Electroconvulsive therapy, known as ECT, is considered a ‘regulated treatment’ for the purposes of the Mental Health Act 2016 (the Act).
ECT is defined in the Act to mean the application of electric current to specific areas of the head to produce a generalised seizure that is modified by general anaesthesia and the administration of a muscle relaxing agent for the treatment of a mental illness.
Because ECT is a regulated treatment, a doctor may perform ECT only in an authorised mental health service if:
- the patient is an adult and has given informed consent to the treatment
- the patient is an adult who is unable to give informed consent and the Tribunal has approved the treatment, or
- the patient is a minor and the Tribunal has approved the performance of the treatment.
The person who is the subject of an ECT hearing is entitled to free legal representation which is arranged by the Tribunal.
In deciding whether to approve the treatment, the Tribunal must consider any views, wishes and preferences an adult has expressed about the therapy in an advance health directive. If the application relates to a minor, the Tribunal must consider the views of the minor’s parents, and the views, wishes and preferences of the minor.
The Tribunal may give the approval only if satisfied:
- the performance of the therapy is in the person’s best interests
- evidence supports the effectiveness of the therapy for the person’s particular mental illness
- if the therapy has previously been performed on the person - the effectiveness of the therapy for the person
- if the person is a minor, evidence supports the effectiveness of the therapy for persons of the minor’s age.
Where approved the Tribunal must state the number of treatments that may be performed in a certain period of time. The approval may also be made subject to conditions the Tribunal considers appropriate.
ECT may also be performed for certain involuntary patients in emergency circumstances.
In some circumstances, emergency ECT may be necessary to save the person’s life or to prevent the person from suffering irreparable harm. In these circumstances, the Act allows a doctor to administer emergency ECT in an authorised mental health service for:
- an involuntary patient subject to a treatment authority, forensic order or treatment support order, or
- a person absent without permission from another State who is detained in an authorised mental health service.
In this situation, ECT may be performed without the person’s consent if:
- the doctor and the senior medical administrator of the service certify in writing that performing ECT on the patient is necessary to save the relevant patient’s life or to prevent the relevant patient from suffering irreparable harm, and
- an application has been made to the Tribunal to perform ECT for the patient.
If ECT has been recommended for you, the best person to speak with is a member of your treating team.
Further information can be found on ECT in the treatment and care section of the Queensland Health website for the Mental Health Act 2016.