Key messages

  • Neurosurgery for mental illness can only be performed with the informed consent of the person and the approval of the Mental Health Tribunal.
  • Neurosurgery for mental illness is used to treat severe and incapacitating mental illness in people who have not responded to other treatments.
  • The treating psychiatrist must provide a written report about the results of the neurosurgery to the Chief Psychiatrist within three months and again within 12 months of the surgery being performed.

Neurosurgery for mental illness can only be performed with the informed consent of the person and the approval of the Mental Health Tribunal.

Neurosurgery for mental illness

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

Neurosurgery for mental illness is most commonly used to treat severe depression and obsessive-compulsive disorder. It is always performed by a neurosurgeon.

Neurosurgery for mental illness was previously known as psychosurgery.

When can neurosurgery for mental illness be performed?

Neurosurgery for mental illness can only be performed on a person who has given informed consent in writing. No guardian, parent or other substitute decision maker may consent to neurosurgery for mental illness on behalf of another person.

The Mental Health Tribunal must also approve the treatment.

The person’s treating psychiatrist must make an application to the Tribunal for a hearing and provide the Tribunal with written evidence of the person’s informed consent.

The Tribunal is made up of three members: a lawyer, a psychiatrist and a community member. The Tribunal can ask an independent neurosurgeon to provide expert advice.

The person has the right to attend the hearing and to be represented.

The treating psychiatrist will present evidence about how the neurosurgery for mental illness will benefit the person. The treating neurosurgeon may also attend the hearing and provide information if required by the Tribunal.

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

  • the person has given informed consent, 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 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.

What happens after the neurosurgery?

The treating psychiatrist must provide a written report about the results of the neurosurgery to the Chief Psychiatrist within three months and again within 12 months of the surgery being performed.

The Chief Psychiatrist monitors the outcomes of neurosurgery and collects data on the effectiveness of the treatment. The Chief Psychiatrist may ask the treating psychiatrist to provide further information relating to the neurosurgery for mental illness and the results of that surgery if necessary.