New UK report from Mind examines patient experiences|
More than half of those in a recently completed survey of 418 ECT recipients said they did not realize they could refuse to give consent to the treatment.
The survey was conducted earlier this year in the UK by the mental health charity Mind, and concludes with several recommendations. Among those, Mind recommends that ECT should not be used against a person's will.
"However, given that it seems impossible to predict who will be adversely affected, and given the seriousness and permanent nature of the potential side-effects recorded above, we believe that it should no longer be able to be imposed without consent," say the authors of the report.
Mind reports that during a three month period studied by the Department of Health (January through March 1999), 2,800 patients received 16,000 administrations of ECT. 700 (25%) of these patients were detained under the mental health act and only 29 percent of those consented to the treatment.
Other key findings from the Mind report:
- One-third (33%) of respondents had had ECT in the last 5 years.
- Depression was by far the most common diagnosis among respondents (53%).
- Over half (52.5%) of the total sample and over one-third (34%) of those given ECT most recently were not aware that they could refuse to give consent to the treatment.
- Almost three quarters (73%) of the total sample and almost two-thirds (60.5%) of those given ECT most recently were not, as far as they remember, given any information about possible side effects.
- Of those consenting to treatment in the last two years, 48% received, as far as they remember, no information about how the treatment would work and 44.5% no information about possible side effects.
- Only 8% of respondents (15% of those receiving ECT most recently) had the opportunity to consult an independent advocate before making a decision about ECT.
- 84% of respondents said that they had experienced unwanted side effects as a result of having ECT.
- 40.5% reported permanent loss of past memories and 36% permanent difficulty in concentrating.
- Among those receiving ECT within the last two years, 30% reported that it had resulted in permanent fear and anxiety.
- A third (32.5%) of recent recipients felt hopeful before having ECT but 29% felt terrified and 22% felt that they were being punished.
- In the short term, 36% of more recent recipients found the treatment helpful or very helpful and 27% unhelpful, damaging or severely damaging. However, in the long term, 43% of more recent recipients felt that it was unhelpful, damaging or severely damaging.
- 66.5% of the overall sample and 49% of those having ECT in the last 2 years would not agree to have it again.
- Respondents from black and minority ethnic communities were more likely to be detained under the Mental Health Act and to have received ECT without consent. They reported a more negative view of ECT than the overall sample with 50% finding it unhelpful, damaging or severely damaging in the short-term and 72% in the long-term.
The full report may be viewed at the Mind website - it is in Microsoft Word format for downloading.