Thousands get controversial shock therapy

Sarah Hall
Oct. 4, 2006
Norwich Evening News 24

Health bosses have come under fire today after it was revealed that almost 3,000 patients have been given electric shock therapy in the past three years to treat depression and other mental health problems.

Campaigners have called electro-convulsive therapy (ECT), barbaric and claimed patients’ lives were being ruined.

Figures obtained from the West Norfolk Primary Care Trust and the Norfolk and Waveney Mental Health Partnership NHS Trust under the Freedom of Information Act showed there were 2,837 administrations in Norfolk since 2002. ECT is banned in countries including Holland and Italy.

Chris Wrapson, spokesman for the Citizens’ Commission on Human Rights (CCHR), founded by the Church of Scientology in 1969, said: “ECT is a violation of human rights. It is torturous and barbaric with horrendous side effects. There are nearly 3,000 cases of therapy in Norfolk and this is not acceptable.”

According to the CCHR, ECT involves:

A person being given powerful drugs;

A current reaching up to 500 volts sent through a pad on the head;

This often leads to a patient having a seizure or blacking out.

A Royal College of Psychiatrists survey conducted on psychiatrists, psychotherapists and general practitioners, confirmed memory loss was a side effect of ECT. Of the 1,344 psychiatrists surveyed, 21pc referred to “long-term side effects and risks of brain damage, memory loss and intellectual impairment”. General practitioners reported that 34pc of patients seen in the months after receiving ECT “were poor or worse”.

Dr Hadrian Ball, the Norfolk and Waveney Mental Health Trust’s medical director, said: “Electroconvulsive therapy (ECT) is a well-recognised and effective treatment for some forms of serious mental illness, most usually severe depression.

“The use of ECT is determined by strict guidelines that have been set out by the National Institute for Clinical Excellence and by the Royal College of Psychiatrists. ECT is only used within the trust in complete accordance with these national guidelines and with the law. When psychiatrists make decisions as to whether ECT is required, this is done on the basis of a full assessment of the potential risks and potential benefits to – and the views of – the individual service user.”

What is ECT?

Introduced in the 1930s as a treatment for schizophrenia, electrotherapy was found to cause changes in depressive disorders.

Medical experts say it is a rapid and effective treatment for severe depressive disorders.

Its main benefits come from its efficacy and speed and it is said to be beneficial where there is a high risk of suicide or danger to health because the patient is not eating or drinking enough.

In severe postpartum depression, it may help with the early development of the bond between mother and child.

The effectiveness of ECT depends upon the induction of a convulsion thorough an electric shock. Two important factors in ECT are the amount by which the electrical dose exceeds the seizure threshold of the patient; and where the electrodes are placed on the body.

Adverse effects include confusion, nausea and vertigo. People may also suffer muscle pain in their jaw. There have been reports of seizures for months after ECT. People’s teeth, tongue or lips may be damaged if a gag is not positioned properly and small electrical burns can occur if electrodes are not properly applied.

Anyone with information on adverse reactions to psychiatric drugs is asked to contact the CCHR on 0845 260 2247.

Do you have a mental health story for the Evening News? Contact Sarah Hall on 01603 772426 or e-mail sarah.hall2@archant.co.uk

Shock Treatment: Efficacy, Memory Loss and Brain Damage

Shock Treatment: Efficacy, Memory Loss, and Brain Damage – Psychiatry’s
Don’t Look, Don’t Tell Policy
by Richard A. Warner

This downloadable paper was written by a paralegal in an ECT case that is currently on appeal. He researched the subject for two years, and decided to put that research to use, in this paper.

Shock Treatment: Efficacy, Memory Loss, and Brain Damage

PDF: 300k

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Shock Therapy Loses Some of Its Shock Value

September 19, 2006
New York Times
By JANE E. BRODY

For an older woman I know who was suffering from “implacable depression” that refused to yield to any medications, electroconvulsive therapy — popularly called shock therapy — was a lifesaver. And Kitty Dukakis, wife of the former governor of Massachusetts and 1988 Democratic presidential nominee, says ECT, as doctors call it, gave her back her life, which had been rendered nearly unlivable by unrelenting despair and the alcohol she used to assuage it.Neither woman has experienced the most common side effect of ECT: memory disruption, though Mrs. Dukakis recalls nothing of a five-day trip to Paris she took after her treatment.

