Dáil debates

Thursday, 16 April 2015

Ceisteanna - Questions - Priority Questions

Mental Health Services Provision

9:50 am

Photo of Kathleen LynchKathleen Lynch (Cork North Central, Labour) | Oireachtas source

Under the Mental Health Act 2001, the written consent of a patient is required where a programme of electroconvulsive therapy, ECT, is to be administered. When an involuntary patient is "unable" or "unwilling" to give consent, ECT may be administered if it has been approved by the consultant psychiatrist responsible for the care and treatment of the patient and also authorised by another consultant psychiatrist. Both consultant psychiatrists must be of the opinion that the administration of ECT would be of benefit to the patient and they must give reasons for their opinion. The Mental Health Commission has published rules regarding the administration of ECT. Adherence to these rules is monitored on an annual basis by the inspector of mental health services.

ECT usage in Ireland is low and in line with other European countries. The latest analysis carried out by the Mental Health Commission for which there is a breakdown available on the administration of ECT was published in March 2014. This relates to 2012 figures. The Deputy recently received figures on the total number of patients who received ECT without giving consent for the period 2011 to 2014. Of the 22 such patients recorded in 2011, I can confirm that only three were recorded as unwilling, while the remaining 19 were recorded as being unable to give consent. The Commission has not yet published a 2013 or 2014 analysis but provisional figures made available confirm that the number of patients who received ECT without giving consent in 2014 was 42. I am informed that only five of these patients were recorded as unwilling, while the remaining 37 were recorded as being unable to give consent. While the total number of patients receiving ECT without consent has risen from 22 in 2011 to 42 in 2014, it is important to note that there has only been a limited increase from three to five in the small number of involuntary patients administered ECT who were recorded as unwilling in that period. These figures need to be considered in the context of a total of 18,173 admissions to psychiatric units for treatment in 2012, of which 2,141 were involuntary admissions.

I have recently published the report of the expert group set up to review the Mental Health Act 2001. The group has made 165 recommendations, which include some important points on the administration of ECT. The main recommendation is that in future, it will no longer be possible to administer ECT to an involuntary patient who has capacity and does not consent to such treatment. I fully agree with the recommendations of the expert group and have instructed my officials to deal separately with the proposed amendments relating to ECT and ensure the legislation is amended as soon as is practically possible. This will ensure that in all cases where a patient who has capacity refuses ECT, this preference will be respected.

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