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Consent to Treatment — MRCPsych Paper B MCQ

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ModerateMental Health LawConsent to TreatmentMRCPsych Paper B

Under the Mental Health Act 1983 provisions currently in force in England, a woman is detained under section 3. During her current continuous period of liability to detention, she first received oral antipsychotic medication for her mental disorder 2 months ago. She has capacity but now refuses further medication. The treatment is given under the direction of the approved clinician in charge and is not a treatment to which sections 57 or 58A apply. Which provision authorises administration of the medication without her consent at this stage?

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Correct answer: E — Part IV, section 63

Section 63 is correct. It permits medical treatment for mental disorder without the consent of a detained patient when given by, or under the direction of, the approved clinician in charge, unless the treatment falls within sections 57, 58 or 58A. For medication, section 58 applies only after three months have elapsed from first administration during the current continuous period of liability to detention. At two months, ordinary antipsychotic medication may therefore be authorised under section 63, although valid consent should still be sought and refusal documented. Section 58 is the later medication safeguard requiring the relevant certification. Section 58A concerns ECT and specified treatments. Section 57 concerns the most invasive specified treatments. Part IVA, including section 64B, applies to community treatment order patients rather than this detained section 3 patient.

Reference: Department of Health and Social Care. Code of practice: Mental Health Act 1983, chapter 24, including paragraphs 24.12 and 24.40–24.41. 2015. https://www.gov.uk/government/publications/code-of-practice-mental-health-act-1983