A new mental health act expected to go before the Victorian Parliament next week will tighten controls around compulsory treatment, including electroconvulsive therapy, in long-awaited reforms that will strengthen protections for patients.
The act, due to take effect from July, will establish a new tribunal to approve ECT for patients who are too sick to provide consent, and for children under 18.
Victoria is the only jurisdiction in Australia that allows ECT for patients unable to provide consent and without external review from a tribunal or second psychiatrist, under existing 28-year-old laws.
The government has backed down on plans to ban ECT for children aged 12 and under after doctors said the treatment, while used very rarely for children, was a valuable option for cases of severe depression when other treatment options had been exhausted.
Mental Health Minister Mary Wooldridge said the likely need for emergency or ”same day” ECT was rare and the tribunal would be able to expedite hearings where necessary.
Psychiatrists are concerned about an increased workload under the new act, which will only allow them to make orders for patients to receive compulsory hospital treatment for up to 28 days before going before the tribunal to seek an extension.
The tribunal will also oversee community treatment orders requiring patients to take medication or attend medical appointments.
Royal Australian and New Zealand College of Psychiatrists president-elect Malcolm Hopwood said a high level of scrutiny over compulsory treatment orders was important but an increased number of tribunal hearings under the new act would place considerable time demands on psychiatrists.
”Some of the estimates we have are there will be an increase of up to 40 per cent in the number of hearings, and we don’t have a 40 per cent increase in the availability of consultant psychiatrists,” he said.
Victorian Mental Illness Awareness Council director Isabell Collins said the act would have significant benefits for patients, including allowing them to make advance care directives stating their treatment preferences in the event they became seriously unwell.
She also welcomed the establishment of a mental health complaints commissioner who will ensure a patient’s rights are upheld, and said the act heralded the beginning of a ”cultural change” in mental healthcare.
A spokesman for Ms Wooldridge said new, ongoing funding of $5.84 million a year would be provided from next financial year to help health services meet new requirements under the act.
He said the act would be reviewed after five years to ensure Victoria’s mental health legislation ”keeps pace with innovation and clinical best practice”.
This article first appeared on ‘The Age’ on 15 February 2014.