TESTIMONY OF ANNA SZYSZKO to New York Assembly, re: brother’s forced shock

My brother Adam is currently being held as a prisoner in a State Psychiatric Hospital. He doesn’t want to be there, the family does not want him there, but for reasons I do not understand, the hospital is being allowed to forcibly contain him. I thought the Law in America was ” Innocent until proven guilty ” but in my brother’s case, he is being punished before he commits the crime. The reasoning behind this is that one day, maybe, Adam could do harm to someone or to himself. There is no reason for this speculation, for Adam is not of violent nature. I’m his sister, I grew up with him, I should know. However Adam does suffer from A Mental Illness called Schizophrenia, and people have a tendency to be afraid of things they don’t understand,

This crippling fear of the unknown is what Psychiatrists use to gain power not only to hold someone captive without any validation but also to make that person undergo an experimental treatment that causes severe side effects, such as permanent memory loss, an inability to learn new skills or retain new information; In general loss of intellect.

My brothers’ biggest gift from God is his intellect, his amazing ability to learn and memorize things quicker than anyone I’ve ever known. It defines who he is. Loosing that could drive him to suicide.

The Doctors justification for feeling that they have a right to force Adam to undergo this treatment regardless, is that it is the only thing, that they know, that may help him. However there is no scientific proof that ECT works, and it seems that the risks out weigh the benefits.

I did some research regarding alternative treatments and it turns out that there are plenty of promising treatments worth trying, that have proven to work for many people, Psychotherapy, of course, is the main one; my family has already found a doctor in our area who has experience working with patients suffering from Schizophrenia, and he is waiting for Adam to be released from the hospital in order to start therapy.

The others are Dietary and Lifestyle changes, as well as specific Nutritional Supplements that correct a deficiency and create a more optimal biochemical environment, I have personally spoken with people who have had the chance to use some or all of these treatments and they are leading full and productive lives, This gives me a lot of hope for Adam, if only he has the chance to try these treatments.

At this point he is in a hospital where he is receiving no treatment at all, and that is what is most frustrating about this situation; While the hospital is fighting for rights to control and limit Adam’s treatment options, my brother’s mental health is deteriorating; None therefore can convince me that they have their best intentions in mind for Adam.

Statement to the Press

After months of feeling hopeless and doubtful that anyone will take interest in improving my brother’s situation and the situation of many others in the same desperate position, I, as well as my parents are happy and optimistic about the passing of this legislation. It’s a great first step towards improving the quality of care for these patients. I hope it will be followed with further legislation to focus on the patient’s right to choose alternative means of therapy as well as giving the family the ability to disagree with the doctor’s recommendations and the authority to pursue alternative treatments.

It is frightening to think that electroshock is currently being performed without access to emergency medical equipment at Pilgrim Psychiatric Center, where my brother has received it and is in danger of receiving more. Therefore, I think it is critical for the safety of my brother that the legislation requiring access to emergency medical equipment be passed.

Anna Szyszko
June 11, 2001

SUMMARY OF WRITTEN COMMENTS REGARDING ECT BY MENTAL HYGIENE LEGAL SERVICES

May 17,2001

The MHLS for all four Judicial Departments submit this letter in connection with the issue of how informed consent is obtained for ECT.

1. The OMH regulations do not contain adequate safeguards for ensuring that the patient has been fully informed of the risks and benefits of the procedure and is capable of giving informed consent.

2. In the case of non-objecting, incapacitated patients, we question whether OMH has the power to vest relatives with the authority to give surrogate consent to ECT. We also question whether the OMH regulations on surrogate consent for ECT comport with the current statutory framework

3. The OMH regulations are inadequate with respect to the procedure to be followed when surrogate consent for ECT is sought and refused.

4. The Legislature should consider amending Section 35 of the Judiciary Law to make it clear that independent psychiatrists and psychologists may be appointed by the courts in ECT and other cases in which judicial authorization is sought for treatment.

Specialist to review shock therapy

May 22, 2003
New Zealand Herald

The Government has agreed to a review of electroconvulsive therapy (ECT), but says it is a safe and important treatment option for severely depressed people.

The Government’s response to the health select committee’s report on a petition against the use of ECT was tabled in Parliament on Tuesday.

The petition claimed ECT was degrading and inhumane, always caused brain damage and when forced on people breached the Bill of Rights.

The Government said it agreed with the committee that an independent expert should review the use of ECT and the Mental Health Commission should look at compulsory treatment with ECT.

It said the call for mandatory ECT audits guidelines, standards and codes of ethics was unnecessary, as there were safeguards in place.

It concluded that numerous studies of ECT showed it was a safe treatment despite the anxiety it caused many.

“ECT is a safe and important treatment option for the management of severe depression. ECT by its very nature, however, arouses anxiety in patients and families as well as a high degree of interest from the public,” the report said.

“Because of this high level of public interest, the Government has agreed to initiatives to give effect to most of the Health Committee recommendations.”

Psychiatrists’ appeal denied; restrictions remain

Press Release from MIND
3-26-03

PSYCHIATRISTS’ APPEAL TO NICE TO DROP NEW RESTRICTIONS ON ECT FAILS AS USERS’ VIEWS WIN RESPECT

An appeal by the Royal College of Psychiatrists to NICE (the National Institute for Clinical Excellence) to drop new restrictions on ECT (Electroconvulsive Therapy) treatments, contained in draft guidance, has failed.

Mind has congratulated NICE on their decision and the way they gave due credibility to the evidence submitted on behalf of people who had been given ECT treatments, and who want tighter controls.

The Royal College was unhappy that ECT treatments were to be restricted to those people who have severe symptoms and not available to people with moderate symptoms. Mind argues that it should only be given as a treatment of last resort and only when all other treatment options had been explored.

Richard Brook, Mind’s Chief Executive said: “At last someone in authority has treated the views and experiences of people with mental health problems seriously, alongside professional opinions and the results of randomized clinical trials.

Mind is also encouraged to see NICE recommend that patients’ wishes, set out in ‘living wills’, are taken fully into account when they lose the ability to express them.

Mind wants to see these ‘living wills’ given legal force so that someone who says they don’t want ECT won’t be given it against their will unless their life is at serious risk and other alternatives have been exhausted. We hope this will lead to a big drop in the number of people having ECT forced on them against their wishes.”

The final NICE guidance on ECT is expected in May.

Mental Health Measure Advances

Feb. 14, 2003
Lexington Herald Leader

Kentuckians would be entitled to sign an advance directive indicating what kinds of mental health treatment they prefer, under House Bill 99, approved by the House Health and Welfare Committee yesterday. The bill allows people with mental health conditions to voice their feelings on certain treatments, choose whether they want electroconvulsive or “shock” therapy, and designate someone to make sure their wishes are carried out when they show up for treatment in a crisis, said Sheila Schuster, director of the Kentucky Mental Health Coalition.

The Health and Welfare Committee also approved bills to hire full-time ombudsmen throughout the state, to reactivate the Task Force on Quality Long Term Care, and to require state public policy to take into consideration options that would help the disabled and frail elderly to live at home rather than in institutions.

HOMEMADE-GOODS EXEMPTION

A bill approved by the Agriculture and Small Business Committee yesterday would exempt makers of homemade jams, jellies, bread, cakes, cookies and fruit pies from obtaining permits to sell their goodies at farmers’ markets, roadside stands or from their homes. Such producers would have to meet sanitation standards, and their goods would have to be properly labeled.

Rep. Charlie Hoffman, D-Georgetown, chief sponsor of House Bill 391, said lifting the permitting requirements would allow Kentucky’s farm families to diversify without the hindrance of expensive upgrades.

FAITH-BASED INITIATIVES

A bill that would have created a “Faith-Based Community Development Initiative Program,” to support and finance religious organizations’ services for low- and moderate-income people will instead simply study the feasibility of establishing the program. The bill’s sponsor, Rep. Paul Bather, D-Louisville, told a House panel yesterday that there was too much confusion about the implementation of his bill to leave it as it was. The committee passed the substituted version of the bill, House Bill 119.

Committee fails to vote on restricting electroshock therapy

Casper Star Tribune
By C.G. WALLACE
Associated Press Writer

SALT LAKE CITY (AP) – A bill that would have banned those under the age of 18 and pregnant women from electroshock therapy was heard by a House committee Thursday night, which decided not to vote on the legislation.

