Hostname: page-component-cd9895bd7-dk4vv Total loading time: 0 Render date: 2024-12-23T08:01:00.132Z Has data issue: false hasContentIssue false
  • English
  • Français

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

Published online by Cambridge University Press:  13 June 2014

Diana Schirliu ,
Edyta Truszkowska  and
Colm McDonald
Diana Schirliu
Affiliation:
Department of Psychiatry, National University of Ireland Galway, Ireland
Edyta Truszkowska
Affiliation:
Department of Psychiatry, National University of Ireland Galway, Ireland
Colm McDonald*
Affiliation:
Department of Psychiatry, National University of Ireland Galway, Ireland
*
*Correspondence E-mail: [email protected]
Get access Rights & Permissions [Opens in a new window]

Abstract

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.

Keywords

ECTCapacityConsentMHA 2001
Type
Original papers
Information
Irish Journal of Psychological Medicine , Volume 28 , Issue 4 , December 2011 , pp. 196 - 200
Copyright
Copyright © Cambridge University Press 2011

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

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: 247–273CrossRefGoogle ScholarPubMed
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): 1337CrossRefGoogle Scholar
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: 425–434CrossRefGoogle ScholarPubMed
4.UK ECT Review Group. Efficacy and safety of electro-convulsive therapy in depressive disorders: a systematic review and meta-analysis. Lancet 2003; 361: 799–808.CrossRefGoogle Scholar
5.Merkl, A, Heuser, I, Bajbouj, M. Antidepressant electroconvulsive therapy: Mechanism of action, recent advances and limitations. Experimental Neurol 2009; 219: 20–26.CrossRefGoogle ScholarPubMed
6.Rose, D, Fleischmann, P, Wykes, T, Leese, T, Bindman, J. Patients' perspectives on electroconvulsive therapy: systematic review. BMJ 2003; 326: 1363–1367.CrossRefGoogle ScholarPubMed
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.CrossRefGoogle ScholarPubMed
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, 77–9Google Scholar
9.National Institute for Clinical Excellence. Depression: the treatment and management of depression in adults. Oct 2009.Google Scholar
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.CrossRefGoogle Scholar
11.Mental Health Commission. Rules governing the use of electro-convulsive therapy. Mental Health Commission, October 2009Google Scholar
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 2008Google Scholar
13.Scottish ECT Accreditation Network. Annual Report 2010. NHS National Services Scotland/Crown Copyright 2010.Google Scholar
14.Mental Health Act 2007 (c. 12), Part 1 – Amendments to Mental Health Act 1983, Chapter 3 – Safeguards for patients, no 27.Google Scholar
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.Google Scholar
16.Harris, V. Electroconvulsive Therapy: Administrative Codes, Legislation, and Professional Recommendations. J Am Acad Psych Law 2006, 34(3): 406–411.Google ScholarPubMed
17. Mental Health Act 1986, No. 59 of 1986, Version No. 092, Version incorporating amendments as at 1 July 2007Google Scholar
18.Report on the Use of Electroconvulsive Therapy in Approved Centres in 2008, Mental Health Commission, Nov 2009Google Scholar
19.Dunne, R, Kavanagh, A, McLoughlin, DM. Electroconvulsive therapy, capacity and the law in Ireland. Ir J Psych Med 2009; 26(1): 3–5.CrossRefGoogle ScholarPubMed
20.Finch, JM, Sobin, PB, Carmody, TJ, DeWitt, AP, Shiwach, RS. A Survey of Psychiatrists Attitudes Towards Electroconvulsive Therapy. Psych Serv 1999; 50(2): 264–265.CrossRefGoogle Scholar
21.Taylor, M, Brown, T. “Do Unto Others As….” – Which Treatments do Psychiatrists Prefer? Scot Med J 2007; 52(1): 17–19.CrossRefGoogle Scholar