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Advance directive (also known as advance decision or living will)
A written or oral declaration which enables a mentally competent adult to refuse specified medical treatment if they lose mental capacity in the future. Advance directives are legally binding on clinicians for cases falling under the jurisdiction of the Mental Capacity Act 2005.
Alliance policy on advance directives...
Advance statement
A written or oral declaration which patients to make their views known on the care and treatment they would like to receive if they lose the capacity to make decisions for themselves in the future. The statement must be taken into account by clinicians making decisions about the care and treatment of people who lack mental capacity but is not legally binding.
Alliance policy on advance statements...
Advocate
A person who assists a patient or their nominated person (usually a carer or relative) to express themselves and to take an active part in making decisions affecting their lives. The assistance may sometimes take the form of speaking on behalf of the patient but will more often comprise the provision of information about their rights and help in exercising those rights.
Alliance policy on advocacy...
Aftercare
Social care and health services which are provided in order to meet the needs of a current or former mental health patient, aimed at reducing that person’s chance of being re-admitted to hospital. These services are currently not means tested for those who have been detained under certain sections of the 1983 Mental Health Act and must be provided free of charge.
Alliance policy on continuation of care...
AMHP (Approved Mental Health Practitioner)
This new role is created in the Mental Health Bill. It is a mental health professional who is responsible for co-ordinating and carrying out the assessment (along with two doctors) which determines whether compulsory powers should be used on a patient. The AMHP could be a social worker (the role replaces the functions of the Approved Social Worker, see below) but could also be a nurse or an occupational therapist.
ASW (Approved Social Worker)
A social worker who has undertaken additional specialist training in the field of mental health. The ASW has specific duties and powers under the Mental Health Act 1983 in relation to the compulsory admission and detention of patients. The ASW role will be abolished under the Bill and replaced by the AHMP (see above).Assessment
The decision-making procedure which determines whether, for example, community services will be provided or whether a person is sufficiently unwell to require the use of compulsory powers, such as detention under the Mental Health Act 1983.
Alliance policy on a right to assessment...
BNF (British National Formulary)
The BNF is a joint publication of the British Medical Association and the Royal Pharmaceutical Society of Great Britain. It provides prescribers, pharmacists and other healthcare professionals with up-to-date information and guidance about the use of medicines.
Alliance policy on treatment safeguards...
Carer
A person who cares for a relative or friend, often providing the help that person needs to stay living at home.
Alliance policy on carers and nominated persons...
Care Plan
A written plan that describes the care and support that staff will aim to give a patient when they are in the community. Patients should be fully involved in developing and agreeing the plan. (See also CPA below.)
Clinical Supervisor
Under the Mental Health Bill, when a patient is registered at a hospital a clinical supervisor must be appointed. The clinical supervisor is the lead clinician responsible for their care. A clinical supervisor will normally be a consultant psychiatrist, but may also be a consultant psychologist.
CPA (Care Programme Approach)
An approach used by specialist mental health services to assess the care needs of, and provide a package of care for, people with mental health problems. For those assessed as needing an enhanced level of care the main elements are a comprehensive assessment, a named care co-ordinator, a written care plan and regular reviews by a multi disciplinary mental health team.
CMHT (Community Mental Health Team)
A multi disciplinary team offering assessment, treatment and care to people with mental health problems living in the community. The team will usually include a nurse, psychiatrist, psychologist, social worker and occupational therapist.
CTO (community treatment order)
A general term relating to any legal order which requires people with mental health problems who are living in the community to comply with specified care and treatment.
Alliance policy on CTOs and non-resident orders...
Conditions
The conditions which must be satisfied before someone can be brought under formal powers and provided with treatment and care for a mental illness under compulsion.
Alliance policy on conditions for compulsion...
ECHR (European Convention on Human Rights
The European Convention on Human Rights is a treaty under international law which declares certain human rights which are or should be protected by the state. It was signed in Rome in 1951,was ratified by the United Kingdom in 1951 and came into force amongst those states which ratified it in 1953.
Alliance policy on human rights...
ECT (electro-convulsive therapy)
Electroconvulsive therapy, also known as electroshock therapy, is a controversial treatment for mental illness involving the induction of an artificial seizure (fit) in a patient by passing electricity through the brain. It is mainly used for people with a diagnosis of severe depression who do not appear to be getting better or are not responding to medication.
Alliance policy on treatment safeguards...
Examination
Under the Mental Health Bill the examination is the first stage in the process to see whether someone meets the conditions for the use of compulsory powers. If the examination shows that the relevant conditions are met, then the person will become liable to assessment (see above). In most cases this decision will be made by two doctors and a social worker or other non-medical professional.
Exclusions
Certain behaviours or illnesses which are specifically excluded from the definition of mental disorder set out in legislation. Thus a person cannot be treated as being mentally disordered for any purpose under mental health legislation unless they have a mental disorder or the behaviour/condition leads to mental disorder. The Mental Health Act 1983 lists 3 exclusions: promiscuity or other immoral conduct, sexual deviancy or dependence on alcohol and drugs. The current Mental Health Bill has no exclusions.
Alliance policy on exclusions...
Expert Panel
The Mental Health Bill proposes to create a panel of persons, known as the Expert Panel, to advise the new Mental Health Tribunal (see below), and the courts when required. The Panel will consist of experts from a range of disciplines such as general psychiatry, old age psychiatry, children and adolescents, learning disabilities, psychology and professionals with social care and mental health nursing backgrounds.