Sectioning Under Mental Health Act
Discussion
A close relative of mine was, till this summer, a successful recovering alcoholic. They managed a decade plus drink free in which they progressed to a senior position within their career, married and became a parent.
In the spring of this year they suffered a work related spinal injury. There was an accusation made that the injury was due to deviation from the employer's health and safety policies and my relative was suspended pending a disciplinary investigation and hearing.
We think the stress combined with boredom from being off ill and the medication for the spinal injury (Tramadol and diazapan) having similar effects to alcohol triggered a relapse.
As well as drinking themself to oblivion every day out of shame and not wanting spouse, child or any family members seeing them drink like this my relative leaves the house and drinks in nearby woods. The police have to be called to find what they class as a missing vulnerable person who when found is checked over by paramedics before being poured home.
In the last two weeks my relative has made two attempts on their life and has been caught driving six times over the limit. They were driving where "they couldn't be found so they could go to sleep and not wake up ".
For the spouse's final straw my relative suffered a head injury while in the woods then fought the police and paramedics trying to attend. As they fought they chanted over and over "leave me alone, let me die. I just want to die".
The spouse tried to have my relative detained the next morning as a danger to themselves. After a mental health review this was declined as my relative presents well when sober.
Police, paramedics, family, friends and spouse are furious and in despair.
Where to go from here?
In the spring of this year they suffered a work related spinal injury. There was an accusation made that the injury was due to deviation from the employer's health and safety policies and my relative was suspended pending a disciplinary investigation and hearing.
We think the stress combined with boredom from being off ill and the medication for the spinal injury (Tramadol and diazapan) having similar effects to alcohol triggered a relapse.
As well as drinking themself to oblivion every day out of shame and not wanting spouse, child or any family members seeing them drink like this my relative leaves the house and drinks in nearby woods. The police have to be called to find what they class as a missing vulnerable person who when found is checked over by paramedics before being poured home.
In the last two weeks my relative has made two attempts on their life and has been caught driving six times over the limit. They were driving where "they couldn't be found so they could go to sleep and not wake up ".
For the spouse's final straw my relative suffered a head injury while in the woods then fought the police and paramedics trying to attend. As they fought they chanted over and over "leave me alone, let me die. I just want to die".
The spouse tried to have my relative detained the next morning as a danger to themselves. After a mental health review this was declined as my relative presents well when sober.
Police, paramedics, family, friends and spouse are furious and in despair.
Where to go from here?
Edited by Tannedbaldhead on Monday 19th September 11:11
king hell. Terrible story.Jasandjules said:
I am afraid sectioning is almost impossible without the agreement of the person in question.
ETA - I would be attempting to get him into some form of rehab.
I agree about rehab, but the point of sectioning is that it is *against* the will of the person in question. If the person agrees to treatment then there is no need to section them.ETA - I would be attempting to get him into some form of rehab.
Honk said:
pim said:
The Doctor or social worker can section a person without his or her permission.
You have to be mentally ill.
...but sober.You have to be mentally ill.
It's exactly what the mental health professionals want to hear.
When drunk they return to drinking themselves unconscious it the cold and rain, necking their prescribed drugs,fighting the police and paramedics then waking up in hospital recovering from injuries and overdose treatment.
I don't know for sure, but could you apply for a deprivation of liberty safeguard through the Court of Protection?
http://www.scie.org.uk/publications/ataglance/atag...
Under this section 'How is deprivation of liberty authorised under DoLS?' it states
' The supervisory body appoints assessors to see if the conditions are met to allow the person to be deprived of their liberty under the safeguards. They include:
The person is 18 or over (different safeguards apply for children).
The person is suffering from a mental disorder.
The person lacks capacity to decide for themselves about the restrictions which are proposed so they can receive the necessary care and treatment.
The restrictions would deprive the person of their liberty.
The proposed restrictions would be in the person’s best interests.
Whether the person should instead be considered for detention under the Mental Health Act.
Could you apply for that in the first instance while the person still lives at home. Via the CoP, then it doesn't invoke the MHA (I think) and you might have a better chance of sectioning if the DoLs order doesn't offer the opportunity for improvement.
