Written answers

Thursday, 3 December 2015

Department of Health

Mental Health Guidelines

Photo of Colm KeaveneyColm Keaveney (Galway East, Fianna Fail)
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22. To ask the Minister for Health if a review has been carried out into the increase in the application of electro-convulsive therapy to patients against their will; the action that is being taken in terms of legislation, policy and medical practice guidelines to address this unacceptable practice; and if he will make a statement on the matter. [42989/15]

Photo of Kathleen LynchKathleen Lynch (Cork North Central, Labour)
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Under the Mental Health Act 2001, the written consent of a patient is required where a programme of Electro-convulsive Therapy (ECT) is to be administered. However where an involuntary patient is 'unable' or 'unwilling' to give consent, the programme 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.

The Mental Health Commission recently published 'The Administration of Electro-convulsive Therapy in Approved Centres Activity Report 2013'. The Commission noted that in 85.5 per cent of cases, ECT was administered with the consent of the person. The Commission also noted that there was an increase in the number of treatments that were administered without consent. However when the figures are examined further there was only one single case where both Consultant Psychiatrists agreed that ECT should be administered on the basis of the 'unwilling' criterion and the overwhelming majority were in the 'unable' to consent category. The Mental Health Commission publishes rules regarding the administration of ECT to involuntary patients and adherence to these rules is monitored on an annual basis by the Inspector of Mental Health Services.

The Deputy will be aware that ECT is an individual -specific treatment prescribed by the treating consultant based on the assessment of the patient concerned. Within the profession, it is acknowledged that there exists a cohort of people with severe treatment-resistant depression for whom ECT appears to be the only treatment that offers any real possibility of improvement. This is also supported by NICE Guidelines in the UK and the World Health Organisation. It is also noted from the recent Mental Health Commission report that in over 90% of cases, the Consultant Psychiatrist reported that treatment of ECT resulted in the improvement of the health of the person concerned.

I fully agree that where a person with capacity refuses ECT, this should be respected. To this end, I have prioritised a change to the existing legislation to remove the 'unwilling' criterion from Section 59 of the Mental Health Act 2001. I will shortly bring legislation before the House to bring about this priority amendment. I have recently written to the Deputy with my proposals on amending the legislation and I appreciate the support that the Deputy has indicated he will give to this short Bill. Subject to obtaining and securing adequate Dáil time, I hope to make this amendment before the end of the year.

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