The Government is to fast-track legislation ending the practice of administering electric shock therapy to mental health patients even if that patient has capacity and refuses the treatment.
A call to end the practice is just one of 165 recommendations in an expert group review of the Mental Health Act 2001 which the Department of Health published last night.
The expert group also recommends that it should no longer be possible to detain someone purely because he or she has a significant intellectual disability and that children aged 16-17 years should be presumed to have capacity to consent to or refuse admission and treatment.
The group says section 59 of the 2001 act should be amended to make it no longer be possible for electro-convulsive therapy (ECT) to be administered to a patient who has capacity and does not consent to it. At present consent is not required even if the patient has capacity.
ECT is a procedure in which electric currents are passed through the brain, intentionally triggering a brief seizure. It has been argued that it seems to cause changes in brain chemistry that can reverse symptoms of certain mental illnesses.
The expert group also “the first possible opportunity should be taken to effect this change in the context of any future miscellaneous health bill”.
“Where the patient is unable to give consent but a decision-making representative appointed legally under capacity legislation for the person gives that consent on the patient’s behalf, then ECT may proceed,” it says.
“Where a patient does not have capacity and a decision-making representative does not give consent to ECT, such treatment may only take place where it is required as a lifesaving treatment, for a patient where there is a threat to the lives of others or where the condition is otherwise treatment resistant, and such ECT may then only be administered subject to approval by a Mental Health Review Board which must convene within three days of the decision being taken.”
In response to that recommendation, Mental Health Minister Kathleen Lynch said that while she had instructed her officials to draw up a roadmap for legislating for a number of the recommendations from the expert group, she intended to deal separately “and within a shorter timeframe” with a change in legislation regarding the use of ECT.
“I believe that a refusal of ECT treatment where a person has capacity must be respected, and I will bring forward early proposals in this regard,” she said.
The Department of Health said the bulk of the expert group’s recommendations related to changes to mental health legislation
“In particular, the changes seek to move away from the often paternalistic interpretation of the existing legislation, to one where insofar as is possible, the individual has the final say in what he/she deems to be in his/her best interests and receives the best possible quality of service required to attain the highest standard of mental health,” it said.
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