IS IT NECESSARY FOR AN INDEPENDENT MENTAL CAPACITY ADVOCATE (IMCA) TO BE INSTRUCTED? Place a cross in EITHER box below YES: Apart from professionals and other people who are paid to provide care or treatment, this person has no-one whom it is appropriate to consult about what is in their best interests. NO: There is someone whom it is appropriate to consult about what is in the best person’s interests who is neither a professional nor is being paid to provide care or treatment. IS THERE A VALID AND APPLICABLE ADVANCE DECISION? Place a cross in EITHER box below YES: The person has made an Advance Decision that may be valid and applicable to some or all of the treatment. NO: The Managing Authority is not aware that the person has made an Advance Decision that may be valid and applicable to some or all of the treatment. ‘’’’ IS THE PERSON SUBJECT TO SOME ELEMENT OF THE MENTAL HEALTH ACT 1983? Yes No If please describe further Yes RELEVANT AND FEELINGS PERSON’S WISHES Is the person objecting to care and treatment, if so, what are they objecting to? What are the wishes, feelings, beliefs and values (present and past) so far as they can be relevant person’s ascertained and have they/have not been met? Note:(If a deprivation of liberty has been identified for a mental health patient accommodated for the purpose of treatment for a mental disorder and they are objecting to care and treatment for their mental disorder only the Mental Health Act 1983 can be used to deprive the person of their liberty).
IS IT NECESSARY FOR AN INDEPENDENT MENTAL CAPACITY ADVOCATE (IMCA) TO BE INSTRUCTED? Place a cross in EITHER box below YES: Apart from professionals and other people who are paid to provide care or treatment, this person has no-one whom it is appropriate to consult about what is in their best interests. NO: There is someone whom it is appropriate to consult about what is in the person’s best interests who is neither a professional nor is being paid to provide care or treatment. IS THERE A VALID AND APPLICABLE ADVANCE DECISION? Place a cross in EITHER box below YES: The person has made an Advance Decision that may be valid and applicable to some or all of the treatment. NO: The Managing Authority is not aware that the person has made an Advance Decision that may be valid and applicable to some or all of the treatment. ‘’’’ IS THE PERSON SUBJECT TO SOME ELEMENT OF THE MENTAL HEALTH ACT 1983? Yes No If Yes please describe further RELEVANT PERSON’S WISHES AND FEELINGS Is the person objecting to care and treatment, if so, what are they objecting to? What are the relevant person’s wishes, feelings, beliefs and values (present and past) so far as they can be ascertained and have they/have not been met? Note:(If a deprivation of liberty has been identified for a mental health patient accommodated for the purpose of treatment for a mental disorder and they are objecting to care and treatment for their mental disorder only the Mental Health Act 1983 can be used to deprive the person of their liberty).