Trust Me, I'm a Doctor

BBC Online

Until a few decades ago, ECT - or Electro Convulsive Therapy - still appeared to belong in the gloom of the torture chamber. Writhing, fitting bodies with probes attached to their heads is the image most people have of this little-understood medical treatment. But ECT has survived into the modern age of medicine and is still the best-known treatment available for severe depression - beating anti-depressant drugs and counselling in its success rate.

Nowadays it has been refined and improved. This is all very well - but a report recently published by the Royal College of Psychiatrists reveals that ECT clinics in England and Wales are operating at very low standards. Training of Junior Doctors is poor; machinery is often out-of-date; and senior or well-trained doctors are often absent from the treatment room. This suggests that doctors are not doing themselves any favours if they want ECT to shed its historical barbaric image. Until the situation improves, patients are recommended to ask a few simple questions before undergoing treatment. "Trust Me, I'm a Doctor" explained what to ask and why.

The practice of ECT has long suffered from its image as portrayed in 1940s medical films, and feature films such as "One Flew Over the Cuckoo's Nest." These images have made most people think ECT is barbaric and dangerous. But there is another side to the story. Modern ECT - when practised with experienced staff, general anaesthetic, muscle relaxant and complete monitoring - is actually the most effective means of treating severe depression. It is generally thought to be more effective than anti-depressant drugs.

Problems still occur, however, when ECT is not practised responsibly. The Royal College of Psychiatrists has set out guidelines, after concerns that a large percentage of clinics were using unsupervised junior doctors and out-of-date equipment. It is hoped that these new guidelines will improve the standard of ECT treatment, but in the meantime it is very important for patients and their families to check that the doctor giving the treatment is fully trained and experienced, and that the equipment is modern.