Over 50 given electro-convulsive therapy without consent in 2018

More than 50 people were given electro-convulsive therapy without their consent in 2018, according to a new study.

In its report on the Administration of Electro-Convulsive Therapy in Approved Centres, the Mental Health Commission has also claimed that those treated with ECT did not understand why they were having it.

The report also says that while fewer people are being treated with ECT, it remains a largely successful form of treatment despite being stigmatized by the so-called “Hollywood” effect.

This is the portrayal in films like One Flew Over The Cuckoo's Nest, where ECT is seen as a brutal punishment for unruly mental health patients.

In 2018, the report says, 516 individual treatments of ECT were administered without consent.

The number of treatments, which were slightly down on the previous year, related to a total of 53 individual patients.

Since the commencement of the Mental Health (Amendment) Act 2015, ECT can only be administered with the written consent of the patient.

However, if the patient is unable to consent, it can be administered with the approval of the responsible consultant psychiatrist and a second consultant psychiatrist.

The same act also stipulates that ECT cannot be administered without consent to a voluntary patient.

The two consultants must be satisfied, following assessment, the patient is not capable of understanding the nature, purpose and likely effects of the proposed treatment.

Some 19% of ECT programmes had one or more treatments without consent in both 2017 and 2018.

The report has also revealed the number of patients who received ECT in 2018 has decreased compared to 10 years previously. The number of residents undergoing ECT treatment has fallen from 396 in 2008 to 282 in 2018.

In addition, there is also an overall decrease in the number of ECT treatment programmes over the same period, from 407 in 2008 to 365 in 2018.

Other findings in the report show the ratio of female to male residents undergoing ECT treatment over the 10-year period stayed at approximately two to one.

The report states the higher number of women being administered ECT “may be related to the relatively higher rate of diagnosed depressive disorders in females than males in Ireland”.

John Farrelly, chief executive of the Mental Health Commission, said ECT treatment generally has a positive effect on those being treated.

In 2018, 81% of people receiving the treatment indicated improvement as a reason for concluding a programme of ECT.

“ECT is a procedure that has been stigmatised throughout history, partly because of the way it has been portrayed on screen, and partly because of a general disconnect that still exists between a patient and public perspectives on ECT therapy,” he said.

“Studies have shown that the ‘Hollywood’ version of ECT has left the impression the treatment is negative, cruel and brutal, with no therapeutic benefit.

“In fact, the portrayal of ECT in films rarely depicts modern ECT practice and experience. What this has done is served to distort public opinion of ECT, and further added to the stigma for those who undergo such treatments.”