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.

Comments (8)

SueSeptember 7th, 2006 at 3:56 am

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

I just got the figures with an FOI request. In fact, of the 26 patients given ECT in Cambridge last year, 10 didn’t consent, but were considered “incapable” and treated under the Mental Health Act without their consent. So much for being “fully informed”.
The 26 people who had ECT were from a total of 961 admissions to adult mental health services.

JuliSeptember 7th, 2006 at 11:37 am

Good work, Sue.

Are there any documents that could be scanned and put online? Hard statistics in ECT are so hard to come by, that anything you can provide to media and other interested parties is a good thing, IMO.

My gut tells me that Dr. Blake, if queried about her statement versus the stats, would explain it away by saying they can’t consent because they’re incapable of understanding anything they’re told. Whether she’s just ill-informed or deliberately setting up a strawman, who knows.

I don’t know how it is in the UK, but here in the US, it’s well known that you’re competent as long as you consent to ECT, but if you say no thanks, if the dr. is determined to give it to you, you’re immediately judged to be incompetent so he can give it against your will. I’ve seen that again and again with forced shock cases I’ve worked on. They know most people have no idea how to fight, nor have the resources to do so.

So the very idea of competency is just another label that’s tossed around for the purpose of manipulation.

Juli

SueSeptember 20th, 2006 at 4:50 am

This was the answer I was given:

“REQUEST FOR INFORMATION UNDER THE FREEDOM OF INFORMATION ACT 2000

Thank you for your e-mail of 12 August 2006. Please find below responses to your questions regarding electroconvulsive therapy administrations in the
Cambridge locality of the Trust. The information provided for questions 1-4 relates to both adult and older adults as this corresponds to the information provided to the Cambridge Evening News and used in the article you referred to (11 August 2006). I respond to your questions in the order you posed them.

Of the 26 people who received ECT during 2005/06:

1. 16 people were treated with their consent
2. 10 people were treated without their consent under Sections 58/62 of the Mental Health Act

Of those treated without consent:

3. 10 people were incapable of giving consent
4. None of the people receiving treatment described as ‘capabable’ under the terms of the Mental Health Act refused treatment

5. There were 961 adult in-patient admissions to mental health services in Cambridge during 2005/06. The figure of 4,000 referred to in the Cambridge Evening News relates to adult and older adults admissions for the Trust’s total catchment area: Cambridgeshire, Huntingdonshire, East Cambridgeshire, Fenland and Peterborough.”

Cambridge seems to be combining a low use of ECT on capable people with a high use on incapable people.

In the UK there hasn’t traditionally been the incentive to designate people who don’t want ECT as incapable, since incapable and “capable but refusing” people are treated the same under the law as far as ECT is concerned – they can both be given ECT without consent.
However, Scotland recently gave capable people the right to refuse ECT. It would be interesting to see if the total number of people being given ECT without consent has decreased in Scotland since the change, or if psychiatrists are just switching people from the “capable but refusing” category to the “incapable” one, in order to comply with the law.

JuliSeptember 20th, 2006 at 11:00 am

Geez, that’s 40 percent of people being given ECT without consent. I know it’s a very small number overall, but that’s just high IMO.

Jane GlasserMarch 5th, 2008 at 10:54 am

Last winter I was hospitalized for severe depression and received 12 ECT treatments. My psychiatrist recommended the treatment as I had stopped functioning and the medications were not working. I was not suicidal. I recall very little but I imagine I went along with the plan the doctor, my daughter and close friend agreed upon. I do not remember being informed of any side effects. I had a horrific experience with one ECT treatment when ketamine was used as an anaesthetic, a psychedelic trip from hell in which I could not stop screaming. I feel I did not benefit from ECT and only got better when my medications were adjusted and I began seeing a new therapist. Unfortunately I have suffered from cognitive impairment from ECT. I can read a novel and two days later have difficulty recalling the plot and characters’ names. I struggle to retrieve names of objects and people that used to be familiar. I find I’m using mnemonic aids as fishing devices. I truly believe this memory impairment is from ECT. Had I been fully informed of the side effects I would not have undergone ECT and I would not recommend it for other depressed patients.

JaneJune 19th, 2008 at 6:10 am

I’m really uplifted and impressed that there are people starting to ask questions about the practices in Cambridgeshire. Dr Blake falsifies documents, so to see that she made a comment completely contradicting the facts doesn’t surprise me any more.

I’m horrified that this sort of practice continues and we should be doing more to eradicate it and the people that abuse it.

LaurenMarch 6th, 2009 at 3:13 am

what are the doctors views on supporting ECT?

Mark BlandJune 30th, 2009 at 10:43 am

Dear Sir or Madam: My wife had a full series, I believe 16 ECT treatments. She left me one month after her last treatment. We had been married for 20 years. Since that time, I still see my wife quite often. She has taken everyone she has ever loved and turned them into enemies. She has isolated herself from any social or intimate interactions. Can I help her in any way?

Mark Bland

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