Mental Health Act and capacity flashcards
10 high-yield MRCP Part 1 cards from the Intellect Medicos Psychiatry course. Try to answer each question before you open it — then study them properly with spaced repetition, which brings each card back just before you would forget it.
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Which section of the Mental Health Act 1983 allows detention for assessment for up to 28 days?
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Section 2.
Why? It needs recommendations from two doctors (one section 12-approved) and an application, usually by an Approved Mental Health Professional (AMHP). It cannot be renewed.
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For how long can a patient initially be detained for treatment under section 3 of the Mental Health Act?
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Up to 6 months (renewable for a further 6 months, then yearly).
Why? Section 3 is used when the diagnosis is known and treatment in hospital is needed. It also needs two doctors and an AMHP.
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An informal inpatient on a medical ward with severe depression and suicidal intent is trying to leave. The psychiatric team cannot attend for some hours. Which holding power can the doctor in charge of his care use, and for how long?
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Section 5(2), lasting up to 72 hours.
Why? It allows time for a full Mental Health Act assessment. It applies to inpatients on any ward, and the doctor in charge or a nominated deputy can use it.
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Under the Mental Capacity Act 2005, what four things must a person be able to do to have capacity for a decision?
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Understand the relevant information, retain it, use or weigh it, and communicate the decision.
Why? Capacity is assumed unless shown otherwise, it is specific to the decision and the time, and an unwise decision does not by itself mean a lack of capacity.
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A man detained under section 3 for schizophrenia sustains a hip fracture and refuses surgery. Can the Mental Health Act be used to authorise the operation?
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No. The Mental Health Act only covers treatment of the mental disorder; if he lacks capacity, surgery is given in his best interests under the Mental Capacity Act.
Why? Treatment for an unrelated physical condition is not covered by the Mental Health Act. If he has capacity, his refusal must be respected.
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Which section of the Mental Health Act lets the police remove a person who appears mentally disordered from a public place (anywhere except a private home) to a place of safety?
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Section 136 (up to 24 hours, extendable by 12 hours).
Why? It allows assessment by a doctor and an AMHP. Section 135 is the equivalent for private premises, which needs a magistrate's warrant.
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Which section of the Mental Health Act allows emergency admission for up to 72 hours on the recommendation of one doctor?
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Section 4.
Why? It is used only in urgent necessity, when waiting for a second doctor for a section 2 would cause undesirable delay. It is usually converted to a section 2.
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A woman with severe anorexia nervosa, BMI 12, is detained under section 3. She refuses food and nasogastric feeding. Can nasogastric feeding be given under the Mental Health Act?
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Yes. Feeding is treatment of the mental disorder itself (its consequence), so it can be given under the Act.
Why? Unlike an unrelated physical problem (e.g. a hip fracture), malnutrition is a direct result of the eating disorder, so the Mental Health Act covers it.
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A nurse's holding power, section ______, can keep an informal inpatient who is being treated for a mental disorder in hospital for up to 6 hours until a doctor arrives.
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5(4)
Why? The doctor's holding power, section 5(2), lasts up to 72 hours.
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A nurse's holding power, section 5(4), can keep an informal inpatient who is being treated for a mental disorder in hospital for up to ______ until a doctor arrives.
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6 hours
Why? The doctor's holding power, section 5(2), lasts up to 72 hours.