After two hours of public comment and committee debate, the House Health and Human Services Committee voted to adjourn without voting. That means the committee could continue discussion of the bill later in the session.

During electroconvulsive therapy, an electric current is quickly passed through the brain from electrodes attached to the head. Those receiving treatment are put under general anesthetic. The treatment is used for severe mental illnesses, most commonly severe depression.

Five facilities in Utah use the treatment and doctors are not sure how or why the treatment works.

Dr. Lee Coleman, a psychiatrist, in arguing in favor of the bill, said he believes the treatment works by injuring the brain. He said patients are not being fully presented with the side effects of the procedure and said some may feel better afterward because ”they are too confused and too disoriented to remember what was bothering them.”

The legislation would also require a patient’s consent for the treatment, something the bill’s opponents said was already happening.

Dr. Louis Moench, a psychiatrist and University of Utah professor, testified that the only portion of the bill that would be helpful is the requirement that only doctors should administer the treatment.

Charlene Fehringer traveled from her home in Pocatello, Idaho, because of the proposed ban of pregnant women from the procedure. She said that when she was pregnant, she could not take her regular medication and the electroshock therapy was the only thing that enabled her to function.

Diagnosed as bipolar, she had to go off her medication when she became pregnant four years ago. The electroshock therapy helped her regain her sanity, she said.

”It was a total, total turnaround for me,” she said.

Kevin Taylor said that when his daughter was 15, she was so severely depressed that his family feared for the girl’s life.

”Everyday we’d wake up and wonder if Lindsey was going to be there,” he said. The therapy worked on her, he said. Lindsey Taylor, now 22, accompanied her father to the hearing, but did not speak to the committee.

”There are enough problems with this bill, that I cannot support it at this time,” said Democratic Salt Lake City Rep. Judy Buffmire, D-Salt Lake City, before the meeting adjourned.

HB 109

Feb. 14, 2003: Committee fails to vote; postponed

Rep. Katherine M. Bryson is sponsoring a bill in her home state of Utah (HB 109) that would require informed consent before having ECT, as well as mandate data collection and other requirements when giving ECT.

HB 109 is a crucial bill that needs to be passed. ect.org supports this bill and Rep. Bryson’s work without question, and I ask that you give your support to HB 109 and Rep. Bryson. Please read through the bill and take the time to express your support and thank Rep. Bryson for her hard work in getting this bill introduced into the Utah House of Representatives.

Email Rep. Katherine Bryson at Kbryson@utah.gov and let her know what you think.

If you are a resident of Utah, please do take the extra time to contact your elected officials and let them know you support this bill and expect to see it passed.

Find your elected officials at the Utah State Official Website.

Full text of HB 109

1

INFORMED CONSENT FOR

2

ELECTROCONVULSIVE TREATMENT AND

3

REPORTING REQUIREMENTS

4

2003 GENERAL SESSION

5

STATE OF UTAH

6

Sponsor: Katherine M. Bryson

7 This act amends the Local Mental Health Authority Act and the Substance Abuse and

8 Mental Health Act. The act applies to physicians, hospitals, and mental health facilities.

9 The act prohibits the use of electroconvulsive treatment on children and pregnant

10 women. The act requires informed consent for the use of electroconvulsive treatment on

11 adults. The act establishes the elements of informed consent. The act prohibits anyone

12 other than a physician from performing electroconvulsive treatment. The act requires

13 registration of equipment with the Division of Substance Abuse and Mental Health. The

14 act requires quarterly reporting of electroconvulsive treatment to the division and the

15 Health Data Committee in the Department of Health. The act requires the division to

16 enforce the reporting requirements and annually report statistical data regarding the use

17 of electroconvulsive treatment to the governor and the Legislature. The act has an

18 effective date of July 1, 2003.

19 This act affects sections of Utah Code Annotated 1953 as follows:

20 AMENDS:

21 17A-3-611, as renumbered and amended by Chapter 186, Laws of Utah 1990

22 62A-15-704, as renumbered and amended by Chapter 8, Laws of Utah 2002, Fifth

23 Special Session

24 ENACTS:

25 62A-15-1101, Utah Code Annotated 1953

26 62A-15-1102, Utah Code Annotated 1953

27 62A-15-1103, Utah Code Annotated 1953

28

62A-15-1104, Utah Code Annotated 1953

29 62A-15-1105, Utah Code Annotated 1953

30 62A-15-1106, Utah Code Annotated 1953

31 62A-15-1107, Utah Code Annotated 1953

32 62A-15-1108, Utah Code Annotated 1953

33 Be it enacted by the Legislature of the state of Utah:

34 Section 1. Section 17A-3-611 is amended to read:

35 17A-3-611. Specified treatments prohibited — Criminal penalties.

36 (1) It is a misdemeanor to:

37 (a) give [shock treatment,] a lobotomy[,] or surgery to anyone without the written

38 consent of [his] the person or the person’s next of kin or legal guardian; or

39 (b) give electroconvulsive treatment to a person without the written consent of the

40 person in accordance with Sections 62A-15-1102 and 62A-15-1103 .

41 (2) Services provided under this part are governed by [the] Title 58, Chapter 67, Utah

42 Medical Practice Act.

43 [(2)] (3) It is a felony to give psychiatric treatment, nonvocational mental health

44 counseling, case-finding testing, psychoanalysis, drugs, [shock treatment] electroconvulsive

45 treatment, lobotomy, or surgery to any individual for the purpose of changing his concept of,

46 belief about, or faith in God.

47 Section 2. Section 62A-15-704 is amended to read:

48 62A-15-704. Invasive treatment — Due process proceedings.

49 (1) For purposes of this section, “invasive treatment” means treatment in which a

50 constitutionally protected liberty or privacy interest may be affected, including antipsychotic

51 medication, electroshock therapy, and psychosurgery.

52 (2) The requirements of this section, and Part 11, Electroconvulsive Treatment

53 Regulations, apply to all children receiving services or treatment from a local mental health

54 authority, its designee, or its provider regardless of whether a local mental health authority has

55 physical custody of the child or the child is receiving outpatient treatment from the local

56 authority, its designee, or provider.

57 (3) (a) The division shall promulgate rules, in accordance with Title 63, Chapter 46a,

58 Utah Administrative Rulemaking Act, establishing due process procedures for children prior to

59

any invasive treatment as follows:

60 (i) with regard to antipsychotic medications, if either the parent or child disagrees with

61 that treatment, a due process proceeding shall be held in compliance with the procedures

62 established under this Subsection (3); and

63 [(ii) with regard to psychosurgery and electroshock therapy, a due process proceeding

64 shall be conducted pursuant to the procedures established under this Subsection (3), regardless

65 of whether the parent or child agree or disagree with the treatment; and]

66 [(iii)] (ii) other possible invasive treatments, except electroconvulsive treatment as

67 defined in Section 62A-15-1101 , may be conducted unless either the parent or child disagrees

68 with the treatment, in which case a due process proceeding shall be conducted pursuant to the

69 procedures established under this Subsection (3).

70 (b) In promulgating the rules required by Subsection (3)(a), the division shall consider

71 the advisability of utilizing an administrative law judge, court proceedings, a neutral and

72 detached fact finder, and other methods of providing due process for the purposes of this

73 section. The division shall also establish the criteria and basis for determining when invasive

74 treatment should be administered.

75 Section 3. Section 62A-15-1101 is enacted to read:

76

Part 11. Electroconvulsive Treatment Regulations

77 62A-15-1101. Application.

78 (1) For purposes of this part, “electroconvulsive treatment” includes prefrontal sonic

79 sound treatment, or applied electrical voltage to the brain through electrodes which results in a

80 gran mal seizure or epileptic seizure and which is administered to treat mental illness.

81 (2) This part applies to the use of electroconvulsive treatment by any person who uses

82 or administers electroconvulsive treatment, including:

83 (a) a physician licensed under Title 58, Chapter 67, Utah Medical Practice Act, or Title

84 58, Chapter 68, Utah Osteopathic Medical Practice Act;

85 (b) a hospital or facility licensed under Section 26-21-9 ;

86 (c) a local mental health authority subject to this title, its designee or providers; and

87 (d) the Utah State Hospital and other mental health facilities.

88 Section 4. Section 62A-15-1102 is enacted to read:

89 62A-15-1102. Use of electroconvulsive treatment.

