Forced medical intervention under Mental Health Act and/or Mental Capacity Act

[flourella]

Does anyone know anything about being forced to have a physical health check under the Mental Health Act or Mental Capacity Act? Alleged lack of capacity is solely down to long-standing mental illness in a middle-aged adult (I am autistic as well, but have no learning disabilities, dementia, acquired brain injury, etc).

It's not even for treatment of a condition. I have refused health checks recommended by mental health professionals (comprising blood draw and ECG) many times before and been perfectly open about the reason why (severe OCD). Nothing has changed regarding my physical health, but suddenly the CMHT have become obsessed with the idea I could potentially have heart problems caused by my bulimia, and in an appointment with a psychiatrist last week detention in hospital under the MHA just to have these tests was mentioned many times. The MCA was mentioned once. Since the appointment I have learned from another source (NHS specialist OCD clinic at which I've recently started outpatient treatment) that a "best interests meeting" has been arranged for the week after; this sounded like a quite specific term so I googled it and it seems it is a MCA thing rather than MHA. I'm not sure whether best interest meetings happen when it's already been agreed a patient has no capacity, or if the meeting is to discuss this and then, depending on outcome, possible courses of action will be discussed at a later juncture. Does anyone know? Will I be invited, or can I insist I am present? I am in contact with an advocacy service but haven't yet spoken to an advocate because they weren't in on Friday afternoon and I don't really know what they do anyway.

I can't believe how quickly this is happening; the CMHT's change in attitude has come out of nowhere and I don't understand why they are suddenly threatening me with this. Well, I know what's precipitated it: the specialist OCD clinic got in touch with them and said that I should have checks done. But there is no justification I can see for removing my right to decide things for myself, when I've been allowed to decline the tests for years so far with no consequences. Do I have the right to appeal if I don't agree with them and their opinions on what is in my "best interests", or am I fucked? Can they seriously section someone over this?!

@flourella yes, they could use a straight needle and a 20ml syringe. Each comes in a sterile pack. Then they would take the syringe, put a new needle on it, and squirt the blood into the bottle.

The stickers do have to stick onto your skin but they are single use. But I'm sure with a bit of care, a sterile sheet could be used to stop the leads touching your skin. If it helps, once the leads are on, if you stay still, the ECG is about 30 seconds. They can take the stickers and leads off at the same time, then take the stickers off the leads once they aren't attached to you.

I agree with @Zone2NorthLondon that this is doable in a way that you feel comfortable with. I think with the right planning, if you would be happy to take diazepam/lorazepam ask for them to prescribe it.

I've taken diazepam when I had to go for an appointment about by bowels. It took the edge off the anxiety so that I could attend.

The staff should be happy to work with you to find a way. They are meant to be looking at the most restrictive ways.

Spending time with you to manage your distress is really important. Especially as this may need to be done more than once. Far better to work together to find a way, than to cause you distress and make things more difficult in the future.

@Lougle so a new needle for each draw, not new syringes while the needle stayed in place? That solves the non-sterile vacuum tube problem, but unfortunately the setting up and insertion into my arm of several needles and their syringes would be a new problem that the set up with the vacuum tubes doesn't have. If I'm understanding you correctly.

I do understand what you mean regarding the ECG now and a sterile sheet would still really help. I also didn't know that test could be so short so that is also good news.

I am starting to think that if I could have a preliminary appointment where I can see the room and all the options regarding equipment, and I can describe any problems I have with each part of the process, we can hopefully come to an agreement on exactly how it can be done. Then I could go back another day for the appointment proper with everyone knowing what's what. If they agree to that I will say I'll do it. I absolutely can't be put in hospital. I got through the MRI and I do feel a bit more positive that it can be done after this conversation. I am a bit concerned it won't be a one-off though, as above. I'm not even contemplating what treatment might be prescribed based on any results and how I'll cope with that, either. It is a nightmare.

You’ve got this, it is achievable with bit of planning
On the day would you tolerate a student being allocated to be with you?would that help? If so raise with the CMHT
a visit to the hospital prior to the treatment that’s a really good idea, talk to your CMHT

feeling knowledgeable and having realistic idea of what’s involved will reduce some of the scary what ifs (not all! But some)

You could get some PRN lorazepam on the day for the anxiety

"@Lougle so a new needle for each draw, not new syringes while the needle stayed in place?"

@flourella no, not at all. I'm thinking one needle, with one 20ml syringe. They could draw off the blood they need all in one go, then take it out of your arm. Then they could fill their bottles from the syringe.

You'll probably need a purple bottle and a gold bottle, possibly one more. They only hold about 3ml of blood.

I honestly think you can do this (I'm an ex ICU nurse). I think a visit to clinic is a brilliant idea.

Would you know if Adult Child had A Mental Capacity Assesment by a Social Worker as I have No Documents about it being done and it is Not Noted on My Daughters GP File but Social Wirker said it had been Done, but I’m Not so Sure?