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Three-Month Rule Proactive Management — MRCPsych Paper B MCQ

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HardMental Health LawThree-Month Rule Proactive ManagementMRCPsych Paper B

An adult patient was first given antipsychotic medication while detained under section 2 of the Mental Health Act 1983. After 25 days, he became detained under section 3 without any break in detention. It is now 2 months and 28 days since medication was first administered. No section 58 certificate is in place, and no formal assessment of his current capacity and consent to this treatment has been recorded. Which is the most appropriate action now?

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Correct answer: B — Review capacity and consent now, complete Form T2 if valid consent is given, or urgently seek SOAD certification on Form T3 if it is not

Section 58’s three-month period runs from the first administration of any medication for mental disorder during the patient’s continuous liability to detention; changing directly from section 2 to section 3 does not restart it. The approved clinician should therefore assess and document capacity and consent promptly. If the patient has capacity and consents, treatment is certified on Form T2; if valid consent is absent because the patient refuses or lacks capacity, a SOAD should be requested for possible Form T3 certification. A merely pending SOAD request does not itself authorise routine medication after the deadline, and section 62 is limited to treatment meeting its immediate-necessity criteria. Medication need not stop before three months, so D is wrong. Neither section 63 nor a tribunal hearing supplies the routine post-deadline authority, excluding C and E.

Reference: Department of Health, Mental Health Act 1983: Code of Practice, chapter 25, paragraphs 25.11–25.15, 2015. https://www.gov.uk/government/uploads/system/uploads/attachment_data/file/396918/Code_of_Practice.pdf