Mental Capacity Act 2005: From 1 Different Sources
legislation for England and Wales, which came into force in October 2007, to govern the treatment of people who lack *capacity to make decisions. It gives legal force to the importance of *autonomy in health care and to *advance directives, decisions, or statements. It also provides statutory legislation for medical and social decision-makers to act in the patient’s best interests should he or she lose capacity (see Independent Mental Capacity Advocate). It allows proportionate force to implement decisions made in a patient’s best interests. For Scotland the current legislation is the Adults with Incapacity (Scotland) Act 2000.
All forms of illness in which psychological, emotional or behavioural disturbances are the dominating feature. The term is relative and variable in different cultures, schools of thought and definitions. It includes a wide range of types and severities.... mental illness
See LEARNING DISABILITY.... mental handicap
A disorder characterized by the display of an intellectual defect, as manifested by diminished cognitive, interpersonal, social and vocational effectiveness and quantitatively evaluated by psychological examination and assessment.... mental impairment
The amount of air that can be forcibly exhaled from the lungs after a deep inspiration. (See RESPIRATION.)... vital capacity
See Learning difficulties.... mental retardation
An entity which provides comprehensive mental health services (principally ambulatory), primarily to individuals residing or employed in a defined catchment area.... community mental health centre
Intended as a key part of the NHS’s local comprehensive mental health services serving populations of around 50,000, these multidisciplinary, multi-agency teams have been less e?ective than expected, in part due to varying modes of operation in di?erent districts. Some experts argue that the services they provide – for example, crisis intervention, liaison with primary care services and continuing care for long-term clients – could be delivered more e?ectively by several specialist teams rather than a single, large generic one comprising psychiatrists, psychologists, community mental health nurses, occupational therapists, support and (sometimes) social workers.... community mental health teams
The absence of psychiatric disorders or traits. It can be influenced by biological, environmental, emotional and cultural factors. This term is highly variable in definition, depending on time and place.... mental health
Emotional and behavioural problems are common in children and adolescents, affecting up to one-?fth at any one time. But these problems are often not clear-cut, and they may come and go as the child develops and meets new challenges in life. If a child or teenager has an emotional problem that persists for weeks rather than days and is associated with disturbed behaviour, he or she may have a recognisable mental health disorder.
Anxiety, phobias and depression are fairly common. For instance, surveys show that up to
2.5 per cent of children and 8 per cent of adolescents are depressed at any one time, and by the age of 18 a quarter will have been depressed at least once. Problems such as OBSESSIVE COMPULSIVE DISORDER, ATTENTION DEFICIT DISORDER (HYPERACTIVITY SYNDROME), AUTISM, ASPERGER’S SYNDROME and SCHIZOPHRENIA are rare.
Mental-health problems may not be obvious at ?rst, because children often express distress through irritability, poor concentration, dif?cult behaviour, or physical symptoms. Physical symptoms of distress, such as unexplained headache and stomach ache, may persuade parents to keep children at home on school days. This may be appropriate occasionally, but regularly avoiding school can lead to a persistent phobia called school refusal.
If a parent, teacher or other person is worried that a child or teenager may have a mental-health problem, the ?rst thing to do is to ask the child gently if he or she is worried about anything. Listening, reassuring and helping the child to solve any speci?c problems may well be enough to help the child feel settled again. Serious problems such as bullying and child abuse need urgent professional involvement.
Children with emotional problems will usually feel most comfortable talking to their parents, while adolescents may prefer to talk to friends, counsellors, or other mentors. If this doesn’t work, and if the symptoms persist for weeks rather than days, it may be necessary to seek additional help through school or the family’s general practitioner. This may lead to the child and family being assessed and helped by a psychologist, or, less commonly, by a child psychiatrist. Again, listening and counselling will be the main forms of help o?ered. For outright depression, COGNITIVE BEHAVIOUR THERAPY and, rarely, antidepressant drugs may be used.... mental health problems in children
Comprehensive mental health services, as generally defined under some national (or state) laws and statutes, include: inpatient care, outpatient care, day care and other partial hospitalization and emergency services; specialized services for the mental health of the elderly; consultation and education services and specialized programmes for the prevention, treatment and rehabilitation of alcohol and drug abusers. They generally include a variety of services provided to people of all ages, including counselling, psychotherapy, psychiatric services, crisis intervention and support groups. Issues addressed include depression, grief, anxiety and stress, as well as severe mental illnesses.... mental health services
n. the state of being able to make decisions about one’s medical care, i.e. to consent to or to refuse treatment. The law, by virtue of the *Mental Capacity Act 2005, requires that to assess capacity doctors should evaluate whether a patient can comprehend, retain, and weigh up information in the balance such as to make a considered decision that can be communicated. The patient must understand the nature, purpose, and possible consequences of having and not having investigations or treatments. Capacity is often impaired in such conditions as stroke, dementia, learning disability, mental illness, and intoxication with illicit substances. The term competence is often used as a synonym, but since the Mental Capacity Act 2005 came into force capacity is the preferred term. See also incompetence. —capacitous adj.... capacity
(CMHT) a multidisciplinary team consisting of psychiatrists, psychiatric nurses, psychologists, social workers, and occupational therapists who treat patients with severe mental illness in the community.... community mental health team
see DSM.... diagnostic and statistical manual of mental disorders
(IMCA) a person who must, by virtue of the *Mental Capacity Act 2005, be contacted to represent the *best interests of a patient who lacks *capacity and has no family or friends while acting as a proxy in medical decision-making. IMCAs are available via the local Independent Mental Capacity Advocacy Service.... independent mental capacity advocate
a regulating body in England and Wales, governed by the Mental Health Act 2007, that was responsible for regularly visiting psychiatric hospitals, reviewing psychiatric care, giving second opinions on the need for certain psychiatric treatments, and acting as a forum for the discussion of psychiatric issues. It was subsumed under the *Care Quality Commission in April 2009.... mental health act commission
(MHRT) a tribunal, established under the Mental Health Act 1959 and now operating under the Mental Health Act 2007, to which applications may be made for the discharge from hospital of a person compulsorily detained there under provisions of the Act (see compulsory admission). When a patient is subject to a restriction order an application may only be made after his or her first six months of detention. The powers of the tribunal, which comprises both legally and medically qualified members, include reclassifying unrestricted patients, recommending leave of absence for a patient, delaying discharge, and transferring patients to other hospitals. Detained patients may also apply to have a managers hearing to review their detention. The powers of the managers hearing are slightly different from those of the MHRT, but both are defined in the Mental Health Act 2007 and both can discharge a patient from a section of the Mental Health Act.... mental health review tribunal
(MSE) a full psychiatric examination of signs and symptoms, which takes place during a psychiatric interview and should apply only to signs and symptoms elicited at that time; it should not take into account historical information. The examination is usually divided into the following subheadings: appearance and behaviour, speech, mood, *affect, thought and perception, *insight, and orientation. Usually it also includes a *risk assessment.... mental state examination
(MMSE) a brief 30-point questionnaire that is used to screen for cognitive impairment in the diagnosis of dementia. It is also used to estimate the severity of cognitive impairment and to follow the course of cognitive changes in an individual over time, thus making it an effective way to document response to treatment. It tests functions including arithmetic, memory, and orientation.... mini-mental state examination
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