1 / 24

INVOLUNTARY TREATMENT & DETENTION

INVOLUNTARY TREATMENT & DETENTION. The Mental Health Act. Purpose of the Mental Health Act.

prisca
Download Presentation

INVOLUNTARY TREATMENT & DETENTION

An Image/Link below is provided (as is) to download presentation Download Policy: Content on the Website is provided to you AS IS for your information and personal use and may not be sold / licensed / shared on other websites without getting consent from its author. Content is provided to you AS IS for your information and personal use only. Download presentation by click this link. While downloading, if for some reason you are not able to download a presentation, the publisher may have deleted the file from their server. During download, if you can't get a presentation, the file might be deleted by the publisher.

E N D

Presentation Transcript

  1. INVOLUNTARY TREATMENT & DETENTION The Mental Health Act

  2. Purpose of the Mental Health Act The mental health act provides authority to physicians, the police and the courts to apprehend, detain and treat mentally ill individuals if they are presenting in a condition in which they are likely to be a danger to themselves or others and are unsuitable for admission to hospital in any other way than as a formal patient.

  3. Conveyance • Admission Certificate issued by a physician (Form 1), • Under a Mental Health Warrant issued by a provincial judge (Form 7 &8), • Statement of Peace Officer on Apprehension issued by a peace officer (Form 10).

  4. Criteria for Commitment The person examined is: • Suffering from a mental disorder • In a condition presenting or likely to present a danger to himself or others • Unsuitable for admission to a facility other than as a formal patient

  5. Definition of Mental Disorder As defined in the Mental Health Act: A substantial disorder of thought, mood, perception, orientation, or memory, that grossly impairs: 1. judgment 2. behavior 3. capacity to recognize reality 4. ability to meet the ordinary demands of life

  6. Brief MSE • Appearance, behavior & attitude • Speech • Affect and mood • Thought content, form and concentration • Orientation • Memory • Fund of knowledge • Insight and judgement

  7. Appearance, Behavior, and Attitude • Manner of dress • Psychomotor behavior • Attitude

  8. Affect Visible reaction a person displays toward events Described as constricted, normal range, appropriate to context, flat & shallow Mood Underlying feeling state or tone Described as anxious, depressed, dysphoric, euphoric, angry, & irritable Affect and Mood

  9. Thought Content, Form & Concentration • Thought Content:examined to identify irrational thoughts, fixations, or distrubances indicative of delusions, illusions or hallucinations

  10. Thought Content, Form & Concentration (2) • Thought Form: sequence of thoughts, logical connections, ability to provide specific information • Concentration: lack of is an indication of thought disturbance

  11. Orientation Includes: time, place, person and self Assesses: confusion or clouding of consciousness

  12. Memory • Both recent and remote memory are assessed.

  13. Fund of Knowledge Also known as the patient’s basic knowledge and awareness of social events.

  14. Insight & Judgement • Patients ability to identify the existence of a problem and to have an understanding of its nature. • Social Judgment may be indicative of psychopathology such as personality disorder, mania, schizophrenia, etc.

  15. Quality Relevance Appropriateness to topic Coherence Clarity Volume Quantity The amount The rate pressure Speech

  16. Example MSE 33 yr. old married woman who is morbidly obese & slightly disheveled. Cooperative with the interviewer. Mood is depressed with a flat affect. Tearful throughout the interview. Poor historian, with tangential thinking evidenced in monotone answers to interviewer. Thought content reveals feelings of low self-esteem. as well as auditory hallucinations that are self-demeaning. Admits to suicidal ideas and plan, is unable to identify any supportive resources. Orientation x4. Recent and remote memory intact. Fund of knowledge is 2/4. The patient shows some insight saying she’s “just not able to think straight.” Patient states she is going to call a cab as she wants to go home.

  17. Assessment of Dangerousness Static factors: history of violence toward self or others, addictions and other factors from the past. Dynamic factors: current mental state and environmental issues that influence the current risk.

  18. Detainment First (Form 1) certificate is valid for not more than 24 hours from time of arrival in facility. 2 Admission Certificate (Form 1) issued within 24 hours of arrival at facility is valid for not more than 1 month.

  19. Treatment and Control • Admission certificates only provide the right to detain and treat in emergent situations.

  20. Mental Competence Competence is task specific “A person is mentally competent to make treatment decisions if he is able to understand the subject matter relating to the decisions, and is able to appreciate the consequences of making the decisions.”

  21. If Treatment is Declined Patient is competent: - the physician may appeal to the review panel for a treatment order Patient is incompetent: - Agent under the Personal Directives Act - Guardian under the Dependent Adults Act - Nearest relative

  22. Nearest Relative Consent • Agrees to consent to treatment – physician treats • Objects to consent to treatment – physician appeals to review panel for treatment order • Agrees to treatment but refuses to consent – office of Public Guardian for a substitute decision maker • No relative available - same as above

  23. The Review Panel • Quasi-judicial body when makes decisions r/t detention, mental competence & treatment • Accountability

  24. Presentations to Review Panel • Onus is on the facility • Review panel deliberates on the Balance of Probabilities • Criteria of certification must be met

More Related