PBS practitioner: Hormonal manipulation (female) Refer to Refer to the individual Consent: Person with capacity Develops the PBSP, individual product product information to give consent. Their relative Menstruation suppressants must contributes to the risk information but but generally should or guardian can give consent not be used for the primary purpose assessment. may include: include: to menstruation suppression if of enforced contraception unless Medical the primary purpose is for specifically authorised by an order Emotional Counselling prior • • practitioner/ health or psychological of SACAT as using suppressants in trauma. to use. psychiatrist (where reasons and if the person is this way represents a violation of a Depression Careful initial • • the restrictive not objecting. person’s human right to experience titration. Menstrual • practice is being full sexuality and fertility. If the person is resisting or irregularity Regular review of • used to administer objecting to the use of Menstruation suppressants must dosage. Loss of medical treatment): • menstruation suppressants for not be used for the primary purpose fertility. Regular review of Prescribes the • the primary purpose of health of convenience. need for therapy. medical treatment or psychological reasons then Menstruation suppressants may be and contributes to Additional • the use of this medication, the used for the purposes of avoiding the PBSP and risk hormonal therapy. consent of an appointed pregnancy or menstruation when assessment as guardian with relevant powers, freely consented to by the person required. usually Section 32 (1) (c), of concerned. Community nurse the Guardianship and Menstruation suppressants may be (where involved in Administration Act 1993. recommended for health reasons the administration If menstruation suppressants such as painful periods or of the medical are being used for the primary psychological reasons such as treatment): purpose of suppressing fertility mood management, or for extreme Contributes to the and the person objects, the distress/confusion during PBSP and the risk issue must be taken to SACAT menstruation. However, other least assessment as for a decision. restrictive alternatives must always required. Endorsement: The delegated be considered and the use of restrictive practices menstrual suppressants must be compliance officer. regularly reviewed. Restrictive Practice Recommended Consent and Potential Risks Prescribing Person(s) Example Controls Endorsement
Hormonal manipulation (female) Menstruation suppressants must not be used for the primary purpose of enforced contraception unless specifically authorised by an order of SACAT as using suppressants in this way represents a violation of a person’s human right to experience full sexuality and fertility. Menstruation suppressants must not be used for the primary purpose of convenience. Menstruation suppressants may be used for the purposes of avoiding pregnancy or menstruation when freely consented to by the person concerned. Menstruation suppressants may be recommended for health reasons such as painful periods or psychological reasons such as mood management, or for extreme distress/confusion during menstruation. However, other least restrictive alternatives must always be considered and the use of menstrual suppressants must be regularly reviewed. Refer to individual product information but may include: • Emotional trauma. • Depression • Menstrual irregularity • Loss of fertility. Refer to the individual product information but generally should include: • Counselling prior to use. • Careful initial titration. • Regular review of dosage. • Regular review of need for therapy. • Additional hormonal therapy. PBS practitioner: Develops the PBSP, contributes to the risk assessment. Medical practitioner/ psychiatrist (where the restrictive practice is being used to administer medical treatment): Prescribes the medical treatment and contributes to the PBSP and risk assessment as required. Community nurse (where involved in the administration of the medical treatment): Contributes to the PBSP and the risk assessment as required. Consent: Person with capacity to give consent. Their relative or guardian can give consent to menstruation suppression if the primary purpose is for health or psychological reasons and if the person is not objecting. If the person is resisting or objecting to the use of menstruation suppressants for the primary purpose of health or psychological reasons then the use of this medication, the consent of an appointed guardian with relevant powers, usually Section 32 (1) (c), of the Guardianship and Administration Act 1993. If menstruation suppressants are being used for the primary purpose of suppressing fertility and the person objects, the issue must be taken to SACAT for a decision. Endorsement: The delegated restrictive practices compliance officer. Restrictive Practice Example Potential Risks Recommended Controls Prescribing Person(s) Consent and Endorsement