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Consent to Treatment — MRCPsych Paper B MCQ

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ModerateMental Health LawConsent to TreatmentMRCPsych Paper B

A 32-year-old woman in England is detained under section 3 of the Mental Health Act 1983. More than 3 months have elapsed since medicine for mental disorder was first administered during her current uninterrupted period of liability to detention. She retains capacity to decide about haloperidol but now refuses further doses. The treating team judges continued antipsychotic treatment appropriate; there is no urgent indication for immediately necessary treatment. Which consent-to-treatment provision governs continuing her haloperidol?

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Correct answer: B — Section 58 – medication after the initial 3-month period, requiring certified consent or a second opinion

Section 58 is correct. It bites once three months or more have elapsed since medicine for mental disorder was first administered in the current period of liability to detention. Thereafter medication may continue only if the patient consents and the approved clinician in charge certifies this (Form T2) or, as here where a capacitous patient refuses, a Second Opinion Appointed Doctor certifies the treatment is appropriate (Form T3) after consulting two other professionals involved in care. Section 63 authorises treatment for mental disorder without these safeguards only where sections 57, 58 and 58A do not apply — including the initial 3-month period — so it no longer covers her. Section 62 permits only immediately necessary urgent treatment, expressly excluded here. Section 57 covers specified invasive interventions (e.g. neurosurgery) needing consent and a second opinion, and section 58A covers ECT, which cannot be imposed on a capacitous refusing patient.

Reference: Mental Health Act 1983, section 58 (Treatment requiring consent or a second opinion), legislation.gov.uk, as amended: https://www.legislation.gov.uk/ukpga/1983/20/section/58/2004-01-20