A new tribunal must approve ECT for involuntary patients.A NEW tribunal will be required to approve electroconvulsive therapy treatment for involuntary patients as part of an overhaul of Victoria’s mental health laws announced by the state government.

Victoria is the only jurisdiction in Australia that allows ECT without the consent of the patient and without either an external review from a tribunal or a second psychiatrist.

The former Labor government began a review of the 26-year-old Mental Health Act but it has been delayed for almost two years since the Coalition won office in 2010.

In releasing details of the reforms, Mental Health Minister Mary Wooldridge said the government took into account hundreds of written submissions and extensive public consultation.

She said the reforms would allow mentally ill patients more say in their treatment, including stating their preferences in advance in case they became too unwell to communicate them.

Patients will also be able to nominate a person to support them during compulsory treatment, which would be deemed necessary only to prevent harm to the patient or others.

A new mental health tribunal comprising a doctor, a lawyer and a community representative will be required to approve compulsory treatment orders beyond 28 days, as well as ECT treatment if the patient is unable to consent.

In a submission to the review St Vincent’s Hospital warned that waiting for tribunal approval for ECT could delay treatment.

Speaking to The Age about the reforms, Royal Australian and New Zealand College of Psychiatrists spokesman Malcolm Hopwood said ECT was an effective and sometimes life-saving treatment for severe mental illness.

”It is a significant change to require the authority of a tribunal to proceed, and we’ll obviously be looking very closely at the detail of how that’s going to be governed, and provisions around cases that require immediate treatment,” he said.

Associate Professor Hopwood welcomed the government’s decision not to proceed with penalties of up to a year’s jail for psychiatrists who breached ECT regulations.

He said there were more appropriate mechanisms for dealing with bad practice, including through the medical board.

Mental Illness Fellowship chief executive Elizabeth Crowther said the reforms were ”very significant”, particularly in recognising that patients’ capacity to make decisions about their treatment could fluctuate.

”Being able to work with the person while they are well and saying you can have some control over what happens to you when you are unwell is a sensational change,” Ms Crowther said.

Ms Wooldridge said the government planned to introduce a bill into Parliament by June, with the laws to take effect a year later.

A new mental health complaints commissioner to be appointed as part of the reforms will have ”broad powers to investigate services, make recommendations and issue compliance notices for serious and flagrant breaches of the legislation”, according to a government summary.

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