Correct way to fill out MHA forms T2/T3/S62/CTO12 SH CP 224 T2/T3/S62/CT012 Aide Memoire Version: 2 Summary: An Aide Memoire to completing or requesting a T2/T3/S62/CT012 Keywords: Target Audience: T2, T3, S62, CT012, section, medications, All mental health staff Next Review Date: April 2019 Approved & Ratified by: Medicines Management Committee Date of meeting: 21 March 2018 Date issued: Author: Director: Rebecca Henry, Principal Pharmacist Education and Training and Specialised Services Medical Director
Version Control Change Record Date Author Version Page Reason for Change Jan 2018 Rebecca Henry 1 New guideline June 2018 Alex Weston 2 4 Addition of record of assessment for consent to treatment to the introduction, as per CQC inspection. Addition of MHA link to references. Approved by MMC Chair - Dr Shez Khan Reviewers/contributors Name Position Version Reviewed & Date Rebecca Henry Pharmacist Version 1 Amanda Bryant Mental Health Act officer Version 1 Juliet Wells Pharmacist Version 1 2
Contents Section Title Page 1. Introduction 4 2. References 4 3 Glossary 4 4. Aide memoire 5 3
T2/T3/S62/CT012 Aide Memoire 1. Introduction When completing a T2 or S62 or a requesting a T3 or CTO12 it is important to include all the relevant medications. This aide memoire is intended to assist mental health staff in the process. Approved Clinician s must complete the Record of Assessment for "Consent to Treatment" for the purposes of section 58(3) of the Mental Health Act 1983. It needs to be filed with the copy of T2/T3/S62 on the ward. A new record of assessment form needs to be done with each T2/T3/S62. 2. Glossary T2 Section 58(3)(a) - certificate of consent to treatment T3 Section 58(3)(b) - certificate of second opinion Section 62 (S62) - Urgent treatment 3. Reference: Guidance note for commissioners on consent to treatment and the Mental Health Act 1983 Sept 2009 CQC letter Consent to Treatment certificates and BNF, dated 27th June 2016 Reference Guide to the Mental Health Act 1983, DoH http://intranet.southernhealth.nhs.uk/tools-and-resources/mental-health-act/in-house/. 4
Store the original T2/3/S62 form in the MHA office and a copy with the drug chart or clinic room folder All drugs prescribed for a mental health disorder, including as required medication, and some drugs for psychotropic induced side effects, either by name or by groups described in the British National Formulary (BNF). Maximum doses (within max BNF dose limits or up to x% BNF dose limits) and route of administration (oral, IM) should be clearly indicated for each drug or group listed, specify the indication (off-label use). What to include Group/individual drug examples Specify indication Beta-adrenoceptor blocker Propranolol, bisoprolol Anxiety, akathisia or antipsychotic induced tachycardia Antihistamine hydroxyzine or promethazine sedation or anxiety Hypnotics and anxiolytic Antipsychotic Antimanic drug Antidepressant CNS stimulants and drugs used for ADHD Anti-Epileptic* benzodiazepines, z-hypnotics (e.g. zopiclone), promethazine all lithium, valproate all methylphenidate, atomoxetine and dexamphetamine carbamazepine, lamotrigine, valproate, pregabalin, clonazepam insomnia, agitation or anxiety mood, agitation, anxiety, antipsychotic induced fits Anti-Muscarinic procyclidine, trihexyphenidyl, extrapyramidal side-effects pirenzepine, hyoscine hydrobromide antipsychotic induced hypersalivation Drugs for dementia donepezil, galantamine, rivastigmine and memantine Fish oils omega 3 mood, psychosis Antidiabetic metformin or exenatide for antipsychotic weight gain Tetrabenazine tardive dyskinesia Clozapine IM Specialised services only What not to include Group examples Indication/comment Laxatives all any Anti-Epileptics* carbamazepine, lamotrigine, valproate, epilepsy pregabalin, clonazepam Naso-gastric feeds see Section 63 of the Act Homeopathic/alternative medicines Example One oral antidepressant drug, within BNF max limits Clonazepam orally, for agitation, up to 4mg in 24hours Up to two oral antipsychotics, combined dose up to 150% BNF max limits 5