Electroconvulsive Therapy (ECT)

What is ECT?

• ECT is a procedure where small electric currents are passed through the brain, causing a brief seizure. You are under general anesthetic when this happens and are unlikely to feel it.
• ECT can only be given by a doctor who is experienced in giving ECT. An experienced anaesthetist must also be present.
• The Ministry of NSW Health have developed guidelines around the use of ECT. Click here for more information.
• ECT can be given to either people who have voluntarily or been involuntarily admitted to a mental health unit.

Is ECT helpful?

ECT can be helpful for some people and is commonly used as a last resort when medication is not effective enough or appropriate to help you manage your mental health symptoms. ECT is normally used to treat severe forms of depression or severe manic symptoms, including bipolar disorder.[1]

According to the Australian government’s Healthdirect website, ECT can be useful “because it works more quickly than other treatments such as medicines or therapy. It is used cautiously because it is more intrusive than other treatments and may cause memory problems. Since the effects are short-lived, long-term treatment with antidepressant or mood-stabilising medicine is usually needed.”[2]

ECT may not be suitable, effective, or helpful for everyone. Speak to your treating team or doctor before deciding on whether ECT is right for you.

Who approves the ECT treatment order?

Before you can receive ECT you must receive confirmation in writing from two medical practitioners that ECT is a reasonable and proper treatment for you, and that undergoing ECT it is the best interests of your safety and welfare.

If you have been admitted voluntarily:

• You can only be given ECT if you agree to it and provide informed written consent
• You have the right to discuss your views about ECT with you psychiatrist and treating team and ask any questions you want to about the treatment option

If you have been admitted to a mental health facility involuntarily, the Authorised Medical Officer needs to submit an application to the Mental Health Review Tribunal who approves and reviews requests for ECT treatment orders.

Can I decline ECT?

You can decline (withdraw your consent) and stop ECT treatments at any time as long as you have been voluntarily admitted to a mental health facility and have not had your status changed to ‘involuntary patient’.

For those involuntarily admitted, the Mental Health Review Tribunal can decide to administer ECT either when:

• You have given informed consent to receive ECT, or
• You have not given consent but it is decided by the Mental Health Review Tribunal that it is necessary for your safety and welfare.

What is the maximum number of ECT treatments I can receive?

The Mental Health Review Tribunal must specify the number of ECT treatments you will be receiving.

In most cases, the number of ECT treatments should not exceed 12 treatments. In some special circumstances, the Mental Health Review Tribunal can approve more if this is beneficial and necessary.

To determine whether more than 12 treatments are required, the doctor would need to clearly explain their reason for the request and would need to submit another application to the Mental Health Review Tribunal asking for more treatments.

How long do ECT orders last?

An ECT order made by the Mental Health Review Tribunal is 6 months from the date of the hearing but can be less if it has been specified or till the time you no longer have “involuntary” status.

Can I still receive ECT treatment when I’m out of hospital?

Yes, in some cases you may require ECT treatment to be continued once you have been discharged. This is usually because other types of treatment options have not been effective in managing your symptoms. These usually range from ECT treatment every week to every few weeks.

How can I best prepare for a Mental Health Tribunal Hearing?

1. Request a clear explanation of your  Statement of Rights. You can request staff to repeat and clarify parts that you don’t clearly understand. Staff must support you to understand your rights. You can ask the staff member for a translator or another explanation if you need.
2. Get clear on the following details for the meeting:

• Where will it be held?
• Who will be there?
• What questions might they ask me?
• What questions would you like to ask?
• What kind of decisions can the Tribunal make?
• What is the process going to look like?

1. Find a time and private space before the meeting to speak to your legal representative, friend, carer and/or advocate and prepare for the hearing.
2. Consider if you would like to have a peer worker, cross-cultural consultant, interpreter or translator to be present at the hearing. Speak to your mental health staff members about organising this.

WANT TO LODGE A COMPLAINT?

Consider first providing feedback or making a complaint directly to the health service or staff. Click the link

If you would like to escalate the matter further, you can click here to make an inquiry or lodge a complaint online to the Health Care Complaints Commission or call 1800 043 159.

NEED ADVOCACY SUPPORT?

Visit the Official Visitors website or call 1800 208 218 for more information.

NEED LEGAL SUPPORT?

Contact Mental Health Advocacy Service, Legal Aid on or 1300 888 529. You can also visit the Legal Aid website.

 

[1] Health Direct. (n.d.). Electroconvulsive therapy (ECT). Australian Government Department of Health and Aged Care. Retrieved from https://www.healthdirect.gov.au/electroconvulsive-therapy-ect

[2] Health Direct. (n.d.). Electroconvulsive therapy (ECT). Australian Government Department of Health and Aged Care. Retrieved from https://www.healthdirect.gov.au/electroconvulsive-therapy-ect