Electroconvulsive Treatment (ECT)
In some circumstances, the Tribunal must decide whether to make an Electroconvulsive Treatment (ECT) Order. In other cases, you can make your own decision about ECT without the Tribunal’s involvement.
For compulsory, security or forensic patients who are adults or young people (under 18) we use the term ‘compulsory adult’ and ‘compulsory young person’. For adults or young people receiving treatment on a voluntary basis, we use the terms ‘voluntary adult’ and ‘voluntary young person’.
When can you make your own decision about ECT without the Tribunal’s involvement?
If you’re a voluntary adult and you have capacity to give informed consent, you are free to decide whether you want to consent to ECT.
Similarly, if you are a compulsory adult AND you have capacity to give informed consent, you can decide whether you want ECT without the Tribunal’s involvement.
When does your psychiatrist have to apply to the Tribunal for an ECT Order?
If you are a compulsory adult or a voluntary adult* and your psychiatrist doesn’t think you have capacity to give informed consent to ECT, they must apply to the Tribunal for an ECT Order before providing ECT.
Your psychiatrist must always apply to the Tribunal before providing ECT if you are a young person. An application must be made whether you are a compulsory or voluntary young person, and whether or not you have capacity to give informed consent to ECT.
* The Medical Treatment Planning and Decisions Act 2016 (MTPD Act) commenced on 12 March 2018 and requires psychiatrists to apply to the Tribunal for an ECT Order if a voluntary adult does not have capacity to consent to ECT. For more information refer to the Department of Health’s website on the MTPD Act.
What are my rights at a Tribunal hearing about ECT?
When will the Tribunal list my ECT hearing?
The Tribunal must list and hear an ECT application within five business days after receiving the application. Your psychiatrist can request an urgent hearing if they are satisfied that the course of ECT is necessary:
- to save your life
- prevent serious damage to your health, or
- to prevent significant pain or distress.
The Tribunal must hear urgent applications as soon as practicable. Hearings of urgent applications generally happen within two business days.
What are the criteria the Tribunal considers when making a decision?
- If you’re a compulsory adult, the Tribunal may only approve ECT if it is satisfied that you don’t have capacity to give informed consent and there is no less restrictive way for you to be treated.
- If you’re a voluntary adult, the Tribunal may only approve ECT if it is satisfied that you don’t have capacity to give informed consent and there is no less restrictive way for you to be treated AND:
- you have an instructional directive giving informed consent to ECT; OR
- your medical treatment decision maker gives informed consent in writing to ECT.
- If you’re a compulsory young person the Tribunal may only approve ECT if it is satisfied that:
- If you’re a voluntary young person, the Tribunal can only approve ECT if you have either:
What are the Tribunal’s powers at a hearing?
If one or more of the criteria are not met, the Tribunal must refuse to make an ECT Order. If the criteria are met, when making an Order the Tribunal must decide how long it is for (up to a maximum of 6 months) and the number of treatments (up to a maximum of 12 treatments).
For more information about ECT, including a description of ECT, see the website of the Department of Health and Human Services here. You can find a statement of rights for adult patients here and one for young people here.