2009-12-10

 

'ECT' without consent

Madam, – I would like to congratulate Mary Maddock (Home News, December 7th) for sharing her experience of the impact that electroconvulsive therapy (ECT) had on her life with respect to long term memory loss, permanently robbing her of memories of the birth of her daughter, and of holding her for the first time in her arms. Her motivation to lobby for its abolition grew out of this heartbreak. Also the insightful letter by Rosemarie Rowley (December 8th) deserves serious reflection.

I was present in the public gallery of the Seanad on December 2nd, when Senators Dan Boyle and Déirdre de Búrca of the Green Party introduced a Private Members Bill seeking the abolition of the forced administration of ECT. It failed to be passed. Minister of State with special responsibility for mental health John Moloney felt he was unable to support it because he believed he had insufficient information on the subject. He stated categorically that before he brings the issue before the Dáil in March 2010, he felt he needed more time to consult with service-user organisations, to receive their testimonials and depositions, meet with interested parties, and to set up forums where the issue could be appropriately debated.

Those who actively lobby for the retention of involuntary ECT are ignoring the fact that its administration does not conform with the WHO guidelines on the human rights of patients. It is not a medical matter alone, but a humanitarian and medico-legal issue in which Ireland currently lags behind best practice, or even minimum standards of practice internationally.

One of the tragic ironies regarding the use of ECT is that it serves to instil high levels of fear in the public mind, especially the young, making vulnerable individuals averse to approaching the very services they are being encouraged to use, and greatly contributes to the stigma associated with “all things psychiatric”.

The Minister is offering a sincere and genuine opportunity for those opposed to ECT, in particular its forced use, to have their voice heard, and help to foster higher standards of practice within psychiatry. The time has come to end the culture of silence surrounding its damaging side-effects. Every week I talk to victims, families, psychiatric nurses, psychologists, and fellow psychiatrists who are deeply concerned at its continued use, and the true facts of its dehumanising atmosphere, which contaminates all concerned.

About the truth, Arthur Schopenhauer wrote that all truth passes through three stages. First, it is ridiculed. Second, it is violently opposed. Third, it is accepted as self-evident. To accelerate the inevitable demise of ECT, particularly its forced use, I encourage people to speak their truth and communicate it to the Minister, John Moloney, who cannot act without the necessary facts, which he seeks in good faith. – Yours, etc,

Dr MICHAEL CORRY,

Consultant Psychiatrist and Psychotherapist,

Institute of Psychosocial Medicine,

Eden Park,

Dún Laoghaire,

Co Dublin.

 

Congratulations to you Michael Corry for your endless work to expose coercive psychiatry in Ireland and worldwide.   

'ECT' without consent

Madam, – On the subject of electroconvulsive therapy (ECT) without consent (Home News, December 7th), it is important we listen to people such as Mary Maddock who are speaking after having had ECT, and personally suffered its effects.

Professionals who advocate it don’t have to undergo it.  Instead, they note that after  the shock is administered to patients, there is sometimes a lightening of mood – euphoria (which is the natural reaction to shock), but very soon this subsides, and the patient returns to depression again, this time with an impaired brain.

It may be that ECT is a drastic remedy, but the cure may be worse than the disease. Trust and confidence are slow to repair, and the loss to memory, especially the time leading up to the treatment – makes the patient very vulnerable. The fact that vessels and connections are ruptured, and cannot be repaired,  as it is a closed head wound – all make this treatment undesirable. In some cases the result is more incapacity.

The loss of memory can be permanent and the nature of the treatment, which is invasive and akin to rape by machine, makes it difficult to justify.  There may indeed be desperate cases requiring desperate remedies, but this is as if you could fix a television or engine with a sledgehammer – you might just hit on the right bit!  Sometimes it works, but the usual result is further damage.

It is often sensitive individuals, prone to emotional illness, who are given this treatment, where there is no respect for mind, or bodily integrity. They live out their lives in fear, until people like Mary Maddock speak out. Thankfully, some have survived: like Austin Clarke, and Paul Durcan, but it a slow process.

This treatment has been described by Ted Hughes as “an atrocity” in a letter to me about Sylvia Plath and her experience of ECT (which is now in the British Library).

I should add that I am a survivor myself. – Yours, etc,

ROSEMARIE ROWLEY,

Rosemount Court,

Booterstown, Co Dublin.

