Mental health and law and policy
? Use the case study to do the learning outcomes.
? Produce a 3000 word written assignment based on a case study chosen (+/- 10%).
? The content must cover the 4 module learning outcomes.
? Write at level 5 standard
Case study two
Jenny is 88 years old, she lives in a “granny flat” within her son Graham’s home. Graham is an only child and he is a divorcee, he works full time in an office close
to home. Graham is Jenny’s main carer he takes Jenny food shopping every week and they enjoy going to the local social club for a game on dominoes on a Saturday
afternoon. Jenny is a fiercely independent lady and takes pride in her flat . Once a month Jenny is visited by her brother Dennis who lives in Leeds. When Dennis
visits he is very critical of the standard of care that Graham is providing. Graham finds the criticism very upsetting but feels he cannot say anything as it will
upset his mum. Jenny and Graham are happy with their living arrangements as they are able to keep in regular contact with each whilst at the same time maintaining
their own independence.
Over recent months Graham has started to notice that Jenny always wears the same clothes when they go out shopping or to the club, Jenny explains that she has done her
washing and there is nothing to worry about. One day Graham receives a call at work fro the police; Jenny has managed to lock herself out and she is very frightened
and confused. Graham rushes home form work to meet the police, they take Jenny into her flat. At this point Graham realises that Jenny has not been coping as well he
previously believed. The kitchen is a mess and there is stale milk and uneaten meals. This event triggers Graham to make an appointment with Jenny’s GP for an
assessment of her memory. The GP suspects that Jenny may have dementia and so refers her to the memory clinic who conform a diagnosis of Alzheimer’s disease. Jenny is
prescribed Aricept and the memory clinic monitor the titration. Initially Jenny tolerates the 5mg dose and seems to be doing well, however when the dose is increased
to 10mg she becomes very agitated and experiences unwanted side effects. The decision is taken to stop the medication and Jenny is discharged back to the care of the
Jenny and Graham continue with their living arrangements, but Jenny refuses to have outside carers in while Graham is out at work. Initially this is not a problem, but
within a few weeks of being discharged from the memory clinic Graham again receives a call at work from the police. Jenny has been found walking around town in her
nightwear in a disorientated and confused state, she is agitated and is asking stranger where the post office is. When the police return Jenny home they find that the
front door is wide open and there is a strong smell of gas. An emergency referral is made to the older adult community mental health team who feel that they cannot
support Jenny and they recommend an admission to hospital as an informal admission for a period of assessment. Initially Jenny agrees to the admission, she is able to
understand that she has recently placed herself in danger. As Jenny is able to retain and recall a decision she is deemed to have the mental capacity to agree to an
informal admission. Sadly within a few hours of arriving on the ward Jenny becomes very distressed and tries to leave. The nurse in charge detains Jenny using her
nurses holding powers while the duty doctor is contacted. When the duty doctor arrives he recommends that Jenny be detained under section 2 of the Mental Health Act
(1983) as she will not agree to stay as an informal patient, she is upset when the doctor explains the reason for admission accusing him of spreading lies. The AMHP
and part 12 medic attend the ward and all agree that Jenny should be detained under the provision of section 2. When the nurse in charge tries to read Jenny her rights
she is very upset and cannot understand what is being said to her, she rips up her patient rights leaflet and cries.
After 28 days Jenny’s section is allowed to lapse and it is not renewed. She remains on the ward as an informal patient while plans are made for her discharge. The
period of assessment reveals that Jenny is struggling to manage her self care needs, she is frequently disorientated to time and place and often gets up several times
during the night, needing to be returned to her bed again by the night staff. During the course of the admission Jenny tries home leave, she is escorted by the ward
occupational therapist and her named nurse who conduct a number of functional assessments within her flat. The home assessment reveals that Jenny is not safe in the
kitchen and is a risk accidental fire setting as she walks away from pans and is having difficulty coordinating her meal plans.
All of this information is fed back in a discharge planning CPA which both Graham and Dennis attend. Graham is very worried about how he will manage Jenny’s care and
working full time. Dennis is highly scathing of his nephew during the meeting is very open that he thinks Jenny would be better off in an nursing home. Jenny however
is adamant that she will never go into care and that she would rather be dead than living with old people in a home. In the CPA it is agreed that Jenny no longer needs
to remain on the ward and that home is no longer an option. The only choice seems to be for Jenny to go into 24 hour care but she continues to refuse this stating she
wants to go home. The ward make an application to the local authority for a depravation of liberty [DOL] order. The local authority approve the DOL application and
Jenny is discharged to St Margaret’s Nursing Home two weeks later.
Learning outcome for the Mental Health and LAW AND Policy
1. Evaluate the social policy, political and economic drivers, which influence mental health and care provision.
2. Evaluate the application of common and statute law in a mental health context, considering its relevance to the development of clinical practice and care/aftercare
3. Demonstrate an understanding of the legal roles & responsibilities of the Registered Mental Health Nurse and other professionals
4. Critically evaluate the care and treatment offered to a person suffering from a mental disorder and conceptualise the complexities associated within law, policy and
Introduction to chosen case study (200-250 words maximum)
? Main Body (3000 words):
? Evaluate the social policy, political and economic drivers, which influence mental health and care provision (600 words)
? Evaluate the application of common and statute law in a mental health context, considering its relevance to the development of clinical practice and care/aftercare
delivery (600 words)
? Demonstrate an understanding of the legal roles & responsibilities of the Registered Mental Health Nurse and other professionals (600 words)
? Critically evaluate the care and treatment offered to a person suffering from a mental disorder and conceptualise the complexities associated within law, policy and
practice (600 words) the critique should be weaved as a narrative throughout the body of the text, this is not a separate section of the essay.
? Conclusion (200 words maximum)
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