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No3Sister
Casual Contributor

Treatment Authority for ECT

Hi - I have only just found this site; have tried searching the forum for this topic but cannot find anything ... so apologies if this has been previously discussed.

My sister (60+ years) has had mental health issues for many years - variously diagnosed as schizophrenia, bipolar, etc. She has been on medication with no hospital admissions for the past 7 years but recently had an episode where she lapsed into a confused, semi-catatonic state. 

She is very compliant - came with me to the hospital and was admitted. After investigating all medical possibilities (stroke, UTI), she was admitted to the psychiatric ward. I won’t bore you with the ins and outs of the ever-changing information we (her family) received from the hospital staff but the diagnoses and treatment options seemed to change daily - and sometimes hourly. Ultimately, they phoned me (as her main support person) and told me they wanted to do apply for emergency electroconvulsive therapy. She has never had this before; I had no idea what it actually even was; and it was never properly explained to me, except for the consulting psychiatrist telling me that I had absolutely no say in whether the treatment would go ahead or not.

I was leaving for overseas the next day - the hospital went ahead with the treatment and my sister was much improved when I returned. She was discharged last week. 

After she was discharged, however, I found a letter from the state government among her things advising that a Treatment Authority had been taken out against her because she was an ‘involuntary’ patient and that they could give her any treatment they liked without consent. It was dated and timed before she was actually admitted to the specified hospital (she was transferred across from one hospital to another) so I am concerned that it has actually been filled out fraudulently. I was never told that there was a TA, despite speaking to the medical staff on an almost daily basis over more than a month and attending three family meetings. Also, there is no end date on the TA so I’m guessing it is still in force even though she is now home. 

I’m trying not to over-react to all of this by firing off letters and lodging official complaints - my absolute focus in for my sister to get well - but can anyone tell me if the above is normal procedure?

Thank you.

8 REPLIES 8

Re: Treatment Authority for ECT

@No3Sister Hi No3Sister and welcome to the forums. I have no experience in this area so I am flying blind here but if it was me I would be contacting your sister's psychiatrist and asking him/her about it. Other than that is there a contact number on the form. Yes you have every right to be concerned particularly as it appears to be open ended ... personally I don't like open ended. Let us know how it goes. greenpea

Re: Treatment Authority for ECT

Thanks for your feedback, Greenpea. Unfortunately, it’s the psychiatrist (from the hospital) that seems to be the problem. He is the one who signed the TA and didn’t tell me about it. (My sister doesn’t have her own psychiatrist - her condition has been managed by her GP - so the only time we have contact with a psychiatrist is when she goes into hospital.) I have sent a written reply to the author of the letter and will also raise the issue with my sister’s GP so thank you for those suggestions. 

Re: Treatment Authority for ECT

Hi there @No3Sister, I'd be trying to contact a disability advocate in your state for your sister. I've been given ECT both voluntarily and involuntarily in the past. In my state, all treatment orders and treatment authorities (such as ECT) as subject to the mental health tribunal. Under tribunal rules and regulations, your sister should have had access to a nominated person to act on her behalf. Also, the fact that the TA is open ended is a worry. 

I'm glad your sister is much improved following ECT, however what has happened under the terms of the treatment authority certainly are different from my experiences.

Former-Member
Not applicable

Re: Treatment Authority for ECT

What state are you in @No3Sister?  Each state's mental health act is readily available on line.  It is my understanding under Australian laws treatment orders are time limited and regular reviews are to take place. I know that in my husband's case ECT had to be specifically authorised under the treatment order. A patient is entitled to free legal aid as well as advocacy.  A patient is at liberty to apply to have an order reviewed.

Re: Treatment Authority for ECT

Thank you all for your feedback and comments. This is a brave new world for me so I really appreciate your insights based on experience. My sister’s situation was complicated by the fact that I was going overseas the day after they sprung this ‘emergency ECT application’ on me - they knew that I wouldn’t be around and I think they took advantage of that fact. I’d had a family meeting with the consulting psychiatrist who told me that they were trying one lot of drugs, had an alternative drug to try if that didn’t work and would look at ECT only as a last resort Plan C. The drugs took a while to work so they would explore that avenue for the two weeks I was away and then look at the situation and the need for ECT when I returned. It all made sense to me.

The very next day, I get a call from the Registrar while I’m in a shopping centre telling me that a different consulting psychiatrist that I’d never heard of, wanted to apply for an emergency ECT. It turns out the first doctor I saw wasn’t actually my sister’s doctor; she was just filling in while this other bloke was away. He returns from his holiday, and makes an on-the-spot decision to totally disregard everything this other dr had told me and go ahead with an emergency ECT application. No-one ever told me that Dr No. 1 was just filling in or that there was a Treatment Authority in place. Nor did anyone ever explain what ECT is. 

I raced into the hospital straight after that phone call from the Registrar to meet with the ‘real’ consulting psychiatrist who talked about the Mental Health Review Panel and that I’d need to get a lawyer but I was leaving the country the next day. Above all, he said straight up that I had no say in the matter.

I could go on and on with my issues with the hospital and medical staff but I think I’m just venting now and I’m sure that’s not what this forum is for!! Thanks for listening anyway ...

Re: Treatment Authority for ECT

@No3Sister

I will tag you in the carer side - there are threads on lack of communication and there was a topic Tuesday - hope this gets you to the link. 

 

https://saneforums.org/t5/Special-Events/Topic-Tuesday-Feeling-excluded-in-a-loved-ones-treatment-jo...

Re: Treatment Authority for ECT

Hi @Former-Member - thank you so much for those tags. Made for some interesting reading and good to know that I’m not alone in my frustration. 

We keep hearing about how mental health is stigmatised by the community, with calls for more understanding ... It strikes me that the stigmatisation is not coming from the community but from the medical professionals and institutions!

I will update my post when / if I receive a response from the mental health delegate about my sister’s treatment authority. Thanks again ... 

Re: Treatment Authority for ECT

Wishing you all the best @No3Sister.
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