The television host Dick Cavett, who also had the treatment, wrote in People magazine, “In my case, ECT was miraculous.”

Mr. Cavett added, “It was like a magic wand.”

But for a man I know who was suicidally depressed and given ECT as a last resort, it did nothing to relieve his depression but destroyed some of his long-term memory.

Such differences in effectiveness and side effects are not unusual in medicine and psychiatry, and they are not played down in a new book called “Shock,” which Mrs. Dukakis wrote with Larry Tye, a former Boston Globe reporter. The book, in which Mrs. Dukakis details her experience with depression and ECT, explores the history, effectiveness and downsides of this nearly 70-year-old treatment, a remedy that has been repeatedly portrayed in film and literature as barbaric, inhuman, even torturous.

Few people seem to know that ECT has undergone significant changes in recent decades, placing it more in line with widely accepted treatments like those used to restart a stopped heart or to correct an abnormal heart rhythm. After a rather precipitous decline in the 1960’s when effective antidepressant drugs became available, ECT since the 1980’s has experienced something of a comeback, and is used primarily in these circumstances:

• When rapid reversal of a severe or suicidal depression is needed.

• When depression is complicated by psychosis or catatonia.

• When antidepressants and psychotherapy fail to alleviate a crippling depression.

• When antidepressants cannot safely be used, such as during pregnancy.

• When mania or bipolar disorder do not respond to drug therapy.

Though there is no official count, experts estimate that more than 100,000 patients undergo ECT each year in the United States.

ECT was developed in the 1930’s by an Italian neurologist, Ugo Cerletti, who “tamed” difficult mental patients with electric shocks to the brain after noting that such shocks given to hogs before slaughter rendered them unconscious but did not kill them. In its first decades of use, ECT was administered to fully conscious patients, causing them to lose consciousness and experience violent seizures and uncontrolled muscle movements that sometimes broke bones. It was sometimes used in patients without their consent, or at least without informed consent.

And while evidence for its effectiveness did not extend much beyond depression, for a time ECT was applied to patients with all kinds of emotional disturbances, including schizophrenia. It was also widely used in mental hospitals to punish or sedate difficult patients, as was graphically depicted by Jack Nicholson in the movie “One Flew Over the Cuckoo’s Nest.”

Some people may also recall that Ernest Hemingway, who suffered from life-long and often self-medicated depression, committed suicide in 1961 shortly after undergoing ECT. He had told his biographer: “Well, what is the sense of ruining my head and erasing my memory, which is my capital, and putting me out of business? It was a brilliant cure, but we lost the patient.”

A Modified Treatment

Though the impression of ECT left in the public mind by such films and writings persists, ECT today is a far more refined and limited therapy. Most important, perhaps, is the use of anesthesia and muscle relaxants before administering the shock, which causes a 30-second convulsion in the brain without the accompanying movements. Thus, there is no physical damage. The pretreatment also leaves no memory of the therapy itself.

The amount of current used today is lower and the pulse of electricity much shorter — about two seconds — reducing the risk of post-treatment confusion and memory disruption. While memory losses still occur in some patients, now the most serious risk associated with ECT is that of anesthesia.

Most patients require a series of six to eight treatments, delivered over several weeks. As my friend discovered, however, it is not universally effective. About three-fourths of patients are relieved of their debilitating symptoms at least temporarily. The remaining one-quarter are not helped, and some may be harmed.

Despite its long history, no one knows how ECT works to ease depression and mania. There is some evidence that it reorders the release of neurotransmitters, favoring an increase of substances like serotonin, which counters depression. Some experts view it as a pacemaker for the brain that disrupts negative circuitry.

The beauty of ECT is the speed with which it works. Antidepressants can take as long as six weeks to relieve serious depression. Mrs. Dukakis reported that she had begun to feel better after the first in an initial series of five outpatient ECT treatments given over a two-week period.

A Stopgap Measure

But — and this is a big but — ECT is not a cure for depression. It is more like a stopgap measure that brings patients to a point where other approaches, including antidepressants and cognitive behavioral therapy, can work to stave off relapses. Although some ECT patients never relapse, most are like Mrs. Dukakis, who over the course of four years has come back for seven more rounds of ECT. She explained that while she used to deny the early signs of a recurring depression, she now calls her doctor “as soon as I spot the gathering clouds.”

