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Attitudes of consultants to prescribing ECT for patients involuntarily admitted under MHA 2001

  • Diana Schirliu (a1), Edyta Truszkowska (a1) and Colm McDonald (a1)


Objectives: The Mental Health Act (MHA) 2001 provides the legislative structure in Ireland for the involuntary admission and treatment, including with ECT, of patients suffering from mental disorders. A recent Seanad Bill proposed removing the option of administering ECT to involuntary patients who do not provide informed consent. This controversial issue has stimulated extensive media and stakeholder debate. In this study we explored the attitudes of consultant psychiatrists towards prescribing ECT for involuntary patients.

Methods: We compiled a current list of consultant psychiatrists attached to approved centres nationwide. We sent a study specific questionnaire to consultants of all adult psychiatry specialties.

Results: From the 249 individualised anonymous questionnaires posted, 164 (66%) were returned and analysed. When clinically indicated for involuntary patients willing to consent to ECT treatment, 159 (97%) consultants stated that they would and three (2%) would not prescribe ECT. For involuntary patients who lack capacity and are unable to consent, 157 (96%) consultant psychiatrists stated that they would and six (4%) that they would not prescribe ECT. For involuntary patients who have capacity to consent but are unwilling to do so, 52 (32%) consultant psychiatrists stated they would and 104 (63%) would not prescribe ECT.

Conclusions: The overwhelming majority of consultant psychiatrists would prescribe ECT for involuntary patients who are unable to consent to this treatment. Divergent attitudes emerged for treating patients who are unwilling to consent, with most consultant psychiatrists stating they would not prescribe ECT for this patient group.


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1.Teh, SPC, Helmes, E, Drake, DG. A Western Australian Survey On Public Attitudes Toward And Knowledge Of Electroconvulsive Therapy. Int J Soc Psych 2007; 53: 247273
2.Kellner, CH, Knapp, RG, Petrides, Get al.Continuation electroconvulsive therapy vs pharmacotherapy for relapse prevention in major depression: a multisite study from the Consortium for Research in Electroconvulsive Therapy (CORE). Arch Gen Psych 2006 Dec; 63(12): 1337
3.Sackeim, H, Prudic, J, Devanand, Pet al.A prospective, randomized, double-blind comparison of bilateral and right unilateral electroconvulsive therapy at different stimulus intensities Arch Gen Psych 2000;57: 425434
4.UK ECT Review Group. Efficacy and safety of electro-convulsive therapy in depressive disorders: a systematic review and meta-analysis. Lancet 2003; 361: 799808.
5.Merkl, A, Heuser, I, Bajbouj, M. Antidepressant electroconvulsive therapy: Mechanism of action, recent advances and limitations. Experimental Neurol 2009; 219: 2026.
6.Rose, D, Fleischmann, P, Wykes, T, Leese, T, Bindman, J. Patients' perspectives on electroconvulsive therapy: systematic review. BMJ 2003; 326: 13631367.
7.Sackeim, HA, Prudic, J, Fuller, R, Keilp, J, Lavori, PW, Olfson, M. The cognitive effects of electroconvulsive therapy in community settings”. Neuropsychopharmacol 2007; 32(1): 244–54.
8.American Psychiatric Association. The Practice of Electroconvulsive Therapy: Recommendations for Treatment, Training, and Privileging (2nd Ed). Washington, DC: American Psychiatric Association, 2001: 24–5, 77–9
9.National Institute for Clinical Excellence. Depression: the treatment and management of depression in adults. Oct 2009.
10.Philpot, M, Treloar, A, Gormley, N, Gustafson, L. Barriers to the use of electroconvulsive therapy in the elderly: a European survey. Eur Psych 2002; 17(1): 41–5.
11.Mental Health Commission. Rules governing the use of electro-convulsive therapy. Mental Health Commission, October 2009
12.Mental Health (Involuntary procedures) (Amendment) Bill 2008. An Act to amend the law on mental health in relation to the use of involuntary procedures, No 36 of 2008
13.Scottish ECT Accreditation Network. Annual Report 2010. NHS National Services Scotland/Crown Copyright 2010.
14.Mental Health Act 2007 (c. 12), Part 1 – Amendments to Mental Health Act 1983, Chapter 3 – Safeguards for patients, no 27.
15.Mental Health: A Report of the Surgeon General – Chapter 4. 1999-12-29. Task Force on Electroconvulsive Therapy. The practice of electroconvulsive therapy: recommendations for treatment, training, and privileging. 2nd Ed. Washington, DC: American Psychiatric Publishing, 2001.
16.Harris, V. Electroconvulsive Therapy: Administrative Codes, Legislation, and Professional Recommendations. J Am Acad Psych Law 2006, 34(3): 406411.
17. Mental Health Act 1986, No. 59 of 1986, Version No. 092, Version incorporating amendments as at 1 July 2007
18.Report on the Use of Electroconvulsive Therapy in Approved Centres in 2008, Mental Health Commission, Nov 2009
19.Dunne, R, Kavanagh, A, McLoughlin, DM. Electroconvulsive therapy, capacity and the law in Ireland. Ir J Psych Med 2009; 26(1): 35.
20.Finch, JM, Sobin, PB, Carmody, TJ, DeWitt, AP, Shiwach, RS. A Survey of Psychiatrists Attitudes Towards Electroconvulsive Therapy. Psych Serv 1999; 50(2): 264265.
21.Taylor, M, Brown, T. “Do Unto Others As….” – Which Treatments do Psychiatrists Prefer? Scot Med J 2007; 52(1): 1719.



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