TREATMENT GUIDELINE FOR BIPOLAR MOOD DISORDER (BMD)
	INDICATIONS FOR ECT
	LEVEL 1
	LEVEL 2
	LEVEL 3
	LEVEL 4
	GO TO ALGORITHM BMD MANAGEMENT
	SEVERE DEGREE OF MAJOR DEPRESSION
	HIGH SUICIDE RISK
	PSYCHOTIC FEATURES
	CATATONIC FEATURES
	FOOD REFUSAL
	PREGNANCY
	PREVIOUS GOOD RESPONSE AND/OR PATIENT PREFERENCE
	MEDICAL CONDITION THAT PRECLUDES THE USE OF ANTIDEPRESSANTS AND WHERE AN ANAESTHETIC WOULD BE SAFE
	INADEQUATE RESPONSE IN 10 TO 14 DAYS
	SEVERE UNCONTROLLABLE MANIA
	RISK TO OTHERS AND SELF
	PATIENT PREFERENCE AND/OR PREVIOUS GOOD RESPONSE
	MENTAL HEALTH CARE ACT, 2002 (ACT NO. 17 OF 2002); GENERAL REGULATIONS
	CHAPTER 5: SURGICAL PROCEDURES, MEDICAL OR THERAPEUTIC TREATMENT
	35. Electro-convulsive treatment
	(1) Electro-convulsive treatment (ECT) shall be conducted by a medical practitioner with special training in mental health and shall only be carried out under a general anaesthetic together witha muscle relaxant.
	(2) No mental health care user shall have more than one treatment carried out in a 24-hour period and not more than three treatments within a week.
	(3) All standard operating procedures relating to written consent for an operation shall be adhered to.
	(4) A heatth establishment under the auspices of the State or a private health establishment must be approved by the head of the provincial department concerned to perform ECT.
	(5) Whenever ECT is utiliied a register signed by a medical practitioner shall be completed and a transcript of the register referred to in subregulation (3) shall be submitted by the health establishment concerned to the Review Board on a quarterly basis in thefo rm of MHCA 47.
	ELECTROCONVULSIVE TREATMENT IS A SPECIFIC SCIENTIFIC TREATMENT METHOD AND NEEDS SKILL AND TRAINING. ONLY PROFESSIONALS WITH THE NECESSARY ACADEMIC TRAINING AT A RECOGNISED ACADEMIC INSTITUTION SHOULD PERFORM ECT WITHIN THEIR OWN SCOPE OF PRACTICE