“ECT has wiped away that foreboding,” she wrote, and “given me a sense of control, of hope.” It has also helped her get off antidepressants, which had side effects like bowel, sexual and sleep disturbances and an inability to experience “the full range of my feelings.”

ECT should not be administered without the patient’s (or the patient’s surrogate’s) fully informed consent, which includes consideration of all possible side effects. The most common side effects are headache, muscle soreness and confusion shortly after the procedure, as well as short-term memory loss, which usually improves over a period of days to months.

But according to the American Psychiatric Association, there is no evidence that ECT causes brain damage. Abuse of the procedure has declined strikingly. Today fewer than 2 percent of patients hospitalized in psychiatric facilities in New York State receive ECT. Properly used, it can be lifesaving.

Though there is not nearly the money to be made from ECT that there is in selling antidepressants, work on improvements continues. Modern ECT is sometimes delivered to only one side of the brain, reducing the chances of memory deficits.

Another new approach uses a magnetically induced current that can be aimed at specific regions of the brain, possibly altering them permanently. An advantage of this treatment, however, is that it does not require the use of anesthesia.

Electric shock therapy outrage

Worcester News
Sept. 14, 2006

MENTAL health care patients in Worcestershire are given nearly 700 electric shock treatments a year, new figures have revealed.

According to the statistics, the controversial electroconvulsive therapy has been administered 3,400 times in Worcestershire since 2001 – more than any of the 27 health trusts nationwide that have provided figures apart from Leicestershire.

The therapy involves electrodes being attached to the head and an electric current being passed briefly though the electrodes to the brain, causing a seizure.

Surveys by the medical profession have highlighted serious long-term side-effects of the treatment – including brain damage, memory loss and intellectual impairment, while human rights campaigners have branded it “cruel and barbaric” and say it should only be given as a last resort.

But mental health care bosses say the figure equates to just 125 patients treated per year from a Worcestershire population of half a million.

The figures were obtained from the Worcestershire Mental Health Partnership NHS Trust by the Citizens Commission On Human Rights (CCHR) under the Freedom Of Information Act. Commission spokesman Chris Wrapson described them as “extraordinary”.

He said: “Psychiatrists cloak shock treatment in medical legitimacy, the effects of which are horrific, and the full ramifications are not explained to the patients or families, The brutality of ECT shows psychiatry has not advanced beyond the cruelty and barbarism of its earliest treatment.”

A survey by the Royal College of Psychiatrists proved patients treated with electric shock therapy can suffer memory loss as a result.

Of the 1,344 psychiatrists surveyed, 21 per cent referred to long-term side from page one effects and risks of brain damage, memory loss and intellectual impairment.

GPs reported that 34 per cent of patients seen in the months after receiving electroconvulsive therapy were poor or worse.

But a spokesman for Worcestershire Mental Health Partnership NHS Trust said: “The figure quoted by the Citizens Commission on Human Rights of 3,400 relates to approximately 680 administrations per year.

“Most administrations would have been given in batches of six per course of treatment, therefore, the figures relate to approximately 125 people being treated per year from a population of 542,107 in 2001 and a population of 555,832 in 2005.

“Each community mental health team has a caseload of 300 to 500 people at any time. Across the whole county that would be a figure in excess of 10,000 people being seen during that year, therefore, this equates to approximately one per cent or less of the people being treated.”

She added that the trust ensures that the therapy is carried out in accordance with the National Institute for Clinical Excellence guidance.

Kitty Dukakis recounts ECT in new book

MSNBC.com
‘I Feel Good, I Feel Alive’
In a new book, Kitty Dukakis credits electroconvulsive therapy for relieving her famously disabling depression.
By Kitty Dukakis
Newsweek

Sept. 18, 2006 issue – As many as 100,000 people in the United States each year receive electroconvulsive therapy, a treatment that has improved dramatically since it was first used in the 1930s. On the advice of her doctors, Kitty Dukakis started ECT treatment in 2001 after suffering for decades from severe depression, substance-abuse problems and hospitalizations. Here, Dukakis’s firsthand account.

Next thing I know I am waking up. I am on an upper floor of Massachusetts General Hospital, in the unit where I slept last night. I feel lightheaded, groggy, the way you do when anesthesia is wearing off and you are floating between sleep and wakefulness. I vaguely recall the anesthesiologist having had me count to 10, but I never got beyond three or four. I am not sure I got the treatment. One clue is a slight headache. Another is the goo in my hair, where they must have attached the electrodes.

