Neurosurgery for mental illness

Neurosurgery for mental illness is a surgical procedure performed on the brain. It may be used to treat people with severe and incapacitating mental illness who have not responded to other treatments.

Neurosurgery for mental illness is mostly used to treat severe depression and obsessive-compulsive disorder. A neurosurgeon always performs it.

Application to perform neurosurgery for mental illness

A psychiatrist may apply to the Mental Health Tribunal for approval to have neurosurgery for mental illness performed on a person only if the person has given informed consent in writing to the neurosurgery.

No guardian, parent or other substitute decision-maker can consent to neurosurgery for mental illness on behalf of another person.

The person’s treating psychiatrist must apply to the Mental Health Tribunal for a hearing and provide the Mental Health Tribunal with written evidence of the person’s informed consent.

Mental Health Tribunal approval to perform neurosurgery for mental illness

Neurosurgery can only be performed with the approval of the Mental Health Tribunal. The Mental Health Tribunal must hear and determine an application for the performance of neurosurgery for mental illness within 30 business days of receipt of the application.

The Tribunal can only approve neurosurgery for mental illness if it is satisfied that:

• the person has given informed consent in writing, and
• the neurosurgery for mental illness will benefit the person.

In determining whether the performance of neurosurgery for mental illness will benefit the person, the Tribunal must have regard to:

• whether the neurosurgery for mental illness is likely to remedy the mental illness or alleviate the symptoms and reduce the ill effects of the person's mental illness
• the likely consequences for the person if neurosurgery for mental illness is not performed
• any beneficial alternative treatments that are reasonably available and the person’s views and preferences about those treatments
• the nature and degree of any discomfort, risks and common or expected side effects associated with the proposed neurosurgery for mental illness, including the person’s views and preferences about any such discomfort, risks or common or expected side effects.

If the Tribunal is not satisfied about these matters, it must refuse to approve neurosurgery for mental illness.

A person for whom the Mental Health Tribunal has made an order for neurosurgery for mental illness must be provided with the relevant statement of rights.

After neurosurgery for mental illness

The treating psychiatrist or psychiatrist who made the application to the Mental Health Tribunal must provide a written report to the Chief Psychiatrist within three months after the surgery is performed and again within 9 to 12 months of the surgery being performed. The report must describe the procedure and outcome of the neurosurgery for mental illness.

The Chief Psychiatrist monitors the outcomes of neurosurgery and collects data on the effectiveness of the treatment. The Chief Psychiatrist may ask the psychiatrist who provided the report to give further information relating to the neurosurgery for mental illness and the results of that surgery.