Policy 200.06 Electroconvulsive Therapy
  1. Requests for Electroconvulsive Therapy (ECT) shall be submitted to the Intensive Care Division (ICD) Consulting Physician by the outpatient consulting physician for authorization accompanied by:
    1. Medical records, including a complete assessment of the client and documentation that indicates:
      1. ???????The reason for ECT.
      2. It is definitely indicated for this client.
      3. It is the least drastic alternative.
    2. Written and informed consent by the client, conservator, or legal guardian through completion of the Department of Health Care Services (DHCS) ECT Informed Consent (Form 1800).
  2. ICD consulting physician shall review all submitted documentation to complete the authorization process.
    1. ???????If additional information is needed, the ICD consulting physician shall contact the outpatient consulting physician for a consult.
  3. Once the ICD consulting physician has made a determination of authorization, a decision shall be provided to the outpatient consulting physician by phone or secure email.
  4. If approved, the DMH specialty mental health service (SMHS) linkage staff shall assist with connecting the client to the appropriate ECT treating physician.
  5. If in the judgment of the ECT treating physician more than the standard number of ECT sessions per client are indicated, prior approval must first be obtained from the review committee of the facility.
    1. ???????The ECT treating physician must then submit the information listed below to the ICD consulting physician for review and authorization of additional ECT sessions:
      1. Documentation of the diagnosis.
      2. Clinical findings leading to the recommendation for additional sessions.
      3. Consideration of other reasonable treatment modalities and the opinion that additional sessions pose less risk than other potentially effective alternatives available for the client.
      4. The specified maximum number of additional sessions.
    2. Procedures B - D above shall be followed.
  6. Any doctor or facility administering ECT shall report the number of persons who received treatment on a quarterly basis to the Patient’s Rights Office (WIC 5326.15(a)).