There is one more sign that I did in fact have my first session of seizure therapy: I feel good—I feel alive.

Michael is standing there next to the nurse as I struggle to keep my eyes open, and I give him a big grin. That surprises him right away. As we head home to Brookline, I remember that it is our anniversary. Our 38th. I turn to Michael and say, “Let’s go out for dinner tonight!” He asks, “What?” I say, “I’m serious. Let’s do it!”

Michael and I did eat out at a restaurant that night, making an anniversary I wanted to forget into one I will remember always. I was back at the hospital on an outpatient basis the next two weeks for four more treatments. After the second one I went to the hairdresser, then a dinner party and watched the Red Sox on TV.

I have had eight sets of ECT since 2001. It is not an exaggeration to say that electroconvulsive therapy has opened a new reality for me. I used to deny when a depressive episode was coming on, to myself and to others. Now I call my doctor, Charlie Welch, as soon as I spot the gathering clouds. As important, ECT has gotten me off antidepressants. I withdrew slowly, with help from my doctors. Since I have been off I know the full range of my feelings. I get into the car now and put on music, the classical station. I sometimes cry because it conjures up feelings of my dad, who died on March 29, 2003, and was a conductor of the Boston Pops. Once I went off antidepressants, I finally could grieve.

ECT has even helped with talk therapy, strange as that may sound. I had been with Roger Weiss, my therapist, for five or six years. After ECT, I was able to work on issues that I couldn’t before, with him and on my own. I stopped smoking 15 months ago and feel terrific about that. I am working on my road rage, which is especially challenging every winter when we head to L.A. and start driving those confounding freeways. I am even addressing what my kids call my sense of entitlement. They kid me for behaving like the “queen bee.” It is not ECT per se that is curing me of those bad habits. It is staying well enough for long enough that I can start looking at behaviors I want to change. Why, for instance, do I always introduce myself by my last name as well as my first? Kara, Andrea and John say I am seeking the recognition that comes with the name Dukakis. Whether they are right or not, it was impossible to acknowledge they might be when I was depressed.

Memory loss is ECT’s most feared side effect. It is what the public hears about most often and what critics complain about most loudly. I believe anyone who says her ability to remember has been permanently damaged, and that big chunks of her life were lost. Who would make up something like that? On the other hand, most ECT patients I know have had milder memory problems, and some have had none. As for the situation I know best, mine, the memory issues are real but manageable.

Things I lose generally come back. Other memories I prefer to lose, including those about the depression I was suffering. But there are some memories—of meetings I have attended, people’s homes I have visited—that I don’t want to lose but I can’t help it. They generally involve things I did two weeks before and two weeks after ECT. Often they are just wiped out.

I forget telephone numbers, including ones I dial all the time. I sometimes don’t know where I am supposed to go or at what time. What embarrasses me most is forgetting people’s names. I live in a political world. My remembering someone may only be mildly important to them, but it is really important to me. After ECT I still go to receptions, dinners and other public events, with Michael or on my own, but I generally am not on my game. I sometimes forget commitments I make to help people. I tell a refugee from Cambodia that I will call the State Department on his behalf. I tell a friend of a friend that I know just the surgeon for her, or a lawyer, or a psychiatrist. Then I don’t make the call or get back to them with the name. Promising it, then not doing it because I don’t remember, is terrible. They must think I’m a ditz, or maybe insincere.

I have learned ways to partly compensate for whatever loss I still experience. I call my sister Jinny, Michael and my kids, asking what my niece Betsy’s phone number is, what we did yesterday and what we are planning to do tomorrow. I apologize prior to asking. I wonder when they are going to run out of patience with “Kitty being Kitty.” I hate losing memories, which means losing control over my past and my mind, but the control ECT gives me over my disabling depression is worth this relatively minor cost. It just is.

From “Shock” by Kitty Dukakis and Larry Tye. To be published by Avery, a division of Penguin Group (USA). © 2006 by Kitty Dukakis and Larry Tye.

