Electroconvulsive Treatment (ECT) is a regulated medical procedure used in the treatment of certain mental health conditions. In Victoria, its administration is guided by stringent legal frameworks to ensure that it is performed ethically and with appropriate oversight.

This guide outlines the key guidelines, processes, and safeguards associated with ECT in Victoria, providing individuals with clear information to understand their rights and navigate the system with confidence.

What is Electroconvulsive Treatment and How Does It Work?

ECT uses a small electrical current to stimulate the brain, inducing a seizure that can help reset certain brain functions and improve symptoms of mental illness. While its exact mechanism is not fully understood, ECT is widely recognised for its ability to restore balance in brain chemistry, alleviate severe symptoms, and improve overall functioning.

Key Features of ECT:

• Administered under general anaesthetic and muscle relaxants for safety and comfort.
• Typically involves a series of up to 12 treatments over a maximum of six months.
• Delivered by a specialised medical team, including psychiatrists and anaesthetists.

When Can ECT Be Administered?

1. Voluntary Administration (With Consent)

ECT can be provided to individuals aged 18 or older who have the capacity to give informed consent, without requiring approval from the Mental Health Tribunal. To meet the criteria for consent:

• It must be provided in writing.
• The individual must understand the purpose, benefits, and risks of the procedure.
• Consent must be given freely and without coercion.

• Involuntary Administration (Without Consent)

In cases where an individual cannot provide informed consent, ECT may only proceed with the approval of the Mental Health Tribunal. The following conditions must be met:

• The individual is under a treatment order.
• They lack the capacity to make informed decisions.
• No less restrictive alternative treatment is available.

For individuals under 18 years of age, tribunal approval is required regardless of whether consent is provided by the individual or their parents.

The Role of the Mental Health Tribunal

The Mental Health Tribunal is tasked with ensuring ECT is only used when necessary and in the best interests of the individual. Before granting approval, the tribunal considers:

• The individual’s preferences and any advanced statements.
• Input from support persons, guardians, or carers.
• The benefits of ECT compared to other treatments.
• Potential risks if ECT is not administered.
• Expert medical opinions, including second opinions.
• The views of parents or legal representatives for individuals under 18.

The tribunal must deny approval if:

• The individual is capable of informed consent and refuses the treatment.
• A less restrictive treatment option is available.

Understanding Tribunal Hearings

Applications for ECT must be reviewed by the tribunal within five business days. The individual must receive a detailed report explaining the need for ECT at least 48 hours before the hearing. During the hearing, individuals have the right to:

• Present their views and preferences.
• Be supported by a guardian, legal representative, or nominated support person.
• Request additional evidence or expert opinions.

Urgent ECT

In emergencies, the tribunal can expedite the approval process. Urgent ECT may be necessary to:

• Save the individual’s life.
• Prevent serious deterioration in their health.
• Alleviate significant and ongoing pain or distress.

If You Disagree with a Tribunal Decision

If you are dissatisfied with the tribunal’s decision regarding ECT, you have several options:

1. Apply for a Revocation of the Treatment Order: If you are still on a treatment order, you can apply to have it revoked.

• Request a Statement of Reasons: Submit a written request within 20 business days of the decision to receive a detailed explanation of the tribunal’s reasoning.

• Apply for a Review: Seek a review of the tribunal’s decision by the Victorian Civil and Administrative Tribunal (VCAT) within 20 business days of the decision or receipt of the statement of reasons.

Seeking legal advice can help you determine the most appropriate course of action.

Key Legislation

The administration of ECT in Victoria is governed by the Mental Health Act 2014 (as amended) and associated regulations. These laws outline the rights of individuals and the responsibilities of healthcare providers.

Resources and Support

If you require assistance or further information about ECT and mental health treatment, the following resources may be helpful:

1. Victoria Legal Aid: Offers legal advice and representation for mental health matters.
2. Mental Health Tribunal: Provides detailed information on tribunal processes.
3. Department of Health Victoria: Contains updates on mental health legislation and policies.
4. Victorian Civil and Administrative Tribunal (VCAT): Reviews tribunal decisions.

Additional Resources and Publications

For in-depth guidance and information, refer to:

1. Mental Health and Wellbeing Act 2022 Handbook
2. Mental Health Law: A Practical Guide
3. Are you on treatment order?
4. Independent Mental Health Advocacy

Conclusion

Electroconvulsive Treatment is a highly regulated procedure in Victoria, designed to ensure that it is administered ethically and only when necessary. If you are facing a decision regarding ECT or have concerns about the process, understanding your rights and the relevant legal framework is crucial.

For tailored legal advice and support, reach out to Pentana Stanton Lawyers. Our experienced team is here to guide you through the complexities of mental health law and advocate for your rights.

Visit Pentana Stanton Lawyers or call us at (03) 900 22 800 to schedule a consultation.