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Call for changes in use of electro-convulsive therapy

The Mental Health Commission has criticised the use of electro-convulsive therapy on patients who are unwilling or unable to give consent.

THE MENTAL HEALTH Commission has called for an amendment to current standards relating to the use of electro-convulsive therapy (ECT) on patients who unwilling or unable to give consent.

In its annual review, the Mental Health Commission (MHC) said that it was committed to introducing Mental Capacity legislation, which would bring Ireland in line with the UN Convention on the Rights of Persons with Disabilities.

Under the current Mental Health Act, patients in Ireland who are unwilling to undergo ECT can be forced to do so.

“It is the Commission’s view that the Section relating to electro-convulsive therapy (ECT) in the Mental Health Act should be amended,” Dr Edmond O’Dea, Chairman of the MHC said. “Under current legislation ECT can be given to those who are unwilling or unable to give consent.  The Commission believes the word ‘unwilling’ should be removed from this section of the Act.”

O’Dea said that the legislative changes would help those with impaired mental capacity or mental illnesses to have input into decisions concerning their treatment.

The MHC also welcomed the review of the Criminal Law Insanity Acts.

Increase in admissions to mental health centres

The report revealed that there had been an increase in the number of involuntary admissions to mental health centres in Ireland last year.

During 2011, there were 2,057 involuntary admissions – an increase of 5 per cent on the previous year. The report notes that ‘involuntary admissions’ refers to the number of admissions themselves rather the the number of people admitted (ie the same individual may have been involuntarily admitted on more than one occasion).

There were also 1,771 Mental Health Tribunal hearings in 2011.

In total, 326 children were admitted to approved centres – a third of which whom were sent to adult centres.

Admissions of children to adult units

O’Dea said the provision of specialised units for children had “directly resulted” in a decline in the number of admissions of children to adult units in 2011. “In 2007 61.6 per cent of child admissions were made to adult units, while in 2011 just 31.4 per cent of child admissions were to adult units,” he said.

However, the Commission added that it remained “concerned” about the number of children being admitted to adult units and hoped to see a reduction in this number in 2012.

The Commission’s code of practice states that, as of December 2011, no child under 18 will be admitted to an adult unit in an in-patient centre or hospital save for very exceptional circumstances.

A separate report by the Inspector of Mental Health Services found an increase in the use of continuous seclusions of 72 hours a week or more, and noted that only three mental health units were fully compliant with regulations last year.

More than 48,000 people treated in hospital after deliberate self-harm>

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