Electric shock therapy for mental illness ‘should be banished to history’

THE use of electric shock therapy (ECT) in people with a mental illness should be “banished to the historical rubbish bin” of previous treatments thought to be effective.

It has been likened to treatments such as “rotating chairs, surprise baths and lobotomies”.

A new and comprehensive review of the treatment insists the cost-benefit analysis for ECT was so poor, its use cannot be scientifically justified.

The findings are to be published in an international scientific journal next week. They point to strong evidence of persistent and, for some, permanent brain dysfunction along with the evidence of a slight, but significant, increased risk of death,

Under Irish law, ECT can be administered on a voluntary basis, or if someone is being involuntarily detained, it can be given without consent.

Statistics compiled for the first time in 2008 showed that about 400 psychiatric patients received 2,700 ECT treatments.

Among those, at least 43 involuntarily-detained patients were either unable or unwilling to consent.

The authors of the new review, Dr John Read of the University of Auckland and Professor Richard Bentall of the University of Bangor in Wales, maintain if an evidence-based approach was taken to the controversy around ECT it would be “banished to the historical rubbish bin of previous treatments thought to be effective in the past, such as rotating chairs, surprise baths and lobotomies”.

According to Dr Read, ongoing campaigns by ECT recipients all over the world to have the “treatment” banned are supported by the lack of scientific evidence that it is safe or effective.

“Certainly the fears of memory loss, so often dismissed as ‘subjective memory loss’ by ECT proponents are, according to the research, well-founded in fact,” he says.

According to Prof Bentall the short- term benefit gained by a small minority cannot justify the risks to which all ECT recipients are exposed.

“The continued use of ECT represents a failure to introduce the ideals of evidence-based medicine into psychiatry,” he said.

“This failure has occurred not only in the design and execution of research, but also in the translation of research findings into clinical practice. It seems there is resistance to the research data in the ECT community, and perhaps in psychiatry in general.”

There is ongoing debate regarding the administration of ECT in this country. A group led by mental health campaigner John McCarthy and HSE consultant psychiatrist Dr Pat Bracken argues for the deletion of the section of the Mental Health Act 2001 which provides for the administration of ECT to involuntary patients who are “unable or unwilling”.

It does not affect the provision of ECT on a voluntary basis.

However, the College of Psychiatry wants the word “unable” retained as this protects the right to treatment of a very small but severely ill and incapacitated group of patients.

The issue was debated in the Seanad last year and was set to be taken up as a proposal in the Dáil but as yet no further action has been taken.

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