Section 58A – Electroconvulsive Therapy (ECT) – English

This leaflet explains the special rules in the Mental Health Act 1983 about the use of electro-convulsive therapy (ECT) to treat mental disorder. These rules are in section 58A of the Mental Health Act.

ECT is a treatment used for a small number of severe mental disorders, such as severe depression, mania, and catatonia. During ECT, an electric current is passed briefly though the brain, which causes a seizure (a ‘fit’). ECT is given under a general anaesthetic and patients are also given drugs to relax their muscles to avoid them hurting themselves during the fit. Usually, ECT is given in a course of 6 or 12 sessions, by specially trained staff.

If the hospital staff think it would be a good idea for you to have ECT, they will explain what it is, and why they think you should have it.

If you are able to decide for yourself, you do not have to agree to ECT if you do not want it. You will only be given ECT if you agree to it, or it is an emergency.

If you are aged under 18 and you agree to ECT, a doctor who is not from the hospital where you are being treated will come and see you.

This independent doctor is called a SOAD (Second Opinion Appointed Doctor) and is appointed by an independent Commission which monitors how the Mental Health Act is used.

The independent doctor will talk to you and to staff at the hospital who know you. You can only be given ECT if both you and the independent doctor agree to it, or it is an emergency.

The hospital staff may think that, because of your mental disorder, you are not able to decide for yourself whether to have ECT.

This means they think you cannot understand what ECT is, what it is for, and what its effects and benefits might be.

If they think you are not able to decide for yourself, the hospital staff will ask an independent doctor (a SOAD) to come and see you. The independent doctor will talk to you and to staff at the hospital who know you.

If the independent doctor agrees that you are not able to decide for yourself, the independent doctor can agree to allow the hospital staff to give you ECT. Unless it is an emergency, you can only be given ECT if the independent doctor has agreed.

But the independent doctor cannot agree to allow the hospital staff to give you ECT if you have made a legally binding advance decision to refuse ECT under the Mental Capacity Act 2005, or someone else who is allowed to take decisions on your behalf under that Act has said that you should not have it. This could be someone to whom you have given a lasting power of attorney, a deputy appointed for you by the Court of Protection, or the Court of Protection itself. The hospital staff can give you more information about the Mental Capacity Act 2005.

In an emergency, you can be given ECT even if neither you nor an independent doctor has agreed to it.

But that can only be done if you need to have ECT straight away in order to save your life, or to stop your mental health getting very much worse.

There is a Code of Practice that gives advice to the staff in the hospital about the Mental Health Act and treating people for mental disorder. The staff have to consider what the Code says when they take decisions about your care. You can ask to see a copy of the Code, if you want.

You can talk to a staff member or use the contacts listed below. See other ways to give feedback

Your Voice
You can use this email to tell us what you think about your care. This can be good or bad. You can also ask us to tell you what happens after you send feedback.

Email: [email protected]

Comments and complaints
If something went wrong, please tell us. This will help us improve services.

Email: [email protected]
Telephone: 0191 245 6672
Write to: Complaints Department, Cumbria, Northumberland, Tyne and Wear NHS Foundation Trust, St Nicholas Hospital, Gosforth, Newcastle upon Tyne, NE3 3XT.

Patient Advice and Liaison Service (PALS)
PALS offer a free, confidential service. They can help if you are worried about your care. They support patients, families and carers.

PALS North of Tyne
(services in Newcastle, North Tyneside, Northumberland and North Cumbria)
Email: [email protected]
Telephone: 0800 032 0202

PALS South of Tyne
(services in Sunderland, Gateshead, South Tyneside and Lotus Ward, Middlesbrough)
Email: [email protected]
Telephone: 0800 328 4397

If there is anything you do not understand about your care and treatment, a member of staff will try to help you. Please ask a member of staff to explain if there is anything in this leaflet you do not understand or if you have other questions that this leaflet has not answered.

Please ask if you would like another copy of this leaflet for someone else.

You can get more information about this leaflet from the Patient Information Centre. This includes how the leaflet was made. We can provide this leaflet in other formats. These include Braille, audio, large print, Easy Read, British Sign Language, and other languages.

We welcome your feedback about this leaflet. You can email [email protected]

Published by the Patient Information Centre
2026 Copyright: Cumbria, Northumberland, Tyne and Wear NHS Foundation Trust

Ref: PIC/215/0526 May 2026 V7
Review date 2027

Website: www.cntw.nhs.uk – Telephone: 0191 246 6800

Find us on social media. Search for CNTW.