ECT guideline

The Chief Psychiatrists's Guideline on electroconvulsive treatment was first published in 2015.

From this revised guideline:

"This 2019 revision was prompted by the passage of the Medical Treatment Planning and Decisions Act 2016 as it affects consent to ECT. It is now possible for guardians and medical treatment decision-makers to consent to ECT on behalf of people who lack capacity to give informed consent themselves but are not patients under the Mental Health Act. The guideline now provides direction about the processes to be followed in this situation, in both public and private mental health facilities.

"Some other elements have been added, reinstated or amplified, including recommendations that:

  • advance statements are checked for people’s preferences relating to ECT
  • capacity to make decisions about ECT must be assessed and documented, regardless of legal capacity, and reviewed periodically as treatment progresses
  • applications to the Mental Health Tribunal for urgent ECT hearings be kept to a minimum
  • people are helped to feel less anxious while in the ECT waiting area
  • rostered psychiatrists administer at least 25 treatments each year
  • anaesthetists be supported by anaesthetic nurses in all treatment settings
  • all treatments be reviewed weekly by the ECT director, ECT coordinator and participating psychiatrists
  • outcomes are mapped using formal cognitive and clinical outcome tools
  • ECT machines must be able to deliver ultra-brief pulse stimulation." (p. iii)

The updated guideline can be found here.

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