Hi Mary

Many thanks for these 2 documents- the article about you and Jim are very supportive, good to read a paper that has the guts to publish the names of some Irish shock mills and the number of ECTs administered in 2008 - so far no Canadian paper has published similar info.The Times/O'Brien article is so-so; it unfortunately parrots shock lies by the College of Psychiatry and psychiatrist Justin Brophy, and neglects to mention well-known facts such as that women and elderly, especially elderly women (60+ years), are the prime targets of electroshock which means the procedure is sexist and ageist, and that wømen and elderly suffer the most brain damage. (Sackeim et al, 2007). The Times article also neglets to mention the important fact that the average amount of electricity delivered to the brain during most shock treatments is 200 volts, today's shock machines can deliver over 400 volts! The College of Psychiatry's promotion of forced electroshock in Ireland is disgusting and unethical. There is no such thing as "informed consent" to electroshock  or psychiatric drugs, mainly because the psychiatrists and other doctors pressure or blackmail their patients to consent. Further, 'ECT' Consent Forms or 'Patiernt information guides misinform and inaccurate, because they dishonestly claim that the grand  mal epileptic seizure caused by every shock treatment is "therapeutic", and consistently neglect to mention the very common risks of permanent memory loss and brain damage.  In this context, "informed consent" in psychiatry is a myth, a  cruel sham. Also, there is not and never was credible scientific evidence to support the College of Psychiatry's claim that ECT is "lifesaving", there is no credible scientific evidence that "ECT' saves anybody's life, no scientific evidence that shock prevents or has prevented suicide, in fact it aggravates underlying or chronic medical conditions and hastens early death in elderly patients. (see Black et al,1989; Frank, 2006; Breggin, 1997,2008)  Where is the scientific study and other evidence that "86%" of shock survivors who refused consent "recovered" or show  "improvement" after 'ECT' - according to whom? according to what independent criteria? As usual, the shock promoters including College of Psychiatry spokespeople like Brophy are misinforming the media and public, they're lying about electroshock - including  the alleged safety of ECT machines which have never been independently tested for medical safety. Electroshock machines and the procedure itself were unsafe in the early 1940s when 'ECT' was introduced in Europe and North America, they're still unsafe, in fact more unsafe today (see Andre, 2009). As we email each other, hundreds of thousands of people - particularly old and young women - are being permanently brain-damaged and traumatized by 'ECT' and had their careers or lives ruined, after being diagnosed with fraudulent psychiatric labels such as 'bipolar mood disorder",  "postpartum depression", and/or "schizophrenia"- in the name of "mental health".  Electroshock itself (not just 'forced shock ') must be and will be banned! 

Mary, my sincere thanks and best wishes to you, Jim, and MindFreedom Ireland for your outstanding initiatives and courageous resistance to this psychiatric torture and crime!

in solidarity

Don  

'A big chunk of your life taken away'

Jim and Mary Maddock are lobbying for alternatives to the "medical model" of psychiatry. Photograph: Daragh MacSweeney/Provision

MARY MADDOCK (62) doesn’t remember anything about the first time she received electroconvulsive therapy (ECT). Memory loss was the biggest side-effect of the treatment. In fact, she says, she has lost entire chunks of her life.

“It completely wiped everything out,” she says. “I spent eight weeks in the psychiatric hospital and most of it is gone. I don’t remember where I ate or slept or who came to see me.”

Mary had given birth to her daughter Claire two weeks earlier. Doctors believed she was suffering from a form of post-natal depression, but she had no history of psychiatric problems or depression.

She remembers more about the second time she underwent ECT, in the late 1980s. “I remember the cylinders for the electric shock; I remember them taking your pillow, so they had better access to your head, taking the anaesthetic and counting backwards until you were knocked out.

“It was a very scary thing to be part of, not knowing what was happening and then waking up with the most awful pain in your head like you wouldn’t believe. And not remembering things which had happened recently. It was like a big chunk of your life being taken away.

“This is why I can’t even remember holding Claire in my arms for the first time. It breaks my heart.”

The ECT formed part of two decades of drug-based treatment which, she says, took a massive toll on her health and ultimately prevented her from emerging from her condition.

After being diagnosed at various stages as being hypomanic, bipolar or manic depressive, she was placed on a range of powerful anti-psychotic drugs over a period of about 18 years. “The effects of the drugs were terrible. You felt like a zombie,” she says. “Movement was very slow and I found it impossible to concentrate on anything.”

