certain nature or degree, and there must be significant risk to self/others if left

Question 3

What is Section 2 for?

Answer 3

Admission to hospital for assessment

Question 4

How long does section 2 work for?

Answer 4

Up to 28 days

Question 5

Who has to approve a section 2?

Answer 5

An approved MHA professional and an approved Doctor

Question 6

Can a section 2 be appealed?

Answer 6

Yes

Question 7

What is section 3 for?

Answer 7

Admission to hospital for treatment

Question 8

How long does section 3 work for?

Answer 8

Up to 6 months

Question 9

Who has to approve a section 3?

Answer 9

2 AMHPs (1 must be independant of the patients treatment)

Question 10

Can a section 3 be appealed?

Answer 10

Yes

Question 11

What happens after 3 months under section 3?

Answer 11

A consent to treatment form must be filled in to review the patients treatment plan vie Second opinion appointed doctor (SOAD)

Question 12

What is a section 5(2)?

Answer 12

An act allowing detention of patients already in hospital

Question 13

How long does section 5(2) work for?

Answer 13

Up to 7 hours

Question 14

What does section 5(2) allow?

Answer 14

The pt to be seen by 2 doctors to assess them for further treatment or sectioning

Question 15

Can you appeal a section 5(2)?

Answer 15

No

Question 16

What is a section 5(4)?

Answer 16

Nurses’ power to detain a person being treated for a mental disorder as a hospital in-patient

Question 17

How long does section 5(4) work for?

Answer 17

Up to 6 hours

Question 18

What does section 5(4) allow?

Answer 18

A patient to be assessed for staying in hospital or further MH disorder treatment

Question 19

Can you appeal a section 5(4)?

Answer 19

No

Question 20

What is section 136?

Answer 20

The police can take someone from a public place to a place of safety (eg ward, A&E, police cells) for 72 hours until assessment

Question 21

What is a community treatment order?

Answer 21

A legal order made by the Mental Health Review Tribunal or by a Magistrate. It sets out the terms under which a person must accept medication and therapy, counselling, management, rehabilitation and other services while living in the community

Question 22

What is capacity?

Answer 22

The ability to make a decision based on information given, remembered, and retrieved

Question 23

What should be the case with capacity?

Answer 23

It should be assumed, incapacity should be proven

Question 24

WRT capacity, what do patients have the right to do?

Answer 24

Make bad decisions

Question 25

What is in place for the incapacitated adult?

Answer 25

Legal safeguards to prevent ill treatment or willful neglect

Question 26

Can lack of capacity be short term?

Answer 26

Yes

Question 27

What must decisions made for the patient without capacity be?

Answer 27

In the patients best interest and should be the least restrictive of their basic rights and freedoms

Question 28

What does the MCA allow patients to do before losing capacity?

Answer 28

Designate someone to make decisions on their behalf for when they lose capacity

Question 29

What is the definition of a mental disorder under the MHA?

Answer 29

“Any disorder or disability of the mind’. This covers a range of disorders including schizophrenia, depression, anxiety disorders and eating disorders.

NB Suffering from one of these disorders by itself does not mean that a person is subject to the provisions of the Act.

Question 30

How does the MHA view learning disabilities?

Answer 30

A disability will only fall within the definition of a mental disorder if it is associated with abnormally aggressive or seriously irresponsible conduct.

Question 31

What is section 17?

Answer 31

Allows a S2 or S3 pt leave if they are assessed as safe to do so

Question 32

When a pt is under level 1a monioring on the wards, what does that mean?

Answer 32

Constant oservation within an arms length, including full sight

Question 33

When a pt is under level 1b monioring on the wards, what does that mean?

Answer 33

Constant observation within close proximity including full sight

Question 34

When a pt is under level 2 monioring on the wards, what does that mean?

Answer 34

Intermittent observations, usually every 15 minutes

Question 35

When a pt is under level 3 monioring on the wards, what does that mean?

Answer 35

Hourly checks

Question 36

If we have done everything we can to help a patient make a decision, but they are still unable to, can we then treat them as incapacitated?

Answer 36

Yes

Question 37

Before we make a decision on behalf of the pt, what must we consider?

Answer 37

If there is another way to achieve what we are trying to achieve which is less restrictive of the person’s rights and freedoms

Question 38

What are the 4 steps to making an informed decision?

Answer 38

• Understand information given
• Retain information
• Weigh up/use the information to make a decision
• Communicate that decision back

Question 39

If a patient seems likely to regain capacity soon, what should you consider?

Answer 39

Can this decision/action wait until they have capacity again?

Question 40

If a pt draws up an advanced decisions document, what can it contain?

Answer 40

Their preference of a range of treatments, and treatments they would specifically not want to have if they lose capacity.

Question 41

What is the name for when a pt under 16 can give consent?

Answer 41

Gillick competence

Question 42

For Gillick competence, what must the pt demonstrate?

Answer 42

The ability to make an informed decision and understand their choices relating to treatment

Question 43

Can a demented person give consent?

Answer 43

Yes - if they can make the decision in the moment, but forget later on, they still have capacity because they made an informed choice.

Question 44

What is important about capacity and they types of decisions the pt can make?

Answer 44

Capacity is not a catch-all. A pt can have capacity for certain things, and not others.

Question 45

What must the pt not have in order to be placed under section?

Answer 45

Capacity!!!

Question 46

If a pt walks into A&E and is clearly having a manic episode, but can demonstrate capacity, and tells you they don’t want treatment, what do you do?

Answer 46

You have to let them walk away, because they had capacity so you can’t section them

Question 47

When is a section 4 used?

Answer 47

When using a section 2 would cause undesirable delay.

Question 48

How long does a section 4 last?

Answer 48

72 hours

Question 49

What is required to place a pt under section 4?

Answer 49

Only 1 doctor needs to make the recommendation. A second order can then be made within the 72 hours to upgrade to section 2.

Question 50

Why would a doctor or nurse put a pt under section 5?

Answer 50

To secure the health and safety of a pt who is trying to leave, or to secure the safety of other pts on the ward

Question 51

What is a section 135 and who uses it?

Answer 51

Police - can take a person from a private place to a place of safety. Lasts 72 hours so a MH assessment can be carried out.

Question 52

What is a section 136 and who uses it?

Answer 52

Police - can take a person from a public place to a place of safety. Lasts 72 hours so a MH assessment can be carried out.

Question 53

What counts as a place of safety?

Answer 53

A hospital or police station

Question 54

Who else can request an assessment of a pt?

Answer 54

The pts nearest relative

Question 55

If the nearest relative who referred a pt pbjects to their relative being put nder section 3, what happens?

Answer 55

That pt cannot be sectioned unless the county court overrules the decision.