Sorry to hear whats happened.
http://www.scie.org.uk/publications/ataglance/atag...
Under this section 'How is deprivation of liberty authorised under DoLS?' it states
' The supervisory body appoints assessors to see if the conditions are met to allow the person to be deprived of their liberty under the safeguards. They include:
The person is 18 or over (different safeguards apply for children).
The person is suffering from a mental disorder.
The person lacks capacity to decide for themselves about the restrictions which are proposed so they can receive the necessary care and treatment.
The restrictions would deprive the person of their liberty.
The proposed restrictions would be in the person’s best interests.
Whether the person should instead be considered for detention under the Mental Health Act.
Could you apply for that in the first instance while the person still lives at home. Via the CoP, then it doesn't invoke the MHA (I think) and you might have a better chance of sectioning if the DoLs order doesn't offer the opportunity for improvement.
Sorry to hear whats happened.
late to this one again, sorry.
the whole point of detrention is that it is against the person's will, without consent etc. the issue of their agreement does not arise.
the MHA is very clear and excludes "drunkeness alone" as grounds for detention.
alcohol is a psycho-active substance and will hinder any attempts to assess mental state. current legal advice to assessors is that they must postpone review until sufficient levels of comprehension are attained. a mental state examination is a complex matter involving abstact themes and higher executive function - intoxication impairs same.
having achieved sufficient levels of comprehension, certain legal criteria must be fulfilled. agreement on the presence of a mental illness or disorder of a nature or degree warranting compulsory admission is top of the list.
many people will present very differently when less intoxicated - those who do not meet the legal threshold for detention are not detainable. if not detainable and not engaging with treatment providers (eg addiction treatment services)there is little else that health services can do.
alcohol is a CNS depressant and mental and behavioural changes secondary to either acute intoxication or continuous harmful use are common. risk taking behaviours increase whilst acutely intoxicated and reasoining, decision making skills etc are often grossly reduced. the duty of care is often limited to ensuring that the person regains sobriety and capacity then, whether we agree or not, they must be allowed to make their own decisions
DOLs is not applicable - person is not in a hospital or care home. It is highly likely that, when acutely intoxicated, he lacks capacity but this is a temporary state and actions taken in the best interest can not continue once capacitous again
sometimes, in cases like these, disposals through the courts following offending are more productive - treatment orders (NOT Sec 37 MHA, conditions are not satisfied) probation with conditions etc. the benches have powers in this respect that health services do not
paul
the whole point of detrention is that it is against the person's will, without consent etc. the issue of their agreement does not arise.
the MHA is very clear and excludes "drunkeness alone" as grounds for detention.
alcohol is a psycho-active substance and will hinder any attempts to assess mental state. current legal advice to assessors is that they must postpone review until sufficient levels of comprehension are attained. a mental state examination is a complex matter involving abstact themes and higher executive function - intoxication impairs same.
having achieved sufficient levels of comprehension, certain legal criteria must be fulfilled. agreement on the presence of a mental illness or disorder of a nature or degree warranting compulsory admission is top of the list.
many people will present very differently when less intoxicated - those who do not meet the legal threshold for detention are not detainable. if not detainable and not engaging with treatment providers (eg addiction treatment services)there is little else that health services can do.
alcohol is a CNS depressant and mental and behavioural changes secondary to either acute intoxication or continuous harmful use are common. risk taking behaviours increase whilst acutely intoxicated and reasoining, decision making skills etc are often grossly reduced. the duty of care is often limited to ensuring that the person regains sobriety and capacity then, whether we agree or not, they must be allowed to make their own decisions
DOLs is not applicable - person is not in a hospital or care home. It is highly likely that, when acutely intoxicated, he lacks capacity but this is a temporary state and actions taken in the best interest can not continue once capacitous again
sometimes, in cases like these, disposals through the courts following offending are more productive - treatment orders (NOT Sec 37 MHA, conditions are not satisfied) probation with conditions etc. the benches have powers in this respect that health services do not
paul
I may be getting hold of the wrong end of the stick but is it the case that he has 6 drink driving cases pending? I am astonished he has not been remanded in custody if that is the case and that bail conditions a) not to drive whilst under the influence and/or b) not to consume alcohol have not been imposed.
