Chief Psychiatrist policy
This page includes information about the following Chief Psychiatrist policy.
| Resource | ||
| Policy | Electroconvulsive therapy (PDF 2521 kB) | |
This policy is mandatory for all authorised mental health services (AMHSs). An authorised doctor, authorised mental health practitioner, AMHS administrator, or other person performing a function or exercising a power under the Mental Health Act 2016 must comply with this policy.
You can also find additional fact sheets, forms, clinical notes and resources that are available for this policy under the relevant subtopics on this page.
Introduction
The Mental Health Act 2016 regulates the following 2 types of treatment for patients at authorised mental health services (AMHSs).
- Electroconvulsive therapy (ECT)
- Non-ablative neurosurgical procedures, such as deep brain stimulation
The Mental Health Act 2016 sets out requirements for the approval and performance of these treatments to ensure appropriate safeguards are in place.
Read our Regulated treatments fact sheet (PDF 751 kB) to learn more.
It is an offence under the Mental Health Act 2016 to perform ECT or a non-ablative neurosurgical procedure on a person for a mental illness unless it is performed in accordance with the Mental Health Act 2016.
Electroconvulsive therapy (ECT)
ECT is a highly effective treatment with a strong evidence base for quickly and significantly alleviating psychiatric symptoms.
The treatment is performed under a general anaesthetic to ensure comfort for the person. An adjustable electrical current is passed through specific areas of the head to produce a generalised seizure.
The experience of the seizure is modified by both the general anaesthesia and the administration of a muscle-relaxing agent.
ECT may be recommended for treatment of a person's mental illness in situations when other treatments have been ineffective or when ECT has worked well previously.
In some circumstances, emergency ECT may be necessary to save the person’s life or to prevent the person from suffering irreparable harm.
When ECT can be used
ECT is a regulated treatment and a doctor may only perform ECT in an AMHS.
It can be performed for a patient who is an adult with the approval of the Mental Health Review Tribunal if the adult is:
- unable to give informed consent whether or not they are subject to a treatment authority, forensic order or treatment support order, or
- subject to a treatment authority, forensic order or treatment support order.
For a patient who is a minor, ECT can only be performed with the approval of the Tribunal. Find out about considerations for children and minors.
ECT can also be performed:
- for an adult who has given informed consent to the treatment
- for certain involuntary patients in an emergency circumstance.
Read the Electroconvulsive therapy policy to learn more.
Forms
| Resource | ||
| Form | Certificate to perform emergency electroconvulsive therapy – Print version (PDF 281 kB) | |
Clinical guideline
The Queensland Health Administration of electroconvulsive therapy (ECT) – Clinical guideline (PDF 668 kB) provides recommendations for best practice for the administration of ECT. It includes guidance on the following topics.
- Governance of the ECT service
- Staff training
- ECT credentialing and scope of clinical practice
- Consent and legal issues
- Indications and medical considerations
- Risks of ECT
- ECT use in special populations including children, adolescents, pregnant women and older persons
- Cultural considerations
Online interactive flowchart
The Chief Psychiatrist has developed an online interactive flowchart about ECT under the Mental Health Act 2016 for AMHSs.
The flowchart helps determine the regulatory requirements for the approval and performance of ECT.
Use the ECT online interactive flowchart
Patient information and rights
The Chief Psychiatrist has developed A guide to electroconvulsive therapy (ECT) for consumers and carers (PDF 391 kB). It includes the following information.
- The history of ECT and improvements over time
- The effect ECT has on the brain
- When ECT is prescribed and guidance on what to do if ECT is recommended for a person
- Patient rights when a person is prescribed ECT
- Where ECT can be carried out and information about the sessions.
- The potential side effects
You can also download our Information about electroconvulsive therapy (ECT) – A fact sheet for you and your family (PDF 354 kB) or find more patient information and consent forms on the informed consent - psychiatry page.
Non-ablative neurosurgical procedures
A non-ablative neurosurgical procedure is a procedure of the brain that does not involve deliberate damage to, or removal of, brain tissue, for the treatment of a mental illness.
An example of this is a deep brain stimulation procedure. Deep brain stimulation was first developed as a treatment for Parkinson's disease to reduce tremor, stiffness, walking problems and uncontrollable movements.
Deep brain stimulation is performed by neurosurgeons.
It's a treatment of last resort for mental illness for patients who can't control their symptoms with medications alone.
A procedure on the brain that does involve deliberate damage to or removal of brain tissue (called 'psychosurgery') is prohibited under the Mental Health Act 2016.