Friday, March 12, 1999
BBC News

Electric shock therapy 'not up to scratch'

Electro Convulsive Therapy has been used for 60 years

Electric shock treatment for mental health disorders is often administered by poorly trained junior doctors, it has been claimed.

A report into the use of Electro Convulsive Therapy (ECT) found that the doctors are also often left unsupervised, and have to rely on out of date equipment.

The report - commissioned by the Royal College of Psychiatrists (RCPsych) and highlighted by the BBC Two programme Trust Me, I'm A Doctor - also presents disturbing evidence that people are being prescribed the treatment inappropriately.

Only one third of the clinics in England and Wales were rated as good.

ECT involves delivering electric shocks to the brain.

The electric current can provoke a fit or spasm, but also appears to have a beneficial impact on mental illnesses such as depression.

ECT has been used for more than 60 years, and was long treated with great suspicion. Some patients have died after receiving treatment, and others have suffered complications such memory loss.

But modern techniques are greatly refined, much safer and estimated to be effective in 70-80% of cases.

Approximately 22,000 people receive ECT treatment in the UK every year.

Professor Robert Kendell, of the Royal College of Psychiatrists, said: "ECT is a highly effective treatment and the evidence is very strong.

"The strongest evidence comes from a series of five or six clinical trials that were done in the 1970s in which a group of patients with severe depressive illnesses were randomly allocated so that half received real ECT and half received dummy ECT in which they had the indentical procedure.

"People who had had the real treatment got better quickly and the others did not."

However, although ECT techniques have improved greatly over the years, there are still serious problems with the way it is administered in the UK.

Sue Mayhew was referred for ECT treatment when six months pregnant. She had become depressed, having previously lost a baby through cot death, and also suffering a miscarriage.

Luckily, her anaesthetist spotted the error.

"When they told him I was six months pregnant he was quite horrified and refused to do the treatment because he said it would abort the foetus," she said.

"I was told afterwards that my consultant had taken it upon himself to decide that this was a sacrifice worth making to improve the state of my mental health, even though my depression was caused by the babies that I lost, he seemed to think that killing another one would make me feel better."

A group known as ECT Anonymous is campaigning for tighter restrictions on the use of the treatment. Members say it is wrong that treatment can be administered under the Mental Health Act without patient consent.

Professor Kendell said the findings of the study were "pretty disappointing".

The RCPsych report was the third of its kind in the last 17 years.

Professor Kendell said: "We assumed perhaps rather naively that simply publishing the results of the audit would put things right."

The Royal College is now threatening to blacklist poor training schemes.

But Professor Kendell said patients and their families should make sure any doctor offering ECT treatment was properly trained.