90

Electroconvulsive treatment may not be used on:

91 (1) a person who is younger than 18 years of age;

92 (2) a person who is pregnant; or

93 (3) a person who is 18 years of age or older, unless the person consents to the use of

94 the treatment in accordance with Section 62A-15-1103 .

95 Section 5. Section 62A-15-1103 is enacted to read:

96 62A-15-1103. Consent to treatment.

97 (1) The division shall adopt administrative rules which establish a standard written

98 consent form to be used when electroconvulsive treatment is considered. The rule shall

99 prescribe the information that must be contained in the written consent for electroconvulsive

100 treatment.

101 (2) The written consent form must clearly state:

102 (a) the nature and purpose of the procedure;

103 (b) the nature, degree, duration, and probability of the side effects and significant risks

104 of the treatment commonly known by the medical profession, especially noting the possible

105 degree and duration of memory loss, the possibility of permanent irrevocable memory loss, and

106 the possibility of death;

107 (c) that there is a division of opinion as to the efficacy of the procedure; and

108 (d) the probable degree and duration of improvement or remission expected with or

109 without the procedure.

110 (3) Before a person receives each electroconvulsive treatment, the physician

111 administering the treatment shall ensure that:

112 (a) the person receives a written copy of the consent form that is in the person’s

113 primary language, if possible;

114 (b) the contents of the consent form are explained to the person:

115 (i) orally, in simple, nontechnical terms in the person’s primary language, if possible; or

116 (ii) through the use of a means reasonably calculated to communicate with a hearing

117 impaired or visually impaired person, if applicable;

118 (c) the person signs a copy of the consent form stating that the person has read the

119 consent form and understands the information included in the documents; and

120 (d) the signed copy of the consent form is made a part of the person’s clinical record.

121

(4) For a person 65 years of age or older, before each treatment series begins, the

122 physician administering the procedure shall:

123 (a) ensure that two physicians have signed an appropriate form that states the procedure

124 is medically necessary;

125 (b) make the form described by Subsection (1) available to the person; and

126 (c) inform the person of any known current medical condition that may increase the

127 possibility of injury or death as a result of the treatment.

128 (5) (a) A person who consents to the administration of electroconvulsive treatment may

129 revoke the consent for any reason and at any time.

130 (b) Revocation of consent is effective immediately.

131 Section 6. Section 62A-15-1104 is enacted to read:

132 62A-15-1104. Physician requirement.

133 (1) Only a physician licensed under Title 58, Chapter 67, Utah Medical Practice Act, or

134 Title 58, Chapter 68, Utah Osteopathic Medical Practice Act, may administer electroconvulsive

135 treatment.

136 (2) A physician may not delegate the act of administering the treatment. A

137 nonphysician who administers electroconvulsive treatment is considered to be practicing

138 medicine in violation of Title 58, Chapter 67, Utah Medical Practice Act.

139 Section 7. Section 62A-15-1105 is enacted to read:

140 62A-15-1105. Registration of equipment.

141 (1) A physician may not administer electroconvulsive treatment unless the equipment

142 used to administer the treatment is registered with the division.

143 (2) A hospital or facility where electroconvulsive treatment is administered, or a

144 physician administering the treatment on an outpatient basis must file an application for

145 registration under this section. The applicant must submit the application to the division.

146 (3) The application must be accompanied by a nonrefundable application fee. The

147 division shall set the fee in accordance with Section 63-38-3.2 in a reasonable amount not to

148 exceed the cost to administer te registration, reporting, enforcement, and monitoring required

149 by this part.

150 (4) The application must contain:

151 (a) the model, manufacturer, and age of each piece of equipment used to administer the

152

treatment; and

153 (b) any other information required by the division.

154 (5) The division by rule may prohibit the registration and use of equipment of a type,

155 model, or age the division determines is dangerous.

156 Section 8. Section 62A-15-1106 is enacted to read:

157 62A-15-1106. Reports.

158 (1) A hospital or facility where electroconvulsive treatment is administered or a

159 physician administering the treatment on an outpatient basis shall submit to the division and to

160 the Health Data Committee created in Section 26-1-7 , quarterly reports relating to the

161 administration of the treatment in the hospital or facility or by the physician.

162 (2) A report must state for each quarter:

163 (a) the name of each physician who has privileges in the facility to perform

164 electroconvulsive treatment and the number of electroconvulsive treatments performed by each

165 physician;

166 (b) the total number of persons who received the treatment;

167 (c) the age, sex, and race of each person receiving the treatment;

168 (d) the diagnosis for each person receiving the treatment;

169 (e) the source of the payment for the treatment;

170 (f) the average number of electroconvulsive treatments administered for each complete

171 series of treatments, but not including maintenance treatments;

172 (g) the average number of maintenance electroconvulsive treatments administered per

173 month;

174 (h) the number of fractures, reported memory losses, incidents of apnea, and cardiac

175 arrests without death;

176 (i) autopsy findings, including investigation of petichial hemorrhages and other small

177 blood vessel hemorrhages in the brain tissue, if death followed within 14 days after the date of

178 the administration of the treatment; and

179 (j) any other information required by the division.

180 (3) The information required by Subsections (2)(h) and (2)(i) must include the name of

181 the physician who administered the treatment for each occurrence listed in Subsections (2)(h)

182 and (2)(i).

183

Section 9. Section 62A-15-1107 is enacted to read:

184 62A-15-1107. Use of information — Report.

185 (1) The division shall use the information received under Sections 62A-15-1105 and

186 62A-15-1106 to analyze and monitor the use of electroconvulsive treatment administered to

187 treat mental illness.

188 (2) (a) The division shall file annually with the governor and the Health and Human

189 Services Interim Committee of the Legislature a written report summarizing the information

190 received under Sections 62A-15-1105 and 62A-15-1106 . The information in the report shall be

191 summarized by facility and by physician.

192 (b) The division may not directly or indirectly identify in a report issued under this

193 section a patient who received the treatment.

194 (c) The report prepared in accordance with this Subsection (2) is a public document

195 under the provisions of Title 63, Chapter 2, Government Records Access and Management Act.

196 Section 10. Section 62A-15-1108 is enacted to read:

197 62A-15-1108. Enforcement.

198 The division shall enforce the provisions of this part and may, as the division considers

199 appropriate:

200 (1) issue a warning to any physician, hospital, or facility who fails to obtain consent or

201 file a report required by this part; and

202 (2) report violations of this part to the appropriate licensing authority for the physician,

203 hospital, or facility.

204 Section 11. Effective date.

205 This act takes effect on July 1, 2003.

Legislative Review Note

as of 1-20-03 1:46 PM

This legislation requires health care providers to disclose protected health information about a

patient. This type of disclosure is generally prohibited under the federal Standards for Privacy

of Individually Identifiable Health Information, 45 C.F.R. Parts 160 and 164. However, the

federal privacy standards have an exception to the general prohibition if the disclosure is

required by law. This bill appears to fall within the exception and would be a disclosure of

protected health information required by law.

Office of Legislative Research and General Counsel

House Passes Shock Treatment Legislation in Vermont

By Morgan W. Brown
January 20, 2000

Within the walls of the Vermont Legislature today (Thursday, January 20, 2000), H. 12 – a bill supposedly dealing with providing citizens with the illusion of “informed consent” regarding shock treatment (ECT) was passed by the House. The shock bill will now be brought under consideration in the Senate.

During the floor action in the House, there was an amendment offered to the bill before it was read the third time and passed. The amendment offered by Rep. Bouricius of Burlington was in two parts and at his request was divided into two separate questions to be voted on.

The first of these concerned whether the Department of Developmental and Mental Health Services (DDMHS) “Shall” promulgate and “adopt rules to govern the practice of electroconvulsive therapy” was defeated. Instead, the House decided to allow the fox to not just guard the chicken coop, but it “May” adopt rules about doing so.

On a division vote, the second question was passed by a mere six votes. That amendment to the previously amended bill, regards the section on reporting requirements and a committee to be created on guardianship relating to electroconvulsive therapy for individuals with developmental disabilities or mental illness by H.12 when passed. The change was in language being added in Sec. 2(c). The words “on consent materials and procedures and,” were added after the word “report” in the first sentence of that section. As passed, the section amended now reads:

Sec. 2(c), The committee shall make recommendations, in the form of a report on consent materials and procedures and, for revision to the current guardianship statute and rules to ensure that individuals with developmental disabilities or mental illness, lacking capacity to make medical decisions relating to electroconvulsive therapy, have access to a fair and adversarial probate court process and have legal representation by knowledgeable counsel. The committee’s report shall be submitted to the General Assembly on or before January 1, 2001.