Moved comments

Update: The spam has gotten out of hand and I can no longer keep up. Fortunately the Akismet system has worked well, but I’m averaging over 1,000 spam attempts a day. I can no longer scroll through the caught spam and try to find comments that may have accidentally been caught in the trap. Therefore, if you try to post a comment and it doesn’t show up, assume it’s been Spaminated for reasons known only to Akismet. You can try to post the comment again, or if it’s important to you to have your comment posted, you can email me (contact info in left sidebar) and I can override the spaminator and post the comment for you. Until spammers realize nothing is getting through (not likely since they’re using bots and never know the results of their bombardments) and go elsewhere, it’s the best I can do. Without Akismet, you would be seeing many thousands of long ads for penis extenders in the comments section of every page.

I know the frustration of unfairly being lumped with the baddies. As a woman with blond hair, very fair skin and blue eyes, I am always the subject of foot wipes and full body searches at airports in the politically-correct effort to prove they aren’t profiling against anyone who might actually fit into a terrorist category. It’s a sign of the times, it sucks, but if I couldn’t be subjected to a rub down by a creepy airport guy once a week, then the terrorists would win. We can’t have that.

/end update

I get an extraordinary amount of comments posted to the site that are blatantly spam: online casinos, porn, virtual viagra, and so on. I have a spam catcher that does a very nice job of catching them and either flagging them, or putting them in a que for me to review. Generally, I delete them all, but a couple caught my eye and I decided to make a separate page for those that actually have something to do with depression and other related topics. Those will be rescued from the spam trap and placed here. Note that ect.org makes no endorsement of any of these, but felt they might be of interest to some.

For those who post something that ends up saying it’s in the moderation que, that means it’s been caught by the Akismet spam trap for review. (It’s a program, and sometimes genuine stuff gets caught there…sorry, but it’s something I must use or this place would be overflowing with porn ads.) Note that I always review them before deleting, though 99 percent are true spam.

I would prefer that advertisements be posted here in the comments section, rather than on unrelated pages. If they aren’t, they will be moved here. Do understand NO ads for casinos and other junk will be permitted. If you’ve got a genuine link that would fit on the links page, email me with the info. That’s the best way to get linked! (But I don’t add all links…only if they’ve got something to do with ECT, mental health issues, or my own personal favorite links which are generally dissidents, music and animal rescue.)
One foul comment from VNSdepression has been moved here:

VNSdepression comment

Moved comments:

Nida Ali Khowaja – ehealthguide
Health Care News, Disease, Diagnose, Physicians, Residents, Medical Officers, Nursing Care, Technical Staff, Health Policies, Organizations, Certification, Standards, Alerts, AKUH and All about Worlds Health. Step to Facilitate the Health Care Professionals and Patients.

http://ehealthguide.info/rss.xml

Posted on 04 Oct 2006 at 10:59 am


David Schmidt
You might be interested in SAME and other supplements for depression. I had severe depression for years and tried antidepressants, electroconvulsive therapy and psychotherapy. Nothing worked until I began to use a regimen of natural products including SAME. This site has good prices:

www.doctorstrust.com

Posted on 23 Aug 2006 at 10:59 pm

—————————

Albert Ellis
A prominent psychologist specializing in depression offers readers step-by-step, clinically proven cognitive behavioral therapy (CBT) techniques to recognize and change depressive thinking.

Read The Cognitive Behavioral Workbook for Depression: A Step-by-step Program now out in paperback!

Posted on 10 Sep 2006 at 10:59 pm

—————————

Charles Donovan
Patients considering ECT may also want to investigate a newly FDA approved procedure for chronic depression called vagus nerve stimulation(VNS). It is the only FDA approved long term treatment option for chronic depression. It has not related to ECT or brain surgery.

The ninety-minute out patient procedure does not have any cognitive impairment( i.e. memory loss), the response is sustained and the therapy does not interfere with any drugs.

The treatment completely changed my life and inspired me to write the book:
“Out of the Black Hole: The Patient’s Guide to Vagus Nerve Stimulation Therapy and Depression”

For more information about VNS Therapy, I would visit www.OutoftheBlackHole.com

on 12 Sep 2006 at 11:17 am
—————————

ect.org will close Sept 11, to remember 2,996 and Philip Thomas Hayes

ect.org will close at midnight ET on September 11, 2006, in remembrance of those who died five years ago. I will keep a link to the old site for those who need information about ECT. The site will reopen 24 hours later. Thank you for your understanding.

I ask that no matter where you are in the world, that you take time to remember those who died. Forget the terrorists and politics for one day. Remember 2,996 individuals.

