Electric shock therapy ‘enthusiasts’ under fire

PSYCHIATRISTS in certain areas of the country are “ECT enthusiasts” who are using the treatment in cases where alternatives could be considered, it has been claimed.

Dr Pat Bracken, consultant psychiatrist and clinical director of mental health services in West Cork, said there was cause for concern for the “massive variations” in the use of electro-convulsive therapy (ECT) around the country.

Electric shock therapy is a medical procedure in which an electric current is passed briefly through the brain via electrodes applied to the scalp to induce seizure activity.

The 2009 figures on the administration of ECT have now been published, and were broadly similar to those published for the first time in 2008 by the Mental Health Commission.

The report shows that 373 programmes of ECT were administered to inpatients in approved centres in 2009, an 8.4% decrease on the number of programmes reported in 2008. Almost 90% of programmes were administered to patients who were capable of giving consent. The majority of patients who were administered ECT had a diagnosis of depressive disorders and there was a higher rate of administration of ECT to females than males.

However, figures show some areas, such as Waterford and Galway, have far higher usage of the treatment than other regions. St Patrick’s Hospital reported the highest number of programmes of ECT accounting for a third (33.8%) of all programmes of ECT.

Dr Bracken, who is campaigning for the abolition of ECT where consent is not given, maintains it is not plausible to say there so many more serious cases that would require ECT in some parts of the country compared to others.

“As a psychiatrist, I can imagine a situation where we might think about giving a patient ECT without their consent — if the patient was not communicating, not eating, not drinking. Something needs to be done or the patient will die. As a doctor, I have a duty to do something.”

“But in 27 years of practice — in Africa, inner-city work in Britain, and now seven years in Ireland — I have never reached this situation with a patient. We have always found something else to do.

“However, it would appear that some of my colleagues are ECT enthusiasts. This is clear from the MHC figures that indicate huge variation in usage.”

Dr Bracken said it was “appalling” that the Government was only going to remove the words “unwilling” to consent from the Mental Health Act, leaving the word “unable” on the advice of the College of Psychiatry.

“Psychiatrists who are ECT enthusiasts will simply say that patients are unable instead of being unwilling. There is evidence that this happened in Britain.”

This is an outrage. It ignores, not only our campaign, but also the detailed advice given by Amnesty.

“The minister said that he would take a ‘balanced’ way forward. They are not doing so, they are simply endorsing the position of the college. This needs to be exposed and challenged.”