Unusual or Hazardous Forms of Treatment for Mental Illness in Illinois

In this article, we explain the law regarding unusual or hazardous forms of treatment for mental illness in Illinois.  We answer the following questions:

• What are common forms of treatment for mental illness? 
• What is electroshock therapy? 
• Why is electroconvulsive therapy so controversial?
• Can parents authorize the administration of electroconvulsive therapy on their own child?
• What is deep brain stimulation? 
• What is transcranial magnetic stimulation?
• What is psychosurgery?
• Can mental health facilities administer psychotropic medication and electroconvulsive therapy against a patient’s will?
  

For more on this topic, check out our article: Mental Health Patient Rights in Illinois.

When it comes to forms of treatments that are unusually invasive, high-risk, or experimental, recipients have to be over the age of 18, and the facility has to obtain the recipient’s informed consent before administering treatment. If the recipient is under the age of 18, or if he or she has a legal guardian, this type of treatment can only be approved by a court order (even if the parents or legal guardians approve of the treatment). If the recipient is unable to provide consent, or if the treatment is against his or her wishes, facilities and legal guardians can file for court-ordered treatment. If your doctor believes not receiving this treatment is a serious risk to your mental health, a judge can permit the facility to force you into receiving treatment. 

In regards to the rights of mental health treatment recipients, “recipient” means any person over the age of 18 who is receiving mental health treatment from any mental health facility, agency, or program. “Mental health facility” means any licensed private hospital, institution, or facility or section thereof, and any facility, or section thereof, operated by the State or a political subdivision thereof for the treatment of persons with mental illness and includes all hospitals, institutions, clinic, evaluation facilities, and mental health centers which provide treatment for such persons. 

What are common forms of treatment for mental illness? 

Many people diagnosed with mental health illness achieve strength and recovery through a variety of individual or group treatments. These treatments include psychotherapy, medication, case management, hospitalization, support groups, complementary and alternative medicine, self-help plans, and peer support. When these treatments are not effective, doctors and patients oftentimes turn to more controversial procedures. While these treatments may sound extreme, some studies suggest they can make a significant positive difference. 

In regards to the rights of mental health treatment recipients, “mental health treatment” includes hospitalization, partial hospitalization, outpatient care, examination and diagnosis, and any other type of care aimed at improving your mental condition. 

What is electroshock therapy? 

Electroconvulsive therapy, also known as electroshock therapy, involves placing electrodes on the forehead and passing electrical currents through the brain in order to induce a 30 to 60 second seizure. When this treatment was first created in the 1930s, patients were not given anesthesia and deadly levels of electricity were used. Today, patients always receive anesthesia and electricity doses are much more controlled. Electroshock therapy can still impair short-term memory and, in rare cases, cause heart problems. It is often used to treat patients with severe depression, risk for suicide, and in some cases, schizophrenia and severe mania. 

Why is electroconvulsive therapy so controversial? 

Electroconvulsive therapy is still one of the most controversial psychiatric treatments today. Much of ECT’s criticizers are concerned about its effectiveness vs. side effects and the use of ECT as a short-term, quick fix solution instead of a long-term psychotherapy or hospitalization. Experienceds go back and forth on the effectiveness of ECT, some researchers insisting that no study proves its effectiveness for more than four weeks, while other experienceds claim they see an improvement rate of 80% in severely depressed patients. 

Can parents authorize the administration of electroconvulsive therapy on their own child?

Parents cannot authorize the administration of electroconvulsive therapy on their own child. Only a court may authorize this treatment, following an official hearing. Before electroconvulsive therapy is approved, the child has to be examined by two psychiatrists. Both psychiatrists have to agree to the child receiving electroconvulsive treatment. 

What is deep brain stimulation? 

Deep brain stimulation refers to the treatment of severe obsessive-compulsive disorder, depression and drug addiction by implanting a tiny device that sends electrical impulses through the brain. The Food and Drug Administration already approved this therapy for tremors resulting from Parkinson’s disease and dystonia. Although some patients with OCD show improvements in mood, such as a decrease in anxiety, they are more so transformed into an “average OCD patient.”  

What is transcranial magnetic stimulation? 

Transcranial magnetic stimulation uses magnetic fields to change the activity in targeted regions of the brain. The procedure does not require surgery. An electromagnetic coil is placed on the forehead, sending magnetic fields to stimulate regions of the brain involved in mood control. This treatment’s side effects include headaches, facial twitching, light-headedness, and less commonly, seizures and hearing loss. 

What is psychosurgery? 

Psychosurgery refers to brain surgery for the treatment of mental disorders. Originating in the 1930s, the practice of psychosurgery has significantly declined with the invention of psychiatric medication. A small number of mental health centers perform psychosurgery procedures today. 

Can mental health facilities administer psychotropic medication and electroconvulsive therapy against a patient’s will? 

Yes. However, a mental health facility has to follow special procedures before it can do so. If you refuse to receive any of the above types of treatment and your doctor believes that not receiving one of the above treatments can cause a serious risk to your mental health, the facility may file a court petition asking a judge to permit them to force you to receive the treatment. If you do not have the mental ability to give informed consent to receive psychotropic medications or electroconvulsive therapy, the facility still has to file a court petition asking a judge to permit them to give you the treatment. 

The term "informed consent" means that the facility must fully inform you of all of the risks involved with the treatment, and you must be given the right to make the final decision whether to receive the treatment.

If you have a legal guardian, you can still refuse to consent to receive this type of treatment. Your legal guardian cannot grant consent for you. If you and your guardian disagree about receiving treatment, your guardian can file a court petition to seek court approval for the treatment. If you consent to the treatment, your legal guardian can consent to the treatment on your behalf.