And remember Philip Thomas Hayes. I hope you will return Monday and get to know him. He was one of many who died that day, but to many, he was special and so very loved.

Read about Philip Hayes

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ECT in Sweden doubles in last five years

Shock rise in electric treatment

Published: 21st August 2006
The Local

The use of electric shocks in psychiatric treatment has more than doubled in the last five years in Sweden.

In 2000 around 18,000 electric shock treatments were administered in Sweden, according to statistics presented by Swedish Radio. Five years later that figure is 40,000.

Electric shock therapy began to be used during the 1930s. Today the method is used primarily on patients who are psychotic, or suffering from deep depression and abnormal mood swings, and when medicine or therapy have failed to have any effect.

Håkan Odeberg, a psychiatric consultant at the Karolinska University Hospital in Huddinge, supports the method.

“In cases where the patient is severely depressed and you have already tried many other forms of treatment, electric shock therapy can have an almost miraculous effect,” he told Svenska Dagbladet.

However, Kjell Broström from the National Association for Social and Mental Health, is not convinced. He told SvD that some patients experience terrible memory loss and that the treatment’s effects can be short-lived.

Shock treatment statistic ‘barbaric’ – New Zealand

19 August 2006
By GEOFF TAYLOR
stuff.co.nz

An opponent wants to stop shock treatment for the mentally ill, but medical experts believe it has positive results. Geoff Taylor reports.

More than one in four people at Waikato Hospital who get electric shock treatment do not consent.

One opponent calls the statistic barbaric, but medical staff say her views are based on out-dated ideas of the treatment.

They say electro-convulsive therapy (ECT) is performed under general anaesthetic and allows many mentally ill people to live normal lives.

Hamilton patients rights advocate Anna de Jonge wants all ECT stopped.

Health Ministry statistics show that in the 2004-05 year 93 non-consented treatments were given to patients at Waikato Hospital. This amounted to 30 per cent of all treatments.

Nationally, 23 per cent of the 307 patients who received ECT did not give their consent.

Waikato Hospital staff said that in the year to March 2006, 23 patients received treatment, six of whom did not give consent.

Anna de Jonge called it barbaric slaughterhouse treatment.

“Treatment without consent is assault,” she said.

“You can’t just grab somebody and shock them. Because it’s done in secret behind closed doors that doesn’t make it okay.”

Waikato Hospital consultant psychiatrist John Strachan said the treatment was used for depression when anti-depressants failed or for people who were psychotic or suicidal.

Patients were deemed not competent to give consent if they lacked the ability to understand information, process it rationally and communicate a choice. At this point, a second opinion was needed from another psychiatrist before treatment could start.

No one was ever forcibly held down and given the treatment. Unlike in the 1950s, patients were fully anaesthetised and had muscle relaxants.

Waikato Hospital general manger mental health Chris Harris said Ms de Jonge’s views were based on perceptions of what occurred about 50 years ago. He said it would be wrong to remove ECT as an option. For a number of people it had been a positive, life-changing experience.

Hamilton woman Margaret Parry, who received treatments in the 1950s, disputed that the treatment was better now.

“I think it’s the worst thing you can do to another human being.”

ECT works in the same way as anti-depressants, affecting the messages sent by neurotransmitters in the brain.

Dr. Bonnie Burstow: shock is a form of violence against women

Dr. Bonnie Burstow explores electroshock as a form of violence against women. She is a feminist therapist, an anti-psychiatry and anti-fascist activist. She is also the former co-chiar of the Ontario Coalition Against Electroshock and is the author of Radical Feminist Therapy: Working in the Context of Violence.

Two versions:
An edited version runs just under 30 minutes and the full speech runs just over 60 minutes.

Listen to an edited version (30 min) or full speech (60 min)

New Zealand ECT rates cause concern

Rotorua electric shock capital

August 17, 2006
The Daily Post
New Zealand

By REBECCA DEVINE Mental health patients in Rotorua and Taupo are three times more likely to get shock treatment than anywhere else in the country.

Latest figures show the area is the shock capital of New Zealand with Lakes District Health Board notching up the highest rate of people receiving electroconvulsive therapy (ECT), or shock treatment.

The figures have prompted at least one psychologist to call for the health board to launch an urgent inquiry.

The rate of treatment for the Lakes area in the 2004/05 year was 22 per 100,000 people – three times the national average of 7.5 people per 100,000.

