Question, again!

[xlaurenx]

Im wondering about this situation I found myself in a few months ago. I was in hospital for a od, had capacity and i wanted to leave. I was told if i left or wanted to leave the doctors could stop me as my health was at Physical risk and was life or death ( eventhough i knew the risks). I stayed but i asked mh and they said this

where I stood legally with having capacity/ wanting to self discharge etc etc. Apparently in theory they couldn't stop me. But if they had concerns to suggest I wouldn't be safe. Or needed physically treatment then my ability to say no goes out the window and they could section me.*


I told them i just wanted to go home and again i had capacity. So how does my choice to way no go out the window? On a 5 (2) they couldnt force treatment. Or would the staff have said because i took a od i lacked capacity at the time? Though people can have capacity and still od? Again would they have said that the fact i oded in the first place showed i has a mh issue? Or would be at risk of doing it again though i said i just wanted to go home.

Just wondered where in the law they could do that?

[Auror.]

I don't know law in the UK, but here in the US, they can force treatment or place you on a hold (equivalent of section) if they feel you're not taking care of your yourself OR deemed a danger to yourself. Not getting medical treatment would, imo, fall under both of those. And where I live, if you seek medical treatment for an od or self harm, you're automatically under a hold and forced to have treatment until you've been assessed by a psychiatrist, which they can't do until you're deemed medically stable first.

So again not knowing the differences and not knowing the law well, I'd say they're will within grounds to say you lack capacity for refusing medical treatment. Especially when it's medical treatment due to harming yourself because it shows you don't fully understand the risks and consequences to what you did. And if you say you DO understand and you did it anyway, that's actually a larger reason for arguing you don't have capacity and are a danger to yourself.

Insiting you have capacity, is again, where I live, generally a sign that you actually lack it because it doesn't show that you're willing to work with the professionals or that you truly understand the consequences of your actions.

So yea, at least where I live, your choice in the situation would go out the window because you lack capacity and are a danger to yourself because of the overdose itself.

[Pomegranate]

This is a really complicated area tbh. And one I’m still learning about from a personal and professional point of view.

Essentially, you would be being held under MCA and then maybe DoLS. Being able to repeat the laws and the consequences etc is not generally seen as being the same as ‘having capacity’. Of course everyone has the right to make I wish decisions. However, if your judgement is believed to be impaired by a cognitive or mental ‘disorder’, legally you can be held. It’s a ‘reasonable doubt’ situation. This is especially likely to be used if the information being given (ie I don’t want to die but I’ve overdosed and you need to let me leave’), is contradictory.

Capacity is actually incredibly complicated! And MCA should only be used for the very minimum amount of time and should be used for necessary treatment and to hold for that.

Ultimately, the professional needs to be able to explain why they don’t feel the person definitely understands the implication of their actions or behaviour, or why that action is being influenced by a disorder.

[Pomegranate]

The mental capacity act and it’s relation to ‘best interest assessments’ are incredibly complicated.

[xlaurenx]

So it would be the route of the MCA? Rather then MHA Emma?

[Pomegranate]

I’m not an expert by any means and am happy to be corrected if wrong, but yes, I believe it would be the MCA for treatment (in this instance) and the MHA would be to prevent you leaving so that you could be psychiatrically assessed

[Fire Fly]

Well any doctor on the ward that felt you needed the treatment and lacked the mental capacity to understand the damage you could be doing and the damage you would be doing if you did not get any further treatment could utilise the MCA and DOLs. However at the same time at doctor could also could put you on a 5(2) should it be relating to a mental illness and whether it needed further treatment and relating to risk to hold you until MHA is conducted should they feel you may need to be in hospital.