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Mental health - establishing capacity

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  • Mental health - establishing capacity

    Hello I am hoping that someone might be able to answer a question about the mental capacity act. My son has mental health problems but has never been sectioned. I have just got his records as we are struggling with the local mental health team so I was hoping to get more information from his records.
    looking at the records it appears that they have been pre planning to establish capacity within meetings that we have been told were about other things. Is this normally done? He is 25 - gp or me as the nearest relative weren't informed.
    And it seems that they swing between wanting to section him or discharging him - its just very odd. Any ideas about this?
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  • #2
    I am sorry for your trouble and that of your son.

    I assume from your writing that your son is presently, voluntarily, an inpatient in some form of medical establishment.

    One question that almost invariably comes up, when considering what is in the best interest of the patient, is whether the patient lacks capacity, but in your son's case, it would seem that no determination has been made about that.

    Another and interrelated question is whether the patient is fit enough to be discharged, or whether he is not. Again, it would seem that no determination has been made about that.

    Those two questions need to be determined, so as to make a decision to detain a patient against their will. Such decision would be a serious one and can only be made by a three person team, two of which must be doctors.

    "Sectioned" is shorthand for a patient being detained against their will - the reason is because there are different sections of the Act that provide for this.

    Rather than going through the Act here, you may wish to read the following link.


    Any decision to "section" can be challenged, by court proceedings, usually a Mental health Tribunal, because the law for many centuries has taken very seriously the "deprivation of liberty of the subject" which nowadays means anyone deprived of their liberty, subject or not.

    I hope my writing has helped to answer your questions.


    • #3
      efpom thank you so much for answering with your wisdom.
      That's the thing he's not an inpatient he's just been trying to get inpatient treatment & help from the CMHT currently as an outpatient but there have been many issues - probably boiling down to finances resulting in delays with my son receiving inpatient support.
      But in the meantime for example, he met with a new psychiatrist - we were informed that this was purely an introduction meeting - in his mental health notes though it says that they were aiming to 'establish capacity' during this meeting.

      I suppose I am wondering about the ethics of this sort of approach & whether in the light that capacity should be assumed & the idea of arranging meetings for one thing but in fact the purpose of the meeting to sctually be a pre section without letting us know.

      And it seems that the team have been talking about discharging him from the service entirely but then sectioning him the next week without his presentation changing. I can't understand what they are trying to do. Honestly if he knew he would he furious & it certainly wouldn't help his mental health.

      In these circumstances is this a normal approach & if not why would they be doing that? My son has bern involved with a mental health team for many years on & off but I've never seen this - the records prior to this team being involved ( he moved area) is all pretty straightforward & exactly what I expected to find - transparent, with my son at the center of it all but I honestly wonder whether this team have some real issues.

      Is there any possibility in the uk if getting a move btween trusts without actually moving?!? I am just wondering if this might be a possibility


      • #4
        My contributions on this forum are to do with the law. I sometimes forget that the law does not exist in a vacuum and the consequences of the application of the law can have a profound effect on people.

        I cannot answer your last question - but my previous post, in the main, stands, whether or not your son is an inpatient.

        I am not good at counseling, for want of a better word, unless it's to do with the law, and I usually abstain from giving my views, except on the law.

        However, I think it would be wise, in your son's interest, to, in a collaborative manner air your concerns, formally or informally, with the team managing your son's treatment.


        • #5
          Yes it does certainly impact people on many levels wider family included.
          So legally speaking then a pre section can happen without the patients knowledge?
          I'm just trying to get some understanding of it from all points of view - legal included as the MHA is enshrined in the law which of course doesn't give workers responsible the right to do what they like - my son alongsde many others is vulnerable but he is still a person & should surely be informed of what's going on & respected.

          thank you again for help on here.


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