It is 10 years since she touched a drug to deal with mental ill-health. Radicalised by her treatment in the psychiatric service, she has become an advocate for change.

Mary, with her husband Jim (60), a former secondary-school teacher, are lobbying for alternatives to the “medical model” that dominates much of psychiatry.

While she accepts the psychiatric service is changing slowly, Mary says treatment options are still too narrow and don’t respect patients’ rights.

“We believe ECT is a human rights abuse. It wouldn’t be accepted in any other field of medicine, but because they [patients] are vulnerable, the psychiatric profession gets away with it,” she says.

ECT: the top 10 

The following list shows which psychiatric hospitals carried out the most ECT treatments during 2008.

1. St Patrick’s Hospital, Dublin: 867

2. St Brigid’s Hospital, Ballinasloe: 281

3. St John of God Hospital, Dublin: 189

4. Waterford Regional Hospital: 181

5. University College Hospital Galway: 167

6. Midwestern Regional Hospital, Limerick: 134

7. Jonathan Swift Clinic (administered in St Patrick’s Hospital, Dublin): 95

8. St Loman’s Hospital, Mullingar: 88

9. Mayo General Hospital: 83

10. St Luke’s, Kilkenny: 74.

Source: the Mental Health Commission’s report on the Use of Electroconvulsive Therapy in Approved Centres in 2008

Psychiatric patients still given ECT treatment without consent

CARL O'BRIEN Chief Reporter

PATIENTS INVOLUNTARILY detained in psychiatric hospitals last year received hundreds of treatments of electric shock therapy against their will.

Official statistics compiled for the first time show that about 400 psychiatric patients received 2,700 electroconvulsive therapy (ECT) treatments during 2008. Of these, at least 43 involuntarily detained patients were either unable or unwilling to consent to about 300 doses of the treatment.

ECT involves an electrical current being passed through the brain via electrodes applied to the scalp. The resulting seizure can have significant beneficial effects, according to consultant psychiatrists.

However, many mental health campaigners say the forced use of ECT is a human rights abuse and is the source of long-lasting side-effects such as memory loss.

The real scale of ECT use may be significantly higher, as the figures do not include patients who were referred to other hospitals for treatment.

Most patients who received ECT last year were diagnosed with depressive disorders, followed by schizophrenia and mania.

The treatment was most commonly prescribed where a patient’s mental illness was not responsive to medication. Other reasons given included the physical deterioration of the patient, suicidal behaviour or because a rapid response was needed.

Official rules on ECT use state that it should only be used when alternative therapies have been considered or proved ineffective.

In general, ECT may only be administered with the patient’s written consent. However, where a patient is unable or unwilling to give consent, ECT must be approved by two consultant psychiatrists.

The figures, compiled by the Mental Health Commission, come at a time when campaigners are calling for an outright ban on forced administration of ECT.

Campaign groups representing service users such as Mind Freedom Ireland and Mad Pride say the procedure is overused and want the forced used of ECT to be banned.

Mental health campaigner John McCarthy said there should be no circumstances where ECT is administered without the consent of a patient. “We wouldn’t accept this in any other form of medicine, yet we accept it in mental health,” Mr McCarthy said.

“While some very depressed patients undoubtedly benefit from it, many don’t. It seems that very often the benefits are short-lived, lasting no longer than a matter of weeks or even days.”

However, professional bodies such as the College of Psychiatry say ECT is an important and potentially life-saving treatment, which has helped many patients recover from mental ill-health.

The college cites recent Scottish evidence which indicated that 86 per cent of people who received ECT in circumstances where consent was not given recorded an improvement in their condition.

College president Dr Justin Brophy also said new research indicated that memory loss among patients was often short-term and could be fully resolved.

ECT use has been falling in recent years, with a greater emphasis on alternative therapies. Official figures also confirm major variations in its use across the State, with patients in some areas much more likely to receive it than in others.

There were also differences over what was considered to be a standard “programme” of ECT. The national average was seven sessions, while in St John of God Hospital, Dublin, the figure was nine. St Patrick’s University Hospital in Dublin – a private hospital – administered the highest number of individual ECT treatments (867), partly because it is a national referral centre.

It was followed by St Brigid’s, Ballinasloe (281), St John of God Hospital, Dublin (189) and Waterford Regional Hospital’s department of psychiatry (181). By HSE region, the west had the highest use of ECT, followed by the south and Dublin Mid-Leinster.