After the amendment was voted on, the shock bill was passed on third reading. It will now go to the Senate for their consideration and for passage there.

Mental Health Bill: For the Consultation Process

Dear Sirs,

Mental Health Bill: For the Consultation Process

I have been unable to access the area of the official website which contains the Draft Bill law, but my understanding is, the following is set to apply re.

‘Electro-convulsive therapy (ECT) (Draft Bill clauses 118-120)’

“The Bill would allow ECT to be given without consent if it were expressly authorised by the Tribunal, or where it constituted urgent treatment. The Tribunal would be able to authorise ECT irrespective of whether the person had capacity to consent.

“The procedure for urgent treatment does not require prior approval and it allows two applications of the treatment. The treatment must be immediately necessary to save the patient’s life, prevent a serious deterioration in his or her condition, alleviate serious suffering, or prevent violent behaviour or danger to self or others.” (From: http://www.mind.org.uk/take_action/Campaigns/Brief_Draft_Mental_Health_Act.asp)

I write in order that it cannot be claimed the government is unaware of material implications of the proposals to give ECT to “prevent violent behaviour or danger to self or others.” What clauses 118-120 actually indicate is the calculated intent to diminish with ECT a person’s mental capacity to perform acts that the person would want to perform otherwise.

Consideration must be given to how ECT subdues the violent or restrains the dangerous. ECT is not direct physical restraint; it acts on the brain. Logically the only way a procedure that works on the brain could control and restrain is by its impact on mental capacity. In truth, no matter the ostensible reason for the prescription of ECT, an inherent capability to subdue exists in a procedure which constricts thinking ­ as when it diminishes the ability of recipients to entertain wishes or thoughts of death. (Prudic and Sackeim, 1999) Decreased thinking from ECT is what prevents violence to self.

Although the professionals say they lack knowledge of the mechanisms by which seizures alter mental functions, two prominent psychiatrists have categorically stated that ECT ‘saves lives’ (sic) by so contracting the ability to think suicidal recipients “are extremely unlikely, at least in the short term, to manifest suicidal ideation or intent.” (‘Electroconvulsive Therapy and Suicide Risk,’ Prudic and Sackeim, J. Clin. Psychiatry 1999:60 (Suppl 2))

According to Professor Appleby, “The main aim of the proposed legislation is to improve safety for people who are at risk, particularly for patients themselves. Sometimes there are people who feel very suicidal but who in a legal sense still have capacity. We have to make sure that they receive the treatment they need.” (http://societytalk.guardian.co.uk/WebX?128@188.ajWeayy2ra0.0@.3ba73fb4) In consequence of the “wish to make sure that they receive the treatment they need” patients are to be subjected to a procedure which retards the mind. ECT’s ‘mind control’ mode of action is decidedly questionable even as therapy, and in implying that people “need” mind control the government takes a less than reputable stance. High-flown rhetoric such as “improve safety…for patients themselves” fails to disguise the fact that a population who will be denied the rights and the effective means to defend themselves are to be cynically exploited.

As for danger to others, restrictions on freedom of expression (Article 10 of the ECHR) are permitted in the interests of public safety, but to slide into law a restriction that is effected through brain regulation is stretching things in relation to the Human Rights Act 1998. ECT contracts all thinking ­ and as action cannot occur if thought has been nullified so ECT also contracts the behavioural repertoire, to include aggressive acts. ECT given to subjugate an individual’s mind in order that others might benefit is particularly questionable. There can be no recourse to the argument that this is therapy for the person thus treated, as is possible where safeguarding health by limiting someone’s freedom of expression in suicide is concerned.

Psychiatrists are very aware of the importance of assuring the public that ECT is a soundly based treatment. The official (RCP) position on ECT for violent behaviour is that:

“There is no case for prescribing ECT to alleviate violent or offending behaviour per se. For a few patients who are suffering from a psychotic illness which has not quickly responded to antipsychotic medication, and where antisocial acts arise directly from psychosis, ECT may limit the acts by alleviating this.” (‘The ECT Handbook, 1995, p. 30)

Of particular note is the absence of evidence for ECT to “limit the acts” even in psychotic illness, as:

“Only one study seems to have made explicit a possible specific advantage for ECT for those with violent propensities. Smith et al (1967) noted that among people with schizophrenia the problems that responded most significantly and favourably to an ECT / chlorpromazine combination…were hostility (not violence) and ideas of persecution.” (p. 30; emphasis added)

Of the Home Office / Department of Health conditions that will govern any decision to apply compulsion, concerning the ‘appropriate treatment is available’ condition, no basis for claiming patients would be protected from inappropriate treatment exists in circumstances lacking evidence of appropriateness (or even evidence the procedure is ‘medical’ in the accepted sense). (Para. 2.9) Clearly, anecdotal accounts referring to ECT which subdues, quieten, restrains, etc., drive ill-considered intent.

When it comes to the universally unpopular government diagnosis of DSPD, absence of clinical justification for ECT is glaringly apparent. Although DSPD isn’t mentioned in the Draft Bill, violence and danger to others are, along with the proposals for ECT as a preventive measure irrespective of either capacity to consent or ‘illness.’

One consequence of the future intentions where ECT is concerned is to throw into doubt the accuracy of the RCP statement that ECT limits antisocial acts due to its effectiveness in treating diseases that are characterised by aggression or violence as symptoms of mental illness. The mode of action of ECT that is going to count by far the greatest is its impact on mental capacity and not its impact on psychosis (or whichever illnesses allegedly have aggression, violence and dangerousness as symptoms). Under the single definition of mental disorder, people with personality disorders will assuredly end up being treated exactly the same as those with any and every conceivable mental, neurological ­ or social ­ disorder, meaning diagnosis becomes flagrantly the means to effect a ‘mind control’ objective.

According to Louis Appleby, “As now, powers of compulsion will only be used for those who present a serious risk to themselves or others.” (http://society.guardian.co.uk/societyguardian) But is it entirely correct to describe the proposals as in no way more draconian than the 1983 act? It seems one test of the appetite in Whitehall for more draconian powers resides in what is being said about ECT to “limit the acts,” compared with present usage. In the light of denial by psychiatrists that they currently use ECT for purposes other than to treat illness, any use of ECT for non-medical purposes would be more draconian.

The youth of this country are understandably wary of what the new laws could mean for them. According to the findings, revealed on 13.9.02, from a relevant MIND survey of 1,000 people, “concerns about the measures were even higher amongst the young, where 52% said they would not seek medical help for a mental health problem.” (http://news.bbc.co.uk/1/hi/health/2253358.stm) Plainly, in relation to danger to self or others, it is widely believed that there exists the potential for increased use of compulsory treatments in the under 20 age group. I must therefore point out that:

a) The WHO draft legislative manual opposes ECT for young people ­ even as treatment ­ and the law in at least two US states restricts use of ECT with minors (see Appendix). b) Absence of evidence the treatment is appropriate is compellingly relevant to ECT for young minds.

In response to Consultation Point 3.10: The Government would welcome your views on these proposals to extend legal protections to children while respecting parents’ rights to make decisions about their children’s treatment, I stress the lack of knowledge of ECT’s long term adverse effects on the personality of the young recipient. It is especially noteworthy that pro-ECT researchers Walter, Rey and Mitchell have stated,

“There is no published data about the experience and attitudes of adolescent recipients of ECT, or their parents, regarding their treatment. However, in a recent survey of 26 patients who received ECT in adolescence, and 28 parents, we found that overall ECT was viewed favourably.” (‘Practitioner Review: Electroconvulsive Therapy in Adolescents, J. Child Psychol. Psychiat 40:3, 1999)

ECT was indeed viewed favourably, but the survey Walter et al.. mention reported of adolescent recipients three years on from the ECT experience that they were socially inadequate, living on welfare benefits, “chronically ill [and] functionally impaired….” (‘Electroconvulsive therapy in adolescents: experience, knowledge and attitudes of recipients,’ Walter, Koster and Rey, J. Amer. Acad. Child and Adolescent Psychiatry, 38, 1999).

