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- 1What does Section 5 (2) of the Mental Health Act 1983 allow a doctor to do?Use his/her "holding power" to assess a patient under Section 2 and 3 of the Act. Can hold a patient up to a maximum of 72 hours.
- 2What are the seven main sections of the Mental Health Act and what do they pertain to?SECTION 2: Assessment order. Lasts up to 28 days. 2 doctors and an AMHP required. SECTION 3: Treatment order. Can last up to 6 months. Requires 2 doctors and an AMHP. SECTION 4: Emergency order. Can last up to 72 hours. Requires one doctor and an AMHP. SECTION 5(2): Emergency order. Can last up to 72 hours. Requires 1 doctor. SECTION 5(4): Emergency order. Can last up to 6 hours. 1 Registered Mental Health Nurse. SECTION 135: Power of entry and removal to a place of safety. Lasts up to 72 hours. Requires a Magistrate. SECTION 136: Place of safety. Lasts up to 72 hours. Requires police officer.
- 3How is Section 2 of the MHA used?This is used when there is no clear psychiatric diagnosis at the given time. It allows you to hold and treat someone against their will for up to 28 days. After this time, a decision needs to made as to whether a Section 3 order needs to be implemented or whether you are to begin treating the patient informally. You cannot implement two Section 2 orders back-to-back.
- 4How is Section 3 of the MHA used?This is used when there is a definitive psychiatric diagnosis or prognosis. It allows you to hold and treat someone against their will for up to 6 months. If the section is renewed it lasts a further 6 months, and any further renewal from then on lasts for 1 year.
- 5What can and cannot be done under Section 5(2)?CAN: Hold the patient for Mental Health Act Assessment.
CANNOT: give treatment, do another 5(2) back-to-back, let it lapse, use it in A&E or Outpatients, have leave, get into trouble for doing it in good faith. - 6Who uses a section 5(2)?In a general hospital it is done by the physicians/surgeons - not the psychiatrist!
It is good practice to get the most senior member of the team present to sign the form.
Only a fully registered medical practitioner can sign the form so a pre-registration house officer, such as an F1, can NOT do it.
If the physician does report the patient under Section 5(2) then the psychiatrist should see the patient as soon as possible.
Section 5(2) only applies to in-patients in a general hospital. - 7What kinds of patients can a Section 5(2) be used for?Patients who are in-patient with a mental illness. If the patient is at risk. If informal admission is no longer appropriate, i.e. the patient wants to leave.
If the patient needs an assessment for Section 2 or 3. - 8Who needs to be informed that a Section 5(2) has been completed?An Approved Mental Health Professional or Specialist Registrar Psychiatrist should be informed. The patient will then be followed up by a Mental Health specialist.
- 9What is Section 136?This is an order which gives the police power to remove a person who they consider to have a mental disorder to a "Place of Safety". This particular order can last up to 72 hours. A Place of safety is a place which is locally agreed upon and is usually a special 136 suite, but can include wither a police station or A&E. Once the person has been taken to a place of safety under Section 136 they can be assessed, and a Section 2 or Section 3 order can be implemented.
- 10What is a Community Treatment Order?This is when a person may be treated under the MHA and still live in the community. This particular order only relates to the patient's psychiatric care and if the said person were to seek healthcare services, that person's health care should be given as normal and their psychiatric condition does not necessarily need discussion. All treatment should be consensually given according to the Mental Capacity Act.
However, if the circumstances to which a person is required to seek medical advice is in direct consequence of their mental illness, then psychiatric care must be given. - 11What is the purpose of the Mental Capacity Act?The MCA 2005 provides the first definite legislation to protect vulnerable individuals who are deemed not to have capacity to make their own decisions. The act provides the means to assess whether or not an individual has capacity it, and, if not, how those caring for them can make decisions in their best interests. It applies to people aged 16 or over, as those below 16 can have consent given by their parents.
- 12What are the 5 principles underpinning the MCA 2005?1. An adult is assumed to have capacity unless it is established that they lack capacity.
2. A person is not to be treated as unable to make a decision unless all practicable steps to help them to do so have been taken without success.
3. A person is not to be treated as unable to make a decision merely because they make an unwise decision.
4. Anything done for, or on behalf of, the person must be in their best interests.
5. Anything done for, or on behalf of, the person should be the least restrictive option with respect to their basic rights and freedoms. - 13What is required for a person to have capacity?MCA 2005 sets out a clear test for assessing whether a person lacks capacity it to make a particular decision at a particular time. The person must:
* Have general understanding of the decision and why they need to make it.
* Have a general understanding of the likely consequences of making, or not making, the decision.
* Be able to understand, retain, use, and weigh up the information presented to them.
* Be able to communicate their decision to others.
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- Degree Psych Fichas sobre Legal Stuff, creado por Anna Walker el 13/03/2015.
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- Anna Walker
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