Craig Mackinlay – 2015 Parliamentary Question to the Department of Health

The below Parliamentary question was asked by Craig Mackinlay on 2015-09-16.

To ask the Secretary of State for Health, if he will undertake an urgent review into the increased use of electroconvulsive therapy (ECT) on people considered incapacitated without their consent; and if he will make an assessment of the potential merits of introducing a ban on the forced use of ECT.

Alistair Burt

The use of electroconvulsive therapy (ECT) for patients who are detained for treatment under the Mental Health Act 1983 (the Act) and for all patients under 18 years is governed by section 58A of the Act. If a patient lacks the capacity to consent a second opinion appointed doctor (SOAD) must certify that the patient lacks the capacity to consent and that:

– the treatment is appropriate;

– no valid and applicable advance decision has been made by the patient under the Mental Capacity Act 2005 (MCA) refusing the treatment in question;

– no suitably authorised attorney or deputy objects to the treatment on the patients behalf; and

– the treatment would not conflict with a decision of the Court of Protection which prevents the treatment being given.

The numbers of these second opinions involving ECT have been declining for the past decade though there has been an increase since 2012/13. It is not clear whether this is a change in overall trend.

The requirements of section 58A can only be overridden in emergency if the treatment is necessary to save the patient’s life and to prevent a serious deterioration of the patient’s condition, and the treatment does not have unfavourable physical or psychological consequences which cannot be reversed.