Lasting functional impairment following treatment and all that this implies is conveniently dismissed as ‘continuing mental illness,’ but interpretation by pro-ECT psychiatrists does not constitute proof of cause of functional impairment or that ECT ought to be being viewed favourably. Besides, ‘continuing mental illness’ is actually an admission that the treatment hasn’t worked ­ and effectiveness in the age group in question is undemonstrated, for:

“No scientific evidence based on controlled evaluations supports the use of ECT with children and adolescents. No data exist to support the use of ECT in preference to other less invasive treatments.” (‘Shock Story,’ Nursing Times, Barker and Baldwin, February 21, Vol. 86, No. 8, 1990

In the matter of adolescent ECT, legal protection as envisaged would not be adequate. To repeat, there is no backing from controlled studies, reliably applied criteria or valid assessment scales ­ in short, no body of scientific knowledge. Therefore, parents should not be able to use the law to force ECT onto anyone whose brain and personality are still developing, and no government should countenance mind control ‘treatment’ where immaturity further compounds the dubious suppositions surrounding such a measure.

In the absence of medical evidence generally, although the expertise of the experts of experience is treated with contempt, ECT survivors are the only ones in a position to counsel the government on the ways in which ECT that subdues and controls actually works. As noted, important questions being avoided include the question of what ECT really does to personality and functioning.

As for the ethics of the proposals, to ignore the ethical dimension is folly. In a Sunday Times article which appeared on 24.1.1999 (‘Psychiatrists accused of serial rapes’) Lois Rogers reported, “One alleged victim, a 41-year old interpreter with two teenage children, claimed that Haslam ensured her compliance with repeated sex attacks by subjecting her to excessive amounts of electroconvulsive therapy….” (The reference is to retired a psychiatrist Michael Haslam, who is still being investigated for sexual assaults on female patients.)

The reasons ECT has the potential to facilitate rape is because:

a) ECT concusses and head trauma often leaves recipients with such poor judgement (Breggin, 1998 ­ see Appendix) they place themselves in dangerous situations. b) The ECT impact on brainwaves increases suggestibility and can result in pathological ductility.

Concerning impact on brainwaves, Grey Walter reported:

“The only characteristic of behaviour which was significantly correlated with the presence of delta activity was…a relatively promising attitude…. … Consideration…has suggested that the common factor related statistically to delta rhythms is a comparatively docile attitude to suggestions from others. The terms ‘malleable’, ‘easily helped’, ‘easily led’ were used, and the word that seems most apt and free from irrelevant or misleading associations is ‘ductile.’ (‘The Living Brain,’ Penguin Books, 1961, p. 182)

Psychiatrists have observed yielding, agreeable, easier patients after ECT, and they acknowledge that ECT induces increased delta activity. The ‘Handbook of ECT’ (Kellner et al., American Psychiatric Press, 1997) reports that “Increased predominance of delta activity on interictal EEG is seen as a function of the number of ECT treatments given in a course of ECT and their rate of administration. (Fink 1979).”

In reality, what the nature of interictal EEG changes is a function of is interpretation. It should not be assumed that a large number of treatments is essential to effect extensive EEG changes. According to Professor Robert Kendell:

“If bilateral electrodes are used paroxysmal delta activity starts to appear in the frontal leads after the first two or three treatments and becomes steadily more prominent and extensive thereafter.” (‘The Present Status of Electroconvulsive Therapy,’ Brit. J. Psychiat. (1981), 139)

Nor should it be assumed that increased delta activity is therapeutic, as this hasn’t been demonstrated and such activity is by no means universally accepted as therapeutic. In fact, Laverne Johnson et al. pointed out that: “With the exception of Fink and his co-workers, there has been almost complete unanimity in the finding that clinical improvement was not related to post-ECT changes in the EEG or to pre-ECT patterns.” (‘Electroconvulsive Therapy (With and Without Atropine),’ Arch Gen. Psychiat., Vol. 2., 1960)

‘Clinical improvement’ is a value judgement according to Professor Fink (see Appendix). Nevertheless, this leader in the field maintains that EEG changes are an index of efficacy, and he advocates the obtaining of an appropriate EEG sequence. By rights, the fact that ECT induces EEG changes with the potential to create victims vulnerable to assault ­ a potential one unscrupulous psychiatrist is accused of turning to advantage ­ should have led to the conclusion the risks vastly outweigh benefits.

A key area of interpretation concerns durability of brainwave changes, which are said to be “transient.” Therefore, I would add my own personal statement to that of the interpreter who claims ECT was employed to ensure her compliance with rape. Whether or not ECT is actively employed for this purpose, I will say that it facilitates all types of victimisation, from scapegoating to rape.

I am a woman who stood there unable to say “No!” when faced with rape eight years after ECT was used. I had been a fighter as a child, yet I let a little man with a little penknife have things all his own way. I wasn’t frightened of him, rather permanent ECT-inflicted ductility prevented appropriate action in word or deed. My mental capacity to resist rape having been diminished, it transpired my behavioural repertoire was lastingly contracted. (I received compensation from the Criminal Injuries Compensation Board, i.e. the fact of rape may not be discounted.)

The point I am making is that although it is true ECT renders people docile and suggestible, those proposing to give ECT to prevent violent behaviour or danger to others cannot afford to ignore the various ramifications of their stated intention. Does the proposed removal of “the problem in the current Act that people with mental impairment or psychopathic disorder need to fulfil a requirement that ‘treatment is likely to alleviate or prevent a deterioration of this condition’” (para. 2.11) mean the pretence ECT is of therapeutic benefit to the recipient disappears in tandem?

This being how things appear, and how they would in any case operate in practice given that the requirement for treatment to be of therapeutic benefit to the recipient will vanish, naturally the question arises as to whether treatment is envisaged, or punishment. According to Abse, “the very nature of the treatment itself can produce the attitudes described. The success of EST principally in depressions is thus associated with hostile or punishing attitudes on the part of the therapist….” (‘Transference and Countertransference in Somatic Therapies,’ Journal of Nervous and Mental Diseases, 1956)

Is the underlying justification actually meant to be of the eye-for-an-eye variety, with perpetrators to be turned into victims, themselves at risk of assault from others? As for would-be perpetrators, is it to be a matter of the authorities getting in a pre-emptive strike via doctors who swear to do no harm but who are nevertheless rendered hostile and punishing by ECT’s very nature? In short, does the State intend health care which is more oppressive than legal sanctions and punishment? That being where the logic of the ECT proposals points, I doubt anyone has thought the matter through at all carefully or considered reasonableness.

Government-sanctioned intent to subdue and make docile with ECT those deemed to require this type of ‘management’ implies the will to gross violations of Article 3. It is obvious psychiatrists (and now officials in Whitehall with a duty to promote public health) are fully aware that ECT is a system not of health but of control, compulsion, restraint and punishment. I find it remarkable that the government should need to be reminded of Article 3 of the ECHR:

No one shall be subjected to torture or to inhuman or degrading treatment or punishment.

Yours faithfully,

Appendix ­ Supplementary Material

… According to Dr. Peter Breggin (a psychiatrist who wishes to see ECT banned),

“Head-injury victims, including post-ECT patients, frequently develop an organic personality syndrome with shallow affect, poor judgment, irritability, and impulsivity. They seem “changed” or “different” to people around them, much as lobotomy patients often seem to their families. Sometimes they become slightly clumsy, moving awkwardly or dropping things. Often they have “lapses” where they cannot think or cannot voice their thoughts. Sometimes their handwriting deteriorates. Headaches frequently begin with the traumatic treatment and may recur indefinitely. “Many post-ECT patients suffer from irreversible generalized mental dysfunction with apathy, deterioration of social skills, trouble focusing attention, and difficulties in remembering new things.. I have evaluated a number who have suffered from dementia, confirmed by neuropsychological testing. Several have developed partial complex seizures or psychomotor epilepsy, permanently abnormal EEGs, and atrophy as measured by brain scans. Many have been deprived of the experience of years of their lives, their professional careers, and their mental ability following ECT.” (‘Electroshock: scientific, ethical, and political issues,’ Peter R. Breggin, International Journal of Risk & Safety in Medicine 11 (1998) 5-40, IOS Press)

… Professor Kendell (1981) has pointed out that, “A course of ECT almost invariably produces extensive EEG changes” and Dr. Breggin mentions permanently abnormal EEGs following head trauma. If ECT is head trauma how likely is it that the inevitable ECT-induced EEG changes are transient in an overwhelming majority of cases, given:

“Williams (1941) has shown that the E.E.G. may remain abnormal for many years after a head injury and has demonstrated a relationship between E.E.G. abnormalities and the severity of the injury, as judged by the length of post-traumatic amnesia.” (‘Electro-Encephalographic Studies of Psychopathic Personalities,’ Denis Hill and Donald Watterson, J. Neurol. and Psychiat., 5-6, 1942-3)

… Professor Max Fink, writing on ECT to ‘improve’ behaviour, has provided indication that so-called ‘therapeutic’ EEG changes are a matter of opinion.

