"Philosophical rhetoric when not grounded in reality is nowt but sophistry of the most facile variety." - DeeDee Ramona
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I thought the Mental Nurse readership might be interested to know that WISH’s campaign against the smoking restrictions in mental health inpatient units, Stubbing Out Our Rights, has been launched this week.
The arguments for and against the restrictions have already been debated here in a lot of depth so I won’t go into them again, but if you’d like to wander over to the campaign’s website you will see WISH’s take on the issue.
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So let’s wade into the biggie. The really controversial one. The changes to the treatability test in order to enable the detention of dangerous people with personality disorders.
In particular, I want to show you all how the Mental Capacity Act can be appreciated, respected, even…dare one say it…loved.
What? What are you all doing, stampeding out through the door? Come back, goddammit! I’ll turn you into a bunch of law geeks if it’s the last thing I do!
But please, I can see I’m losing some of you here, so please indulge me for a moment in my law geekery, and read on…
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For the first post, let’s consider the expansion of professions who can be involved in sectioning somebody (and also discharging them from section, or approving Section 17 home leave).
A quick summary: Under current law sectioning decisions are mainly the responsibility of the Approved Social Worker (ASW) - a social worker who has undertaken additional training, and the Responsible Medical Officer (RMO) - a doctor, nearly always a consultant psychiatrist. Under the new law these roles will be opened up to other professions, such as OTs, nurses, psychologists and physiotherapists. As a result the Approved Social Worker role will be renamed Approved Mental Health Professional (AMHP), and the Responsible Medical Officer role will be renamed Responsible Clinician (RC).
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It was similar to the event I discussed before (I Mental Nurse Am An Idiot) and again entirely my own fault. The problem is usually I don’t lose the plot quite so badly. My current job seems to be sucking life out of me.
No that is not correct. Not the job. It is the ward and the ward atmosphere. There is a culture of fear on my ward and it is not pleasant.
I feel myself being driven to cross the staff patient divide … though often there is not that much of a divide.
That is why this post may not be quite what I am intending, which is to finish off the Guide to the Mental Health Act sequence of posts.
The following is entirely from the top of my head, I am not in the best of moods, you take your chances if you read any further. It is of course entirely my own opinion and should not be considered to be the opinion of any other person.
Cynics Guide To Mental Health Act : 5 : Why We Are Allowed To Lock You Up
I was chatting on the phone last night discussing this series of posts. I was quite proud of myself. Then it was pointed out that I was doing it very much the wrong way. I’ll summarise the conversation:
Mental: Surely it’s better to be sectioned so it clarifies to the patient exactly what their position is ?
Person On Phone: No it is not you idiot !
Turns out they were right.
Was intending to use this post to deal with the legalities and suchlike of longer term sections and compulsory treatment orders. Now I am not. Here are some links though.
England
Scotland
That will cover all the stuff you might actually need to know.
Right back to the conversation.
I never used this during the best part of two years of busy acute nursing. Everybody I asked to stop … stopped.
The Nurses holding power.
Section 5(4)
Under section 5(4) you can also be detained by some suitably qualified nurses (first level ones) for up to 6 hours. This is to give time for the doctor to see you to consider applying section 5(2). This time limit cannot be extended.
The criteria are -
that it appears to the nurse:
that you are suffering from mental disorder to such a degree that it is necessary for your health or safety or for the protection of others for you to be immediately restrained from leaving the hospital; and that it is not practicable to secure the immediate attendance of a medical practitioner for the purpose of furnishing a report under Section 5(2) [Doctors Holding Power].
A written record of this must be made by the nurse and given to the hospital managers, or someone appointed to act on their behalf, as soon as possible.
Nurses’ holding power
Nurses can detain patients for urgent medical examination for up to two hours under Section 299 of the Act. Once the doctor arrives, a further hour of detention is allowed. It is not good practice to immediately institute a second period of nurses’ holding power once the initial two hours has elapsed.
Here is a very selective look at the ways you can be detained for being very mad.
Hello again. I believe the American equivalent of sectioning is being certified. Or at least that’s what television teaches me. Being sectioned allows for a mixture of the following:
I will only be touching upon the basic sections. I have very limited experience with community orders or criminal sections. The choices between sectioned and not sectioned lead to three types of patient.
Cynics Guide To The Mental Health Act : 1 : Principles and Definitions
Please take all the following with a pinch of salt. There are many strictly informative sites about the UK mental health system, remember mental nurse is not one of them 
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