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tilia

capacity vs MHA

6 posts in this topic

I'm getting a bit confused about it all

any ideas re the following?

1) can you treat consequences of mental illness under the MHA rather than via capacity assessment and common law?

eg selfharm in depression, pt already admitted on S3, what if presenting to A&E as outpt?

am aware this is def the case for eating disorders and refeeding

2) Gillick competence: does it also refer to admission for mental illness or only medical intervention?

eg 15 y old needs psy admission, refusing, parents agreeing, do you then admit with their consent or apply MHA assessment?

any help much appreciated because the more curdrice and I think about it the less we seem to solve these Qs

thanks

t

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I'm getting a bit confused about it all

any ideas re the following?

1) can you treat consequences of mental illness under the MHA rather than via capacity assessment and common law?

eg selfharm in depression, pt already admitted on S3, what if presenting to A&E as outpt?

am aware this is def the case for eating disorders and refeeding

2) Gillick competence: does it also refer to admission for mental illness or only medical intervention?

eg 15 y old needs psy admission, refusing, parents agreeing, do you then admit with their consent or apply MHA assessment?

any help much appreciated because the more curdrice and I think about it the less we seem to solve these Qs

thanks

t

#

if in A/E as outpatient and refusing tx she can be sectioned under the MHA if she has capacity and is mentally unwell.. depressed, psychotic (seen it done)

#

if in A/E and hasnt capacity can be treated under common law as emergency intervention

in the case of the child,. if under 16, can be treated under the direction of her parents or legal guardians despite the childs protest.

ie. what bloomin case can a 15 yr old make?

does this help?

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Gillick competence has nothing to do with refusal of treatment. It is only for accepting some treatment.

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Being detained under the MHA doesn't assume lack of competence. You still need to assess this. You can treat them for their mental illness without their consent, but you'll need their consent to treat any physical problems. If they don't have capacity, you go onto common law, best interest...

In the case of anorexia, refeeding etc, is now considered part of the treatment that can be given under the MHA.

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Good reference here!

http://www.mind.org.uk/Information/Legal/OGMHA.htm

Consent to treatment (Part IV)

Part IV of the Mental Health Act applies to

treatments for mental disorder

all formal patients except those who are detained under sections 4, 5, 35, 135 and 136, subject to guardianship or conditionally discharged. These patients have the right to refuse treatment, as have informal patients, except in emergencies.

Part IV states that

(a) any treatment can be given without the patient’s consent, unless the Mental Health Act or DoH regulations specify otherwise

(B) under section 57, psychosurgery and treatments specified in DoH regulations as giving rise to special concern can only be given if

(i) the patient consents; and

(ii) a multidisciplinary panel appointed by the Mental Health Act Commission confirms that her or his consent is valid; and

(iii) the doctor on the multidisciplinary panel certifies that the treatment should be given. Before doing so, she or he must consult two people, one a nurse and the other neither a nurse nor a doctor, who have been concerned with the patient’s treatment.

Note: as the treatments specified in section 57 give rise to particular concern, this section applies to all formal and informal patients.

© under section 58, certain treatments can only be given if

(i) the patient consents; or

(ii) an independent doctor appointed by the Mental Health Act Commission confirms that treatment should be given. Before doing so, she or he must consult two people, one a nurse and the other neither a nurse nor a doctor, who have been concerned with the patient’s treatment.

Section 58 applies to treatments named in DoH regulations (including electroconvulsive therapy). Medication can be given without the patient’s consent for three months. After that, it is subject to the safeguards laid down in section 58.

Note: under section 62, any treatment for mental disorder can be given without consent in specific emergencies, subject to restrictions when a treatment is irreversible or hazardous.

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