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Use of electroconvulsive therapy (ECT) without patient's consent rises

Severe depression is the most common disorder which ECT is used to treat
Andrew Madden

THE use of 'electro-shock therapy' on patients in Northern Ireland without their consent is on the rise.

Electroconvulsive therapy (ECT) involves passing an current through someone's brain (under anaesthesia) to trigger a brief seizure, in an effort to cure the effects of extreme mental disorders.

Severe depression is one of the most common disorders for which ECT is used to treat.

Seen by many as an old-fashioned and crude instrument for dealing with mental illness, evidence suggests the use of ECT has decreased internationally in favour of more modern techniques.

In the north, however, the use of ECT has increased dramatically in the last two years.

Two years ago, a total of 122 patients across the five health trusts in the north underwent ECT.

Last year this figure was 177 - a 45 per cent increase.

Furthermore, over the same period there has been a 29 per cent rise in the number of patients given the treatment without their consent, up from 34 in 2015 to 44 last year.

The figures were obtained by The Irish News through a freedom of information request.

In the case of a patient assessed by a doctor as not having capacity to consent to ECT, a second opinion is sought from a specialist doctor before treatment can begin.

Proponents of the therapy argue that there is established and robust evidence to show that ECT works effectively and is safe, but there is still debate in the medical community on exactly how the treatment works.

Opponents say that there is no evidence that ECT performs any better when compared to a placebo treatment (where a patient is anaesthetised but no shock is given).

There are also several prominent physicians who argue that ECT can have severe side effects.

One such physician is Dr John Read, Professor of Clinical Psychology at the University of East London, who has published numerous reviews of the research on the efficacy and safety of ECT.

Speaking to The Irish News, Dr Read claimed that there is "absolutely no evidence" that ECT has any lasting benefits, compared to placebo treatment.

"There are many studies showing that ECT causes long lasting brain damage, in the form of memory loss, for a significant proportion of recipients. ECT zealots continue to deny this," he said.

"The continued use of this procedure suggests that psychiatry is not an evidence-based profession."

In relation to the rise in ECT in Northern Ireland, Dr Read said it could be down to a small group of clinicians using the treatment more frequently.

"Internationally, the use of ECT has been steadily decreasing for 20 years," he said.

"However there is huge variation between regions, and even between psychiatrists - with some refusing to use it at all."

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