ECT involves passing an electric current through the brain to induce a seizure, altering brain chemistry to regulate a patient’s mood.

Advocates for the procedure say it is one of the most effective ways to treat depressed patients who don’t respond to other forms of treatment.

However, those against it say it is primitive, causes long-term brain damage and should be banned.

The Lakes District Health Board also had the highest percentage of patients over 20 who were seen by a mental health service and went on to receive ECT. Nationally just 0.4 per cent of people seen by mental health services get the treatment but Rotorua’s rate is more than 1.1 per cent.

Five per cent of those who received the treatment in the Lakes area were given it without their consent under the Mental Health Act.

A statement from Lakes District Health Board communications officer Sue Wilkie said the board was “looking at the figures quoted in the report and carrying out some analysis around that information”.

“Until such time as that work is complete, it would be inappropriate for the DHB to make any further comment,” the statement said.

The report released by the Ministry of Health does not explain why the rate is so high in the Lakes region. However, it says regions with smaller populations are more likely to have fluctuations from year to year and some areas have better access to the service.

Dr John Read, a senior psychology lecturer at Auckland University, said its use had generally either stabilised or declined so it was troubling the Lakes figures had increased.

There was certainly no evidence there were three times as many seriously depressed people in the area, so the only explanation had to be that it was simply being used more often, he said. Dr Read described the treatment as an overly medical approach and there were better ways to treat depression, like looking at the causes.

He said women between 60 and 70 were common recipients of the treatment because they were prone to depression.

“Why is that? The best predictions are loneliness and poverty. How is electricity going to solve that?”

But the country’s top psychiatrist has said Lakes’ figures are still low on an international scale.

Health Ministry mental health chief adviser David Chaplow, who was in Rotorua yesterday, said he was happy with the figures. While he would look at any investigation carried out, Dr Chaplow said the jump certainly wouldn’t prompt the ministry to order such an investigation.

Dr Chaplow said because Lakes was a tiny health board in terms of population the results could be easily skewed. The increase could be caused by more people being seen for depression or psychiatrists who are happier using the treatment, Dr Chaplow said.

Electro therapy facts ‘not given to patients’

Cambridge Evening News
August 11, 2006

INFORMATION given to some mental patients are before they undergo electric shock treatment has been criticised.

Supporters of Electric Convulsive Therapy (ECT) say the treatment is a “last resort” for patients who are severely depressed and it can help stop them committing suicide.

ECT “resets” the brain with an electric pulse.

Opponents say there is little evidence it works. They claim it can have severe side-effects and is a form of torture.

Cambridgeshire and Peterborough Mental Health Trust has revealed it has conducted 2,600 ECT treatments since 2002.

On average 50-55 people a year are given ECT by the trust in a course of six to 12 treatments. It said 26 people were done in Cambridge during the past year.

Mental health charity MIND, which found information about side-effects is often inadequate, said patients should be given a choice of receiving the treatment.

Paul Farmer, MIND chief executive, said: “Some people do find ECT helpful, but 84 per of respondents to our last survey on ECT had experienced side- effects.

“Our survey found nearly twothirds of people given ECT were not provided with information about its side-effects beforehand.

“Nearly half said they would not agree to have the treatment again. The most common longterm side-effects are memory loss, difficulty concentrating, and problems remembering new information, while headaches and dizziness are common in the short term.

“ECT is an invasive and irreversible procedure. It should only ever be used as a last resort for cases of extreme depression, when every other treatment has been tried.

“Even then, it should certainly never be given without fullyinformed consent, except in an emergency.”

But the mental health trust said the number of ECT treatments was small compared to the 4,000 in-patient admissions a year.

Dr Fiona Blake, consultant psychiatrist, said all patients were fully informed before undergoing treatment.

She said: “ECT is an effective treatment for depression, but our consultants take great care to ensure it is only offered in cases where it is likely to be clinically effective.

“The treatment is always discussed and explained, and we have good-quality information leaflets to support clinical consultations and a robust consent procedure.

“ECT treatment is a ‘last resort’ for depression when the patient has symptoms that indicate a likely good response and when other strategies have failed.”

She said it was sometimes the preferred treatment, for example for someone intensely suicidal, or too depressed to eat or drink.

She said the trust had been approved by the Royal College of Psychiatrists to administer ECT and commended by it for its consent procedures.