16th November 2015

Question:

“My mother suffers from depression and is in psychiatric hospital under section 3 of the Mental Health Act. I saw a television programme which frightened me because it talked about people being given electro-convulsive therapy (ECT) if they suffer from depression. Could this happen to her?”

Answer:

Electro-convulsive therapy is one of a number of recognised treatments for depression.  However, doctors who treat patients for depression will generally try to resolve their problems by using medication or therapy.  These treatments are usually effective but in very severe cases, ECT could be prescribed.

If ECT is felt to be an option for your mother, her doctor must discuss it with her and she should be given written information about the nature, purpose and likely effects of the ECT.  Her doctor must assess whether or not she has sufficient mental understanding (capacity) to be able to agree to the procedure.  If your mother has capacity to consent and does consent then she can be given ECT.  She can withdraw her consent at any time.  If she is felt to have capacity and does not consent then she cannot be given ECT.

If it is felt that your mother is not capable of giving consent (i.e. she lacks capacity) the situation is different.  A person lacks capacity if they have an impairment or disturbance (e.g. a disability, condition or trauma) that affects the way their mind or brain works and the impairment or disturbance means that they are unable to make a specific decision at the time it needs to be made.  If she lacks capacity then a Second Opinion Approved Doctor (SOAD) must certify in writing that she is not capable of understanding or consenting to the treatment, but it would be appropriate for the treatment to be given, and giving it would not conflict with any advance decision (a statement about treatment she would not wish to have should she become incapacitated) she previously made, or a decision made by a person who has power of attorney for her, or the Court of Protection.

The SOAD must also consult two other mental health professionals, one of whom should be a nurse and the other neither a nurse nor a medical practitioner, and neither of which should be the doctor in charge of your mother’s case. In all cases, the SOAD should indicate on the certificate the maximum number of treatments s/he approves.