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Terms beginning with J K M and N

Joint crisis plans

Joint crisis plans are a type of advance statement, a document written in case someone becomes seriously unwell again. They are drawn up after a discussion with the mental health professionals involved in their care and someone who is not involved in their treatment. The role of that person is to negotiate a way forward if the person who is unwell and the mental health professionals do not agree. Joint crisis plans are currently not in use in mental health services in the UK but research is being carried out to test how effective they are.

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Key worker

A key worker is the person who is responsible for organising and co-ordinating the package of treatment and support offered to someone with mental health problems. They are also known as care co-ordinators. If someone is admitted to hospital, they will have a different key worker or care co-ordinator during the time they spend there.

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Mental Capacity Act

The Mental Capacity Act gives a legal way of making a wide range of decisions on behalf of someone aged over 16 when they are unable to make a decision for themselves because they ‘lack capacity’. The law defines what ‘lacking capacity’ is and says what checks must be made to prove someone is lacking capacity at any one time.

The Mental Capacity Act can be used to give treatment to somebody without their consent if it is proven that an individual lacks capacity at a particular time, and that the treatment is in their ‘best interests’. Treatment cannot be given under this law to protect other people.

If it is in the best interests of a person to be detained in hospital, then mental health professionals have to follow the rules of the ‘Deprivation of Liberty Safeguards’. These are part of the law and involve six assessments of an individual.

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Mental Health Act

The Mental Health Act 2007 (formerly 1983, but amended in 2007) is the law that allows people with a ‘mental disorder’ to be admitted and treated in hospital without their consent – either for their own health and safety, or for the protection of other people.

People can be admitted and treated under different sections of the Act, depending on the circumstances, which is why the term ‘sectioned’ is used to describe a compulsory admission to hospital.

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Mental Health Act Code of Practice

This gives guidance to mental health professionals about good practice when treating people under the Mental Health Act and to make sure they stay within the law.

The Mental Health Act Code of Practice includes ‘Guiding Principles’ that mental health professionals must consider when they take a decision to detain someone under the Mental Health Act. These include involving family members and other carers in a decision to admit someone to hospital compulsorily, unless there are specific reasons why family members should not be involved.

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Mental Health Tribunals

People who are detained in hospital under the Mental Health Act, placed on a Community Treatment Order, or under guardianship, have the right to appeal to an independent Mental Health Tribunal against the decision.

The Mental Health Tribunal is at:
The Tribunals Service
PO Box 8793, 5th Floor
Leicester LE1 8BN
Telephone 0845 223 2022

People can ask a solicitor to write to the Tribunal for them, and help them with an appeal. Help from a solicitor is free under the Legal Aid scheme. The Law Society has a list of solicitors who specialise in mental health law.

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National Institute for Health and Clinical Excellence

This organisation is responsible for producing ‘clinical guidelines’ for health professionals, which recommend how people with specific illnesses and conditions should be cared for and what treatments they should and should not be offered. NICE also produces ‘technology appraisal’ guidance, which advises on when and how drugs and other treatments and procedures should be used in the NHS.

NICE guidance is designed to make sure people across England and Wales receive the same standard of care. This means people should be able to ask for NICE recommended medicines and treatments from the NHS. However, mental health professionals still have to decide if the recommendations are right for individual people, and local resources need to be made available to provide what has been recommended.

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Nearest Relative

‘Nearest relative’ is a term used in the Mental Health Act to describe someone who has some rights and powers under the law. They can apply for someone to be admitted to hospital under the law, for example.

The law says the ‘nearest relative’ is someone’s husband, wife, or unmarried partner, if they have been living together for more than six months. If someone does not have a spouse or partner, the ‘nearest relative’ is their child, if they are over 18. If someone does not have a child, or their child is under 18, their nearest relative is then one of their parents.

If their parents are not alive, their nearest relative is the first relevant person in the following order who is aged over 18: a brother or sister; a grandparent; a grandchild; an uncle or aunt; a nephew or niece; somebody who is not related but with whom the person has been living for more than 5 years. People with mental health problems can apply to change their nearest relative if they think the person named by law is unsuitable.

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Negative symptoms

People with schizophrenia can have what health professionals call ‘negative symptoms’. They may have no energy and lose the motivation to do anything; they may lose interest in friends, family members and activities they previously enjoyed. They may also have memory problems and find it very hard to concentrate. They may no longer care about their personal appearance and become isolated and withdrawn.

People who have schizophrenia also have what health professionals describe as ‘positive symptoms’ – delusions, hallucinations, disordered thinking – during episodes of psychosis.