“Behavioral change is a consistent accompaniment of alteration in cerebral function. Changes in mood, language, attitude, judgment, thought process, perception, and insight attend changes in cerebral function, from whatever cause…. “In this study, electroshock has been shown consistently to alter the electroencephalogram in a fashion which we have come to associate with states of altered cerebral function. The studies of Davis and Davis (1939), Ostow and Strauss (1953), Ostow and Ostow (1946), and Jung (1954) have affirmed the significance of diffuse delta activity as an index of altered brain function.. Symmetric dysrhythmic delta activity has been interpreted as evidence of dysfunction of midline hypothalamic centres ­ the centrencephalic system (Ostow and Strauss, 1953). Such activity is also indicative of an alteration in the state of consciousness, more marked alteration being directly related to the duration, amplitude, and frequency of the slow-wave activity. The demonstrated relationship between induced delta activity and behavioral response after electroshock, therefore, permits the conclusion that changes to the centrencephalic system with attendant alteration in consciousness are the physiologic basis of the electroshock process. … “These studies of the electroshock process have demonstrated that alteration in brain function is induced early and is sustained in patients in whom the greatest degree of behavioral change is noted. … “We have been impressed that the ratings of improvement are value judgments of the behavioral response. All patients in whom cerebral changes are induced by electroshock manifest changes in behavior. The range of behavioral patterns induced under these conditions is wide. … “Improvement” is a special case of behavioral response, being a subjective evaluation on the part of the observer that the patient is “better.” Electroshock does not induce “improvement”; it induces a milieu of cerebral activity in which behavior is different than before electroshock. To the extent that the induced behavior in depressed patients is perceived as less complaining, or anxious, or in schizophrenic patients as less delusional, hallucinatory, or excited, the patient is evaluated as “improved.” When behavior, however, is perceived as anxious, agitated, paranoid, complaining, or withdrawn, it is evaluated as “unimproved.” The particular type of behavioral pattern induced by electroshock is dependent on a number of factors, such as personality. “Another aspect of the rating of improvement is the environmental response to the induced behavior. The modification of mutism, withdrawal, and negativism to excitement, overactivity, and irritability may be considered a positive movement by the therapist but a disorganization by the ward physician or family.” (‘Relation of EEG delta activity to behavioral response in electroshock: Quantitative serial studies,’ Fink and Kahn, Arch. Neurol. Psychiatry, 1957, 78:516-525)

… Restrictions on use of ECT with minors: Texas law stipulates:

§ 578.002. Use of Electroconvulsive Therapy (a) Electroconvulsive therapy may not be used on a person who is younger than 16 years of age. (b) Unless the person consents to the use of the therapy in accordance with Section 578.003, electroconvulsive therapy may not be used on: (1) a person who is 16 years of age or older and who is voluntarily receiving mental health services; or (2) an involuntary patient who is 16 years of age or older and who has not been adjudicated by an appropriate court of law as incompetent to manage the patient’s personal affairs. (c) Electroconvulsive therapy may not be used on an involuntary patient who is 16 years of age or older and who has been adjudicated incompetent to manage the patient’s personal affairs unless the patient’s guardian of the person consents to the treatment in accordance with Section 578.003. The decision of the guardian must be based on knowledge of what the patient would desire, if known. Added by Acts 1993, 73rd Leg., ch. 705, § 5.01.

… Respecting medication employed to “limit the acts,” as with ECT, there is no established indication for any substance to control aggression ­ even aggression as a mental illness symptom.

“Most clinical information on treating aggression has been collected for atypical neuroleptics, particularly for clozapine. … At the moment, clozapine seems to be the first choice in aggression treatment. Within the last few years, about 10 articles were published showing that this is the most effective antiaggressive agent in the treatment of aggression and agitation in psychiatric patients, independent of psychiatric diagnosis. However, clozapine, like all the other substances used, does not have an established indication for the treatment of aggressive symptoms. … Ethical, juridical and methodological problems prevent controlled studies from establishing a reference in the treatment of aggression in mentally ill patients.” (‘Psychopharmacological Treatment of Aggression in Schizophrenic Patients,’ T. Brieden, M. Ujeyl and D. Naber, Pharmacopsychiatry 35, 2002)

ECT has been abolished in the Republic of Slovenia

Wayne Smyth
West Australia desk

In the heart of Europe, nestled between Italy, Austria, Croatia and Hungary, ECT is forbidden in Slovenia, which serves as a cradle of sanity on this topic.

The only caveat, per Igor Spreizer co-chair of ‘ALTRA, Committee for Innovation in Mental Health’ Ljubljana, Slovenia, is that a small number of patients are referred outside of Slovenia to Zagreb, Croatia where the procedure is still used. Slovenian authorities claim only 3-12 patients are referred each year. This, nonetheless, does make Slovenia, effectively, an ECT Free Zone.

ALTRA (loosely from the word alternative) has been active and effective in advocacy and patient rights. This is not without attention from official psychiatry, which ALTRA has fought with many times. While ALTRA, which employs 23 staff, does not claim responsibility for the Slovenian experience, ALTRA is unquestionably a major influence in holding this position.

Verification of the Slovenian experience comes from Marinka Kapelj the representative of Slovenia, board member of the European Network of ex Users and Survivors of Psychiatry (ENUSP). ALTRA is hosting this years ENUSP conference in Slovenia, in November. Details at www.enusp.org

Most of ALTRA’s resources come from the State and lotteries commission. Around 300 people support and use ALTRA services.

Slovenia is a strong toehold, indeed a full foot on the ground for the anti shock movement. It might be that your currency goes a long way in terms of Slovenia. Attend the conference, tells your friends. Support ALTRA.

ALTRA can be reached at:
ALTRA
Miklosiceva ul. l4
1000 Ljubljana
Slovenia
Europe
tel.:++386 1 434 73 18

CALLOUS SHOCK DOCS ZAP HOLES IN PEOPLE’S LIVES

New York Post
By DOUGLAS MONTERO

May 20, 2001 — LINDA Andre has a five-year hole in her life. Chilling things happen to her, like the time she met a man in the street – a man she had once had an intimate relationship with – and did not recognize him. She treated him like a stranger.

There’s the time she sat down to read a book only to be told she’d already read it.

There are happy times forever lost in that five-year hole.

Her graduation from NYU, acceptance into its graduate school, vacationing in California, or the day her roommate called the fire department when their room flooded – all were erased from her mind.

Last week, Andre, 41, attended a hearing of the Mental Health Committee of the state Legislature. There she told the state suits about the electroshock treatment that blasted the five-year hole in her brain.

“It was horrifying, not just to me, but for the people who knew me,” the Manhattan woman said about the 1984 electroshock treatment she received when hospitalized for severe depression.

The hearing was designed to find out why shock treatment has increased by about 70 percent over the past 18 months at state-run mental hospitals and whether it is being monitored properly.

The increase comes mostly from mental patients or their relatives who agree to the procedure and get a judge’s order.

But there’s mounting evidence state doctors are getting too aggressive in their ordering of the procedure.

For example: Paul Henri Thomas, a well-read, mentally ill Haitian immigrant, agreed to get zapped at Pilgrim State Hospital in June 1999.

After three sessions he said “stop,” and the doctors at Pilgrim suddenly said Thomas was incompetent and went to court. He got zapped 57 more times.

John Javis, an advocate for the New York Association of Psychiatric Rehabilitation Services, told the committee Thomas’ symptoms still persist and the Pilgrim docs are literally cooking his brain.

There’s also Adam Szyszko, a 25-year-old Pilgrim patient who also objected but got zapped anyway before lawyers could get a court injunction.

His parents can’t even get him out of Pilgrim for their treatment of choice – psychotherapy. Szyszko is allergic to medication and docs want to zap him some more.

But it appears these doctors also suffer from memory loss.

Committee Chairman Martin A. Luster (D-Ithaca), an assemblyman, and State Sen. Daniel R. Hevesi (D-Queens) both asked the state for statistics on electroshock.

