Capacity to consent to informal admission to hospital

Socialcaremusings

What are the essential elements to take into account when determining whether a person has capacity to consent to informal admission to a psychiatric hospital?

As Approved Mental Health Professionals (AMHPs), we are trained to use the least restrictive alternative. This phrase only formally arrived on the Mental Health Act scene in 2008 with the publication of the most recent Code of Practice. But as Approved Social Workers (ASWs) before that time, we were very clearly expected to follow the least restrictive route, even though the words did not appear in any legislation or guidance at the time.

But how do you measure levels of restriction?

Historically, it seems that professionals believed the existence of a set of section papers, authorising detention, indicated a higher level of restriction than if the person remained an informal[i] patient, who is, in theory, free to leave the ward whenever they wish. But…

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David

Mental Health Cop

During the inquest last December after the death of David Stacey in Leicester in 2017, his family requested he be known in proceedings by his first name. The story behind David’s death is tragic and will be familiar to all AMHPs, police officers and mental health professionals across the country. The inquest returned its verdict of accidental death contributed to by the neglect of NHS mental health services on Friday 14th December which allowed me to use the verdict as the most pertinent available example on Monday 17th when the Care Quality Commission held an event in Manchester to discuss s140 of the Mental Health Act. Regular readers of this BLOG will know I’ve been banging on about s140 MHA for more than a decade and stubbornly refusing to listen to people more qualified and experienced in these matters than me.

Early in 2019, the Coroner for Leicester issued…

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AND / OR

Mental Health Cop

Compare and contrast the following two pieces of law –

  • Section 136(2) says someone removed to a Place of Safety may be taken there to be examined by a registered medical practitioner and interviewed by an Approved Mental Health Professional; and of making any necessary arrangements for his treatment or care.
  • When you read section 135(1), it says someone may be removed to a Place of Safety with a view to the making of an application under the Act, or of making other arrangements for his treatment or care.

The bold is my emphasis – does it matter that the apparent purpose of one of these Place of Safety orders is interview AND arrangements, whereas the other is interview OR arrangements? … is this a distinction without a difference, or could it be crucial to something?! Both seem to imply the purpose of removing someone to a Place of Safety…

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Because I have capacity

jl's blog

I’ve heard this phrase a lot recently in relation to myself. Mostly it seems to be used as a cop out to avoid admitting me to hospital, give me extra mental health support in a crisis or believe that I’m feeling suicidal. A psychiatrist once said that I can flip in and out of capacity and I think that’s about right. It’s actually quite frightening to be like that. To know that I can dissociate, lose awareness of time or where I am or what I’m doing.

Here’s what the Mental Capacity Act Code of Practice says in general terms

‘Whenever the term ‘a person who lacks capacity’ is used, it means a person who lacks capacity to make a particular decision or take a particular action for themselves at the time the decision or action needs to be taken.’

I’ve been threatened with the Act having taken an overdose…

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Re X (a child) No 3 (2017)

Mental Health Cop

Today, the head of the Family Division has handed down a judgment containing some of the most extraordinary language I’ve ever known a senior judge to use, questioning whether the issues before him mean we can lay claim to being a civilised society and warning that we may soon “have blood on our hands.”

WOW! …. just WOW!!!

It concerns the case of a 17yr old young woman, currently detained under criminal law after being sentenced by a Youth Court and who is due to be released from that secure custody location 11 days from now – the 14th August. It is agreed by prison staff, mental health and social care professionals that she requires admission to an inpatient mental health unit for further assessment and treatment, one estimate being that she may need to be there for as much as two years in the opinion of the Consultant…

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Policing Challenges in 2017

Sobering in parts…..I thought it was bad in the NHS! The level of scrutiny must be unbearable at times, however I can say I see positive practice every day.

policecommander

So here we are then, at the beginning of 2017.

And the multitude of challenges facing the police service in Britain are, it seems to me, greater than at any point since the end of the Second World War.

I.    Operational

There are the crime challenges:

  • Terrorism
  • Serious Violence – including Homicide, Domestic Abuse & Knife Crime
  • Sexual Offences – including Child Sexual Exploitation
  • Human Trafficking
  • Cyber Crime
  • Drug & Alcohol related criminality
  • Fraud (some of it on an industrial scale)
  • And so the list goes on.

And it’s not just crime:

  • Mental Health
  • Missing Persons
  • Roads Policing
  • Anti-Social Behaviour
  • And so the list goes on

Given the fact that everything can’t be a priority, there are any number of exceptionally difficult decisions to be made – not least in terms of the people, resources and money we invest in:

  • crime vs. everything else
  • short-term enforcement vs. long-term prevention

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