31 - Electroconvulsive therapy (ECT)

Electroconvulsive therapy (ECT)

952 The Maudsley® Prescribing Guidelines in Psychiatry CHAPTER 14 Section 62 urgent treatment If after 3 months medication is needed urgently to treat a patient’s mental disorder and it is not covered by a T2 or T3, S62 may be applied. The Code of Practice 25.38 states: This applies only if the treatment in question is immediately necessary to: ■ ■save the patient’s life; ■ ■prevent a serious deterioration of the patient’s condition, and the treatment does not have unfavourable physical or psychological consequences which cannot be reversed; ■ ■alleviate serious suffering by the patient, and the treatment does not have unfavourable physical or psychological consequences which cannot be reversed and does not entail significant physical hazard; or ■ ■prevent patients behaving violently or being a danger to themselves or others, and the treatment represents the minimum interference necessary for that purpose, does not have unfavourable physical or psychological consequences which cannot be reversed and does not entail significant physical hazard. Each Trust should design a form for the clinician in charge of treatment (usually the consultant) to state what the treatment is, why it is immediately necessary and the length of treatment. Section 132 duty of managers of hospitals to give information to detained patients With regard to S132 and consent to treatment the Code of Practice 4.20 states: Patients must be told what the Act says about treatment for their mental disorder. In particular they must be told: ■ ■the circumstances (if any) in which they can be treated without their consent – and the circumstances in which they have the right to refuse treatment; ■ ■the role of second opinion appointed doctors (SOADs) and the circumstances in which they may be involved; and ■ ■(where relevant) the rules on electroconvulsive therapy (ECT) and medication administered as part of ECT. Electroconvulsive therapy (ECT) Section 58a deals with ECT. Treatment for ECT is authorised on forms: T4 For consenting adults 18 and over, may be written by the RC or SOAD T5 For consenting patients under 18, to be written by SOAD only T6 For patients who lack capacity, to be written by SOAD only