And the response from the state Office of Mental Health? There aren’t any!

Instead, OMH sent the state’s well-respected electroshock czar, Dr. Harold Sackheim of the New York State Psychiatric Institute, to the hearing.

Sackheim, who has been zapping people since the late ’70s, said electroshock is used as a last resort when medication does not work. He said electroshock is being “stereotyped” even though he said his experiments show it more effective than drugs to treat depression.

But Sackheim babbled like an electroshock patient when Luster asked him why doctors are quick to zap willing mental patients and are even quicker to declare them incompetent when they say “stop.”

Sackheim told the committee that short-term memory loss is brief and later recouped. But Andre’s problem is permanent – life altering.

She can’t hold a steady job because she can’t concentrate. Andre, an advocate for the Committee for Truth in Psychiatry, said she knows one electroshock survivor who lost 25 years of her life.

Some electroshock patients lose the memory of their children’s childhood. They don’t remember why they love their spouses.

“You lose the whole context of the relationship,” she said.

There is clear-cut evidence that electroshock works, as Sackheim and the established medical community say – which is fine.

There is also clear-cut evidence that it bulldozes people’s brains, and that’s a risk that should prod state legislators to act.

New Hampshire HB406

HB406, which prohibits ECT on children under age 16, has a floor date of March 8, 2001.

If you are an electroshock survivor, you are urged to contact those involved and tell your stories/voice your opinions.

From someone involved, a report on the last committee meeting:
The HB406, anti-shock, insulin shock and psychosurgery bill on kids under age 16 was interesting. NAMI stayed out of the picture and the NH Consumer Council came forward in favor of the bill. Three legislators testified in favor of the bill and none against it. Five shock psychiatrists and the Human Services Dept. came out against the bill. Without the NAMI buffer, it was clear that the patients didn’t like the psychiatrists.

BAN ECT, INSULIN SHOCK AND PSYCHOSURGERY ON CHILDREN UNDER AGE 16 IN NEW HAMPSHIRE. CALL NOW!!!!!!!

New Hampshire House Bill 406, “AN ACT prohibiting electro-convulsive therapy on children under 16 years of age” had a public hearing February 20th. This bill would also ban insulin shock and psychosurgery on kids.

The New Hampshire Consumer Council came out in force with three legislators in favor of this bill. FIVE psychiatrists came out in favor of electroshocking children. They were listened to. Now it’s your time to be heard.

Please help the New Hampshire Consumer Council by contacting the following members of the New Hampshire Health, Human Services ?

VOTE IN FAVOR OF HB 406. ECT CAUSES PERMANENT BRAIN DAMAGE AND CHILDREN HAVE NO POWER TO REFUSE PSYCHIATRY’S MOST HARMFUL AND BARBARIC PROCEDURES.

Here is the most updated list:

House of Representatives
Health, Human Services ?
Chairman:
Peter L. Batula
12 Paige Dr.
Merrimack, NH 03054-2837
(603)424-6091
stoj@juno.com

Vice Chairman:
Andre A. Martel
237 Riverdale Ave.
Manchester, NH 03103-7301
(603)622-8411
(no email listed, try andre.martel@leg.state.nh.us)

Clerk:
Margaret A. Case
44 Beach Head Rd.
Nottingham, NH 03290-4921
(603)895-2718
(no email listed, try margaret.case@leg.state.nh.us)

Members:
Robert F Chabot
73 Joseph St.
Manchester, NH 03102-5617
(603)625-5617
bob.chabot@leg.state.nh.us

Martin Feuerstein
801 Central St.
Franklin, NH 03235-2026
(603)934-3849
martyfeuerstein@aol.com

Fran Wendelboe
238 Lower Oxbow Rd.
New Hampton, NH 03256-4648
(603)968-7988
mattwenfran@cyberportal.net

James R. MacKay (this guy is a psychotherapist)
139 N. State St.
Concord, NH 03301-6431
(603)224-0623
jamesmackay@sompuserve.com

Cecelia D. Kane
391 Colonial Dr.
Portsmouth, NH 03801-4706
(603)436-3454
(no email listed)

Stephanie K. Micklon
163 Brady Ave.
Salem, NH 03079-4812
(603)893-6677
smicklon@worldnet.att.net

Joseph P. Manning
9 Bradley Ct.
jaffrey, NH 03452-5400
(603)532-8083
(no email listed, try joseph.manning@leg.state.nh.us)

James P. Pilliod
504 Province Rd.
Belmont, NH 03220-5379
(603)524-3047
jimp@together.net

Walter D. Ruffner
10 Benjamin Rd.
Stratham, NH 03885-2101
(603)772-9558
walterl709@juno.com

Susan Emerson
571 Rte. 119
Rindge, NH 03461-3704
(603)899-6529
(not email listed, try susan.emerson@leg.state.nh.us)

Barbara C. French
17 Fairview Ave.
Henniker, NH 03242-3310
(603)428-3366
(no email listed, try barbara.french@leg.state.nh.us)

Sandra C. Harris
43 Ridge Ave.
Claremont, NH 03743-3166
(603)542-6973
scharris@turbont.net
sandra.harris@leg.state.nh.us

Phyllis M. Katsakiores
1 Bradford St.
Derry, NH 03038-4258
(603)434-9587
(no email liste, try phyllis.katsakiores@leg.state.nh.us)

Janeen Dalrymple
7 Penobscott Ave.
Salem, NH 03079-4527
(603)898-4527
janeen76@aol.com

Alida I. Millham
426 Belnap Mtn. Rd.
Gilford, NH 03249-6814
(603)524-1278
amillham@worldpath.net

Daniel M. Burnham (this guy is a newspaper pulisher)
PO Box 496
Dublin, NH 03444-0496
(603)563-8629
danburnham@pobox.com

Gloria Seldin
54 Church St.
Concord, NH 03301-4550
(603)225-3787
seldglo@com.con (WRONG e-mail – DOESN’T GET THERE)

Hilda W. Sokol
6 Storrs Rd.
Hanover, NH 03755-2410
(603)643-2702
h.w.sokol@dartmouth.edu

HB406 – for up to date info, type in HB406 under “Bill Number” and click submit.

Missouri SB266

News flash!

Final: The bill went to the Missouri Senate as part of SB266, where it went to committee. There, it was stripped off the bill. Sen. Betty Sims opposed the bill, saying it was too “controversial.” I honestly fail to understand why data collection is controversial and Sen. Betty Sims disappoints me. I thought our elected officials went into office to do the right thing, not avoid controversy.

Older update:
Missouri HB134, which would require ECT reporting, has now passed out of the Children, Families, and Health Committee, with a vote of 10 to 1.

The dissenting voter was Rep. Vicky Riback Wilson.

Four members were not present.

Next, the bill must be pushed to the floor for a vote, or may be tacked onto another bill.

Your letters and phone calls are still needed to get this bill passed.

Thank you so much to the many people who have supported this important bill.

Previous info on the bill:

Thanks to Rep. Harold Selby (he’s a hero!), the Missouri House of Representatives are considering HB134, which would require reporting of ECT. Yes, folks, Missourians mean it when they say “SHOW ME.”

Even though I’m a lifelong Illinoisan, those of us who live in Metro East (considered St. Louis suburbs) kind of share a foot on the other side of the river. I’m sorry I don’t vote in Missouri, because Rep. Selby would get MY VOTE in a heartbeat. We need this bill and we need it now. We need bills like this in every state. We need a federal bill that would mandate reporting. See the stats page on this site for more information on why we need this. You can also take a look at the stats that do exist and see how we don’t even know how many people have ECT annually! That 100,000 – 200,000 number you hear? It’s a GUESS because only a few states keep any records. The National Mental Health Association recently issued an official policy statement recommending a national version of this.

What can you do to help? Write an email (or fax or snail mail) to the members of the Missouri House of Representatives Children, Families and Health Committee. The bill is still in committee and representatives need to know why this bill is so important. Patients need to have access to statistics so they can make an informed decision. If you have a personal story about ECT, please share it with them, pro or con.

Here is a listing of the committee members. Please consider sending them an email and expressing your support of HB134. And while you’re at it, send Rep. Harold Selby a big THANK YOU for his hard work.

