Chief Psychiatrist's annual report 2008-09 - Department of Health

Chief Psychiatrist’s annual report 2008–09 11
2.4 Electroconvulsive therapy (ECT)
ECT is a procedure performed under short general anaesthetic
in which modified seizures are induced by the selective passage
of an electrical current through the brain. Representations of
ECT in popular culture have tended to generate negative public
perceptions of the practice despite significant advances in ECT
technology and knowledge over recent years.
Most commonly prescribed for severe depression, ECT may also
be used for other types of serious mental illness such as mania,
schizophrenia, catatonia and other neuropsychiatric conditions.
It may be life-saving for some patients who have not responded
to other treatments and is most often prescribed as part of a
treatment plan in combination with other therapies.
Electroconvulsive
therapy
For more information
on minimum practice
standards on ECT, see
the Electroconvulsive
therapy manual.
Licensing, legal
requirements and clinical
guidelines (Department
of Health, 2009)
The Act contains specific provisions regulating consent to ECT and the circumstances under which
a patient may give informed consent to ECT and also under which the authorised psychiatrist can
provide substitute consent to ECT for involuntary patients 3 . The Act also requires any public or
private mental health service administering ECT to comply with certain procedures and standards,
and report monthly to the Chief Psychiatrist on ECT use.
The Act establishes a framework for the licensing of premises. ECT can only be provided in premises
licensed by the Secretary to the Department of Health. In practice this power is delegated to the
Chief Psychiatrist 4 . Licences may be granted for up to five years.
ECT can be administered as a course (a number of consecutive single treatments) or as a periodic
continuation or maintenance therapy following an acute phase of illness.
2.4.1 Use of electroconvulsive therapy in 2008–09
Number of treatments
A total of 19,558 ECT treatments were given in 2008–09, an increase of 10 per cent compared to
2007–08. Sixty-two per cent of all ECT treatments were provided by public mental health services
and 38 per cent by private psychiatric hospitals.
3 See Part 5, Div 2.
4 See sections 72–80 of the Act.