Memorandum  DMH Requirements for Approval of ECT use in Children Younger than 16

Date:	08/19/2025
Organization:	Massachusetts Department of Mental Health
Referenced Sources:	104 CMR, s.27.10 (2)

Informational Notice

TO: Class VIII Licensed Facilities 

FROM: Amam Saleh, M.D. Deputy Commissioner for Clinical and Professional Services Commissioner Brooke Doyle, M.Ed., LMНС 

Cс: Brooke Doyle, M.Ed., LMНС

DATE: August 12, 2025 

RE: DMH Requirements for Approval of ECT use in Children Younger than 16

The Massachusetts Department of Mental Health (DMH) is updating its approval process for the use of ECT (Electroconvulsive Therapy) in patients younger than sixteen in accord with 104 CMR, s.27.10 (2), which regulates the use of ECT in children and adolescents. This updated procedure, which supersedes guidance issued in 2011, is effective immediately. 

Facilities seeking approval for ECT use in patients under 16 shall provide the Department's Deputy Commissioner for Clinical and Professional Services with the following information when making a request: 

• The patient's name, date of birth, and the name and relationship of the person authorized to give informed consent;
• A clinical summary provided by the treating (or attending) child and adolescent psychiatrist:
• A signed copy of a consultation note from an independent child and adolescent psychiatrist who has seen the patient and who concurs with the recommendation for ECT;
• A consultation note by the psychiatrist who will perform the ECT.

When these documents have been reviewed, and/or following the collection of additional information, the Department will provide a written notification regarding the request. This notification shall be incorporated into the patient's medical record. Providing the required information in a timely manner can help safely and expeditiously manage this process. 

Thank you for your attention to this important matter. Please feel free to contact me at 617-626-8059 if you have any questions or concerns.