CME 22/10/15 – Emergency Medicine, Psychiatry and the Law

Emergency medicine, psychiatry and the law from SCGH ED CME

Here is Salam’s very informative talk on psychiatry in the emergency department, including the recent changes to the Western Australian Mental Health Act.

General Psychiatry Resources:

• Office of the Chief Psychiatrist WA:
  • New Mental Health Act Forms (MHA 2014)
    • password protected (password available from the OCPWA – see link above) 
  • WA Mental Health Act 2014 (PDF)
    • not password protected!! so you can read this one as much as you want?!

Assessment of Capacity:

• Capacity Definition:
  • Mental capacity can be defined as having ‘sufficient understanding and memory to comprehend in a general way the situation in which one finds oneself and the nature, purpose, and consequence of any act or transaction into which one proposes to enter’ (www.dictionary.com) – in other words, as the ability to make a decision.
• Capacity assessment principles:
  • A person has decision making capacity to make a specific decision if (at the relevant time) they have the capacity to do ALL :
    • Understand any information about the decision
    • Understand the matters involved in the decision
    • Understand the effect of the decision
    • Weigh up the above factors for the purpose of making the decision
    • Communicate the decision in some way.
    • No Coercion
  • Assess the person’s decision-making ability – not the decision they make

Referral for Psychiatric Examination:

• Form 1A (MHA 2014)
• A practitioner can only refer a person for examination by a psychiatrist where they reasonably suspect that:
  • the person is in need of an involuntary treatment order (see below), or
  • if the person is currently on a community treatment order, the person is in need of an inpatient treatment order.
  • The assessing practitioner must have regard to the criteria for an involuntary treatment order