XCP said:
I may be getting hold of the wrong end of the stick but is it the case that he has 6 drink driving cases pending? I am astonished he has not been remanded in custody if that is the case and that bail conditions a) not to drive whilst under the influence and/or b) not to consume alcohol have not been imposed.
One conviction, five times the limit. Six taking into account it's a Scottish offence.look after yourselves in the first instance. contact Al-Anon or your local addiction treatment services and ascertain what support for family is available.
he's pre-contemplative at the moment (in that he has not committed to change - he talks the talk but his actions indicate his underlying lack of motivation).
the good news, if there is any, is that his history suggests that change is possible and a decade of abstinence is very good going indeed. damage limitation until he moves forward and becomes truly contemplative.
paul
he's pre-contemplative at the moment (in that he has not committed to change - he talks the talk but his actions indicate his underlying lack of motivation).
the good news, if there is any, is that his history suggests that change is possible and a decade of abstinence is very good going indeed. damage limitation until he moves forward and becomes truly contemplative.
paul
In the spring of this year they suffered a work related spinal injury. There was an accusation made that the injury was due to deviation from the employer's health and safety policies and my relative was suspended pending a disciplinary investigation and hearing.
Is the accusation true or ar^e covering by the company?
Is the accusation true or ar^e covering by the company?
Short Grain said:
In the spring of this year they suffered a work related spinal injury. There was an accusation made that the injury was due to deviation from the employer's health and safety policies and my relative was suspended pending a disciplinary investigation and hearing.
Is the accusation true or ar^e covering by the company?
Works in special needs social care. A patient they were walking with fell. Policy is to let them drop then give aid and seek help after they hit the ground. Catching them is against the rules as firstly you could hurt yourself and secondly if you fell with the patient whose to say you didn't cause the injury rather than the floor exposing the employer to litigation.Is the accusation true or ar^e covering by the company?
Apparently letting someone taking a seizure fall on their face is more difficult than it sounds.
Technically speaking H&S patient handling rules were breached. Relative suffered spinal injuries as a result. In their defence it's an instinctive reaction to brake the fall. I'll leave you to judge.
Edited by Tannedbaldhead on Monday 19th September 20:47
and, as devil's advocate, if you attempt a "catch" and injure yourself to the point where you are incapacitated then who will summons help for the patient? who cares for your patients whilst you're on sick leave?
so i kind of see what the employer is claiming and, hypothetically, it's a sound position which i would probably assume myself as a head of service; a failed intervention has created two casualties in this case. the primary responsibility is always to yourself, not the patient, that's almost "Healthcare 101".
alcohol is currently his solution to problems for which he has no answer key; it's avoidant, decompensatory and maladaptive but until he finds a better one he will continue to use to harmful excess.
his risk demographic is high given his social circumstances and is increased when disinhibited by the effects of alcohol on the frontal lobe (which is where the smarter stuff goes on). but, he has been here before and responded well to intervention. keeping him alive to the point where he is ready to address his re-emergent dependency is the hardest part and is on a day by day, situation by situation, basis.
paul
so i kind of see what the employer is claiming and, hypothetically, it's a sound position which i would probably assume myself as a head of service; a failed intervention has created two casualties in this case. the primary responsibility is always to yourself, not the patient, that's almost "Healthcare 101".
alcohol is currently his solution to problems for which he has no answer key; it's avoidant, decompensatory and maladaptive but until he finds a better one he will continue to use to harmful excess.
his risk demographic is high given his social circumstances and is increased when disinhibited by the effects of alcohol on the frontal lobe (which is where the smarter stuff goes on). but, he has been here before and responded well to intervention. keeping him alive to the point where he is ready to address his re-emergent dependency is the hardest part and is on a day by day, situation by situation, basis.
paul
Jasandjules said:
I am afraid sectioning is almost impossible without the agreement of the person in question.
ETA - I would be attempting to get him into some form of rehab.
That's the whole point of sectioning someone, it's when they won't agree to treatment because they are too ill to recognise they need treatment. ETA - I would be attempting to get him into some form of rehab.
You cannot section someone just because they are an alcoholic.
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