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'Worrying' jump in electroshock without consent and with physical restraint of mental health patients

Seclusion increased for the first time in six years, while the use of physical restraint increased by 8% in 2013 compared to 2012.
Nov 12th 2015, 6:00 AM 9,795 33

THERE WAS A 70% increase in the number of ECT programmes administered without consent in 2013 compared to 2012.

According to figures published by the Mental Health Commission (MHC) today, the use of electroconvulsive therapy (ECT), formerly known as electroshock therapy, on people in inpatient mental health services also increased for the first time in years.

In 2013, there were 318 programmes of ECT administered to 257 individual residents, a 2.3% increase compared to 2012.

Commenting on the newly published data, chairman of the Mental Health Commission John Saunders said, “Over the past number of years we have seen a steady reduction in the use of practices such as seclusion and restraint. However the increases in their use during 2013 is very worrying.

What is most concerning is the percentage increase in the administering of ECT to patients who are either unable or unwilling to receive it.

“There were 46 programmes of ECT where one or more treatments of ECT were administered without consent. This increased from 27 programmes in 2012. This is an increase of 70%.”

ECT programmes involve up to 12 separate treatments of ECT prescribed by a consultant psychiatrist. A total of 2,217 separate treatments or sessions of ECT were administered in 2013.

In the majority (85.5%) of these programmes, ECT treatments were administered with the resident’s consent.

However, in 14.5% of programmes one or more ECT treatments were administered without consent. That’s an increase from 27 in 2012 to 46 in 2013.

In seven of these 46 programmes, the person was unwilling to give consent, while the person was unable to give consent in the remaining 39 programmes.

Physical Restraint

The use of seclusion and physical restraint also increased in 2013. Seclusion increased for the first time in six years, by 12% in 2013. While the use of physical restraint increased by 8% in 2013 compared to 2012.

Saunders added:

Seclusion and restraint are emergency measures and should only be used in exceptional circumstances and only when in the best interests of the patient.

Depression 

Of the 257 individuals who were administered ECT in 2013, the majority (63.4%) were female and 36.6% were male. Individuals ranged in age from 18 years of age to 93 years of age with an average age of 60 years of age.

Most programmes of ECT (81.8%) were administered to individuals with depressive disorders and resistance to medication was the most frequent indication for ECT (62.9% of programmes).

Saunders added that, “The Commission has consistently said that it should not be possible to administer ECT to a patient who is unwilling to receive it. I know that this is something which the minister and the department are currently reviewing, with a view to changing legislation, and I would urge them to do so before the end of this year.”

St Patrick’s University Hospital administered the highest number of programmes (125) of ECT nationally in 2013, while the Department of Psychiatry, Waterford Regional Hospital recorded the highest number of programmes (32) of ECT in a HSE managed service.

In over 90% of programmes of ECT the treating consultant psychiatrist reported that the treatment resulted in an improvement in the condition of the person receiving ECT treatment.

Read: ‘Lax’ response by Cavan hospital to electro-shock blunder>

Read: Minister Lynch: ‘Unwilling’ patients no longer to receive electric shock therapy>

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Cliodhna Russell

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