Barry, Joan, Chair
Selby, Harold R., Vice Chair
Coleman, Maida J.
Curls, Melba J.
Fraser, Barbara
Hilgemann, Robert
Holand, Roy W.
Hunter, Steve
Kelly, Van
King, Jerry R
May, Bob
Monaco, Ralph A.
Phillips, Susan C.
Reid, Michael J
Wilson, Vicky Riback

Click here if you would like phone numbers or snail mail addresses.

INVOLUNTARY AND ILLEGAL ELECTROSHOCK IN MICHIGAN

A report submitted to the Department of Community Health Recipient Rights Advisory Committee on June 14, 2001, by committee member Ben Hansen.

Michigan’s Mental Health Code prohibits the administration of involuntary electroconvulsive therapy (ECT, electroshock) to an adult who has no guardian. Section 717 (1) (a) of the Code states, “A recipient shall not be the subject of electroconvulsive therapy or a procedure intended to produce convulsions or coma unless consent is obtained from … the recipient, if he or she is 15 years of age or older and does not have a guardian for medical purposes.”

Unfortunately, this section of the Code is ignored by probate judges who sign court orders authorizing involuntary ECT in direct violation of Michigan law.

In October 1999, a petition was filed in Lenawee County Probate Court by Dr. Daniel F. Maixner, who wished to administer ECT to a patient who had been involuntarily committed. The doctor’s petition asserted “that the individual is a person suitable for electroconvulsive therapy pursuant to 330.1717.”

Probate Judge John Kirkendall found “by clear and convincing evidence, the individual is a person requiring treatment because the individual has a mental illness, pursuant to order entered 10/6/99; it is advisable and reasonable to administer electroconvulsive therapy and diligent effort has been made to locate individuals eligible to give consent.” The judge ordered “that the individual receive electroconvulsive therapy pursuant to the following schedule: maximum number of treatments: 12. Time within which such treatments shall be administered: over a 30 day period from the date of initial treatment.”

An appeal was filed by Michigan Protection & Advocacy, and on May 31, 2000, 39th Judicial Circuit Court Judge Timothy Pickard issued an order which declared, “The statute is clear in identifying those individuals authorized to give consent. Competent adults, for whom a guardian has not been appointed, retain the right to make decisions about the administration of electroconvulsive therapy. It is apparent that Appellant is an individual for whom a guardian has not been appointed and that she is an adult. Under those circumstances, MCL 330.1717 does not authorize forced administration of electroconvulsive therapy. This Court therefore holds that the Order entered on October 12, 1999 be VACATED.”

Two weeks after the circuit court decision cited above, a petition was filed in Calhoun County Probate Court by another psychiatrist who wished to administer ECT to a patient who had been involuntarily committed. Filling out a form entitled “PETITION AND ORDER FOR ECT TREATMENT,” Dr. Ravinder K. Sharma asserted that “it appears that the individual is in need of a course of ETC. It further appears that the individual will not or cannot consent to such a course of treatment and that there is not a guardian to give such consent. I therefore request that the court permit that the individual undergo a course of ECT.”

Probate Judge Phillip Harter granted the petition on June 16, 2000, ordering that “ECT may be performed upon the patient at Oaklawn Hospital, Marshall, Michigan. The number of treatments shall not exceed 12 and the last treatment shall be performed on or before 9/14/00.”

Again Michigan Protection & Advocacy filed an appeal, this time in the 37th Judicial Circuit Court, and on October 23, 2000, Circuit Court Judge James Kingsley issued an order which echoed, almost word for word, the order which had been issued by 39th Circuit Court Judge Pickard five months earlier: “The statute is clear in identifying those individuals authorized to give consent. Competent adults, for whom a guardian has not been appointed, retain the right to make decisions about the administration of electroconvulsive therapy. It is apparent that Appellant is an individual for whom a guardian has not been appointed and that she is an adult. Under those circumstances, MCL 330.1717 does not authorize the forced administration of electroconvulsive therapy. This Court therefore holds that the Order entered on June 16, 2000, be VACATED.”

The circuit courts have ruled with language that is unequivocal: Michigan’s Mental Health Code prohibits the administration of involuntary electroshock to an adult who has no guardian. Unfortunately, some probate judges continue to ignore and/or defy the law.

Replying to an email query regarding court protocol as it pertains to ECT, Probate Judge Phillip Harter wrote the following in an email which he sent on May 14, 2001:

“There are generally two ways that ECT can be authorized without the consent of the patient. First, a guardian can be appointed for the patient and the guardian can give permission for the treatment. Second, a court can under the Mental Health Code find that the individual does not have the ability to consent and the treatment is necessary. Such a court could then give a hospital the authority to use ECT treatment for the patient.”

When a follow-up email asked Judge Harter to clarify his interpretation of the law, the Judge wrote the following in an email which he sent on May 25, 2001:

“…in the context of a mental hearing, a judge may make a finding that the individual is not competent to give or withhold consent. This would be similar to a finding that the person meets the criteria for the appointment of a guardian. Once that finding is made, I believe the court can inquire as to whether or not ECT treatment is appropriate and order it if it is appropriate. The same thing would be accomplished by holding a guardianship hearing, appointing a guardian and authorizing the guardian to consent to ECT. I believe the better procedure is to have the guardian appointed for the purpose of consenting to ECT treatment.”

Judge Harter seems to openly defy the circuit court rulings on involuntary ECT. Moreover, his remark that a guardian may be appointed “for the purpose of consenting to ECT” is most troubling, for it appears to be yet another example of how probate judges use guardianship as a way to circumvent competency standards, involuntary commitment procedures, involuntary treatment requirements and other laws designed to protect individual rights. This may be one reason why Michigan leads the nation in the number of adults who have been assigned legal guardians.

Consent laws are made a mockery by judges who rule that individuals are competent when they consent to treatment, but incompetent when they refuse treatment. The recipient rights system is a farce if the Mental Health Code is systematically violated and the Office of Recipient Rights takes no action in response.

On this question, ORR Director John Sanford wrote in an email which he sent on May 16, 2001:

“…Our mandate is to ensure that providers of mental health service maintain a rights system consistent with the standards established by the Mental Health Code. Administrative rule 7001(L) defines a provider as the department, each community mental health services program, each licensed hospital, each psychiatric unit and each psychiatric hospitalization program licensed under section 137 of the act, their employees, volunteers, and contractual agents. The courts are not considered a provider. Thus, ORR has no control or jurisdiction over them.”

The fact that ORR has no jurisdiction over the courts is no justification for looking the other way when the Mental Health Code is violated. At the very least, ORR should provide rights officers and others with a correct interpretation of 330.1717, instead of contributing to the confusion by promoting contradictory and misleading information, as it did at “The 2000 Recipient Rights Conference” held at the Grand Traverse Resort in October of last year.

Conference participants received an information packet which included a document entitled, “A Mental Health Professional’s Guide to Michigan Mental Health Procedure,” authored by Probate Judge John Kirkendall. In a section on electroshock and the requirements for its use, the document states the following:

“The probate court may grant consent. This can occur if 1) No one can be found after diligent effort who meets the criteria above; 2) There is a petition and hearing. Once you believe ECT is indicated and you can find no one to give consent, you must cause a petition to be filed with the probate court. Call the prosecuting attorney in the county who handles these matters to take care of this for you.”

The Office of Recipient Rights should make a concerted effort to inform all who attended last year’s conference that the information quoted above is contrary to the Mental Health Code. Failure to do so will put ORR in the embarrassing position of appearing to endorse an interpretation of the Mental Health Code which has been ruled unlawful by the circuit courts.

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Attachments:

1. Michigan Mental Health Code, “330.1717 Electro-convulsive therapy; consent.”

2. “Initial Order Following Hearing on Petition for Admission,” Lenawee County Probate Court, File No. 99-438-M, October 12, 1999.

3. Order, 39th Judicial Circuit Court for Lenawee County, File No. 99-8390-AV, May 31, 2000.

4. “Petition and Order for ECT Treatment,” Calhoun County Probate Court, (Probate Court No. 99-033MI) June 16, 2000.

5. Order, 37th Judicial Circuit Court, File No. 00-2429AV, October 23, 2000.

6. Email correspondence between Ben Hansen and Calhoun County Probate Judge Phillip Harter, May 22 – 31, 2001.

7. “A Mental Health Professional’s Guide to Michigan Mental Health Procedure,” Hon. John N. Kirkendall, Judge of Probate, Washtenaw County Probate Court, pages 1, 4 and 5.