The National Institute for Health and Care Excellence’s (NICE) assessment found electroconvulsive therapy (ECT) to be an effective treatment for certain subgroups of individuals with mental disorders. However, it recognised that there remained a number of uncertainties, including a lack of information on longer term outcomes and the negative experiences of some individuals who have undergone ECT.
NICE recommends that ECT is used only to achieve rapid and short-term improvement of severe symptoms, after an adequate trial of other treatment options has proven ineffective and/or when the condition is considered to be potentially life-threatening, in individuals with catatonia or a prolonged or severe manic episode. These guidelines recommend that a decision should be made on case by case basis and that a risk–benefit assessment is made of the individual to determine if ECT is appropriate. NICE’s ‘Guidance on the use of electroconvulsive therapy’ and ‘Depression in adults: treatment and management’ are available at the following links:
The Mental Health Act 1983 and the Mental Capacity Act 2005 allow for ECT to be administered in particular circumstances, without the person’s consent. The Independent Review of the Mental Health Act recommended further safeguards around the use of urgent ECT without the patient’s consent or where it conflicts with an advance decision, which the draft Mental Health Bill seeks to address.