Mental healthcare act and electroconvulsive therapy: Making a case for review

The Mental Healthcare Act of 2017 has introduced some restraints on the practice of electroconvulsive therapy (ECT) in India. It has prohibited the administration of unmodified ECT and ECT to minors without permission from the mental health review board. While intended as safeguards for the patients, blanket application of these restraints has practical concerns. ECT is known to be one of the most effective and rapidly acting treatments in some psychiatric emergencies. The unavailability of anesthesiologists or required infrastructure may limit access to modified ECT in resource-poor settings. In such situations, the patient may consent to the unmodified ECT. If the patient lacks the capacity to provide consent, the nominated representative may provide it. Such intervention can be life-saving at times and mitigate complications. This article makes the case for reconsidering the current legislature. The unmodified ECT may be considered in certain exceptional situations. Relevant authorities should consider amending the Mental Healthcare Act of 2017 in this regard.