Non-consenting patients make up an increasing proportion of people treated with electroconvulsive therapy (ECT) in England. Most, though not all, of the people given ECT without their consent are treated under section 58A of the Mental Health Act. The patient has to be assessed as lacking capacity to make a decision about treatment, and the treatment approved by a psychiatrist from the Care Quality Commission panel.
Last year (April 2016/March 2017) the Care Quality Commission received 2,261 requests for a visit from one of their psychiatrists to approve the use of ECT on a patient who was not consenting to treatment. The number of requests does not equate to the number of people treated without their consent: some requests may be cancelled, sometimes (very rarely) the psychiatrist does not authorise ECT, and more than one request may be made for the same person during the year; on the other hand there are other ways to treat people without their consent, for example, under section 62 of the Mental Health Act or under the provisions of common law.
In 2016/17 two NHS trusts in England made more than 100 requests for a visit from a Care Quality Commission psychiatrist to approve the use of ECT without consent under section 58. They were Avon and Wiltshire Mental Health Partnership NHS Trust (116 requests) and Southern Health NHS Foundation Trust (106 requests).
Avon and Wiltshire Mental Health Partnership NHS Trust treated 143 people with ECT in 2016/17, of whom nearly half (68) lacked capacity to consent. Southern Health NHS Foundation Trust meanwhile treated 176 people with ECT and were not able to say how many had not consented to treatment.