ECT for children questioned

Press, 24 May 1977, Page 3

ECT for children questioned

iPA Wellington. ] The Chief Ombudsman! i(Mr G. R. Laking) yesterday! released a summary of the: \ report of an investigation done by his predecessor, Sir I Guy Powles, into a coml plaint against the Department of Health and the Department of Social Welfare. | The complaint came from (parents of a 15-year-old boy about their son’s detention jand treatment in Lake Alice (Hospital and the handling of I the case by the departmental (officers involved. | Sir Guy concludes that the conduct of both the departements in relation to the boy’s detention and treati ment is open to criticism in I terms of section 22 (1) of 'the Ombudsman Act, 1975. In his opinion the cumulative effect of a number of j the actions and decisions of the departmental officers involved was that the boy was i done a grave injustice. I Sir Guy expresses reservations about the way electroI convulsive treatment (ECD (was administered to the boy and suggests that the Department of Health review i this form of treatment to I children and young persons I detained in psychiatric hospitals. | In particular he considers that unmodified ECT should Ibe discontinued. i Sir Guy makes the following recommendations. — The Director-General of Social Welfare discharge the guardianship order in respect of the boy. The Department of Health adopt and apply in psychiatric hospitals a suggested standard relating to consent to psychiatric treatment. The Department of Health review the adminisi tration of Lake Alice Hospital with a view to controlling more closely the operation of the disturbed children’s unit. The practice of the Department of Social Welfare of placing children and young persons subject to guardianship orders in psychiatric hospitals be stopped. The departments take steps to alert staff to the absolute necessity to observe the strict statutory requirements for the safeguarding of the liberty of the subject, no matter his or her age.

The departments have been asked to report to the Chief Ombudsman the steps being taken to give effect to these recommendations. Sir Guy lists a standard which he says the Department of Health should adopt and apply in psychiatric hospitals relating to consent. “Treatment (other than nursing care) should not be imposed on any patient without his consent if he is able to appreciate or understand what is involved. Three exceptions should be allowed — treatment may be given without consent: Where it is not hazardous or irreversible and is the minimum necessary to prevent the patient behaving violently or being a danger to himself or others. Where it is necessary to save his life, or Where (not being irreversible) it is necessary to prevent him from deteriorating. Where, by reason of his age or disability, the patient is unable to understand or appreciate what is involved, despite the help of an explanation in simple terms, treatment may be given, but where irreversible treatment is involved: Obtain a second psychiatric opinion independent of the treating hospital (unless delay would cause or exacerbate a danger to life). The patient’s nearest relative or legal guardian should be consulted if this consultation is possible within a reasonable time.

Sir Guy said: “In my opinion the Children and Young Persons Act does not authorise the detention of a young person in a psychiatric hospital when he is either in social welfare ‘custody,’ under ‘supervision’ or ‘guardianship’ without recourse to the formal committal procedures of the Mental Health Act, “In my view, any case referred to a psychiatric hospital must be brought squarely within the terms of the statute, and the principles of law must be properly applied, in each instance. “The other matter of concern related to communication between the Lake Alice authorities and the parents and the social workers responsible for the boy’s supervision, and later, guardianship,” Sir Guy said. “The boy was held in the hospital in an arbitrary manner and the parents were handled in a cursory fashion. There appeared to be no free flow of information about the boy’s detention and treatment with the consequence that the relationship of hospital staff with the parents was ex“Similarly, the Social Welfare officers were not kept as fully informed of the developments as would have been desirable, with the result that they were unable to keep a closer watch over the boy’s welfare. “In my view the over-all effect was to undermine the harmony and well-being of the family when confronted with an unfortunate social problem and impaired their relationship with and respect for the State agencies seeking to assist.”