UK's Council for Evidence-Based Psychiatry joins multiple national organizations to highlight requesting a formal inquiry into safety and efficacy of ECT in their blog entitled:
Blog: Call for an independent review into the practice of ECT
"Electroconvulsive therapy, or ECT, is still given to about 2,100 -2,700 people a year in England, about half of whom have not consented to it. This blog reports on a campaign for an independent review of this highly controversial procedure, and provides links to relevant articles. There will be updates as the campaign progresses.
"We are a group of 40 mental health professionals, researchers, ECT recipients and carers who are calling for an independent review into the practice of ECT, along the lines of the recent Cumberlege report into pelvic meshes. We have written to Matt Hancock MP, Secretary of State for Health and Social Care, as well as conducting reviews, writing articles, giving talks, and taking other actions as described in the blog below. We hope that whatever your views on ECT, you will support the need for safe and properly-regulated practice. You can do this by:
- "Writing to your MP (see link to our letter to Matt Hancock here: https://www.uel.ac.uk/-/media/staff/r/john-read/call-for-independent-review-of-ect-july-10.ashx
- Circulating the letter, articles and campaign updates to your contacts and on social media via @Readreadj @CunliffeSue @ClinpsychLucy @PeterKinderman. Long-standing campaigners about ECT include @PsychRecovery, @KellyMartin02, @CherylPrax, @lifeafterECT, among others.
"Why do we need this campaign?
"Dr Sue Cunliffe writes:
"I was a paediatrician until 2005 when I suffered devastating brain damage from ECT. I have improved over the last 15 years but am left with disabling neuronal fatigue. I can never work again and I have lost my independence. Saying I was lucky seems strange, but I am the only ECT victim I know who has been diagnosed with brain damage as a result of ECT, and has received neuro rehabilitation, which preserved my sanity and helped me get off all my medications. A combination of the fear of going near a psychiatrist and the drive to prevent others suffering my fate has enabled me to stay positive and grateful for everything good in my life.
"I was admitted to hospital in the context of an abusive marriage. Instead of receiving therapy and support, I was persuaded to undergo 21 sessions of ECT. My medical notes clearly demonstrate lack of monitoring and supervision. They list my complaints about my memory deteriorating, my speech slowing up, feeling continuously ‘sedated’ and my motor and coordination being affected. Instead of reviewing the treatment plan, the dose was increased from 90Millicoumbs to 700MCs with devastating consequences. Reading my notes has proven hard. It’s a comprehensive account of my brain being blown to bits and my life stolen from me with 20 negligent flicks of a switch. Since then, I have campaigned for recognition and rehabilitation of the harms caused by ECT. I spoke at the recent Maudsley debate on ECT and described my experiences in a recent podcast.
"We are calling for an independent enquiry into the practice of ECT on behalf of all of those whose lives have been devastated.
"Dr Lucy Johnstone writes:
"I have opposed the use of ECT throughout my career as a clinical psychologist, for reasons that I explained in this article in The Psychologist in 2003. Working on adult inpatient wards, I have seen countless examples of it being used to counter staff feelings of hopelessness and stuckness, with results that were almost invariably disastrous for the patient, and sometimes fatal. ‘Successes’ rarely looked like that further down the road – rather, people were blasted into a temporarily different state of mind, only to crash down again when the reality of unbearable life situations re-asserted itself. One dramatic ECT ‘success’ was discharged home to an unhappy marriage, where she spent a week frantically cleaning, and then killed herself. Another ‘success’ was able to leave hospital and take up a job – but she never felt that the new, disinhibited person who emerged from the electrical storm in her brain was her real self, and she too took her own life. Other ‘successes’ re-appeared on the ward only months later, with treatment choices narrowing until more ECT, and yet more ECT, seemed the only option. One woman who roamed the ward in an unreachable dissociated state, briefly connected with me to tell me that ECT had caused the loss of her unborn child, followed by a hysterectomy which destroyed her chance of having a family. Another, a victim of gang rape, described re-living her trauma when the anaesthetic failed to work, and she lay helpless on the ECT trolley. A long term client felt herself sliding into depression and, unable to face the thought of more rounds of ECT, took a massive overdose, and was only found just in time. My own research uncovered many more examples of ECT reinforcing feelings of fear, shame, humiliation, distrust, badness and despair, along with loss of precious memories, and the re-activation of experiences of trauma and abuse.
"These are the rarely-described consequences of ECT. As in any form of institutional abuse that is as yet unacknowledged by society as a whole, they are largely hidden – by shame and fear in patients, by denial from professionals, by research that turns human testimony into numbers, and by professions and organisations who are massively invested in denial and self-protection.
"There are people who say ECT helped them, and there are certainly professionals who believe that ECT can be helpful. But the bigger issue is the overall risk/benefit ratio. How lucky do you have to be to fall into the ‘mostly helpful’ group, and how many people will suffer longterm damage – psychological and cognitive – for each person who benefits? And would there have been alternative ways of achieving good outcomes? (The evidence suggests yes, even in those who are most severely depressed; Buchan et al, 1992). And, if the most likely mechanism of action is brain damage, it is ethical for professionals to offer ECT at all? In the words of neurologist John Friedberg:
"Assuming free and fully informed consent, it is well to reaffirm the individual’s right to pursue happiness through brain damage if he or she chooses. But we might well ask ourselves whether we, as doctors sworn to the Hippocratic Oath, should be offering it (Friedberg 1977).
"However, the purpose of this blog is not to reiterate these arguments. It is to ask for support in a campaign that we hope everyone will feel able to sign up to, whatever their views. We are arguing for an independent review of ECT practice in order to ensure that it is subject to appropriate training and accreditation procedures, that recipients are fully and accurately informed about potential risks and alternatives as well as benefits, and that monitoring, assessment and rehabilitation for potential damage is available.
To read the rest of their blog, please see their website directly.
Thank you Council for Evidence-Based Psychiatry for choosing to highlight the need for a public inquiry into determining whether ECT is safe and effective for human use based on present deficits of safety evidence. We need more professionals to prioritize patient safety to call for an immediate audit. Suspending ECT until researchers can prove safety using modern clinical parameters is wise to prevent risking patient the exposure to injuries with life-long morbidity implications.