Section 58A – Electroconvulsive Therapy (ECT) – English

This leaflet has been produced to provide information to patients who have been detained about electro-convulsive therapy(ECT). It explains what this is, if you can refuse ECT and information if you are under 18.

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This leaflet may not be reproduced in whole or in part, without the permission of Cumbria, Northumberland, Tyne and Wear NHS Foundation Trust

  • What is this leaflet about?

    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.

  • What is electro-convulsive therapy?

    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.

  • Can I refuse ECT?

    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.

  • What if I am under 18?

    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.

  • What if the hospital staff think I am unable to decide for myself?

    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.

  • What happens in an emergency?

    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.

  • Code of Practice

    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.

  • What if I have a comment, suggestion, compliment or complaint about the service?

    If you want to make a comment, suggestion, compliment or complaint you can:

    We are always looking at ways to improve services. Your feedback allows us to monitor the quality of our services and act upon issues that you bring to our attention. You can provide feedback in the following ways:

    • the quickest way for you to do this is to complete our short online survey at
    • complete a Points of You survey, available on wards, reception areas or from staff
    • other options for sharing your feedback and experience

    Patient Advice and Liaison Service (PALS)
    PALS provide confidential advice and support, helping you to sort out any concerns that you may have about any aspect of your or your loved ones care.

    We act independently when handling patient and family concerns, liaising with staff, managers and, where appropriate, relevant organisations, to negotiate prompt solutions. If necessary, we can also refer patients and families to specific local or national-based support agencies.

    North of Tyne
    Tel: 0800 032 0202
    Email: [email protected]

    South of Tyne
    Tel: 0800 328 4397
    Text: 07825 061 035
    Email: [email protected]
    Post: Patient Advice and Liaison Service, Garden Lodge, Hopewood Park, Ryhope, Sunderland, SR2 0NB

    9am – 4.30 pm, Monday to Friday
    An answerphone is available at all times for you to leave a message. A member of the PALS team will aim to return your call as soon as possible.

    If you do not feel that the hospital complaints procedure can help you, you can complain to an independent Commission. This is called the Care Quality Commission and it monitors how the Mental Health Act is used, to make sure it is used correctly and that patients are cared for properly while they are in hospital. The hospital staff can give you a leaflet explaining how to contact the Commission.

  • Further help and information

    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.

  • Information about content, other formats and version control

    Further information about the content, reference sources or production of this leaflet can be obtained from the Patient Information Centre. If you would like to tell us what you think about this leaflet please get in touch.

    This information can be made available in a range of formats on request (eg Braille, audio, larger print, easy read, BSL or other languages). Please contact the Patient Information Centre Tel: 0191 246 7288

    Published by the Patient Information Centre
    2024 Copyright, Cumbria, Northumberland, Tyne and Wear NHS Foundation Trust
    Ref, PIC/215/0124 January 2024 V6 Tel: 0191 246 7288
    Review date 2027