ECT

SLUSK

ECT is a type of psychiatric treatment used in cases of severe depression. The idea is to somehow cure the person by sending electric shocks into the patients brain.
http://en.wikipedia.org/wiki/Electroconvulsive_therapy

There was a big scandal in Sweden about ECT. It turns out that the patients were not properly warned about the side effects like memory loss. Do you have the same type of problems in Ireland? Can a psychiatrist legally force someone to undertake this treatment?

In this documentary I saw ECT was compared to lobotomy would you say that it is an accurate comparison?

Kevster

I think that it is an unfair comparison, and the two should never be considered in the same breath as they are fundamentally different. In this country, I imagine that the possible effects of ECT are indeed explained to the patient (or at least to his/her legal guardian). You must remember that ECT is used as a last resort too - i.e. when all other therapies have failed.

New.White.Socks

It's rare for a procedure to be done without consent (either from the patient themselves or parent), and when it does happen the decision is not taken at all lightly. The decision is made by a group of professionals, and only happens under exceptional circumstances. I don't know the legal requirements though, a medical lawyer would know that kind of thing.
As Kevster pointed out ECT is only used as a last resort in very severe cases so is very rare. I would be interested to know what the law says about it though.

sam34

New.White.Socks wrote: »

It's rare for a procedure to be done without consent (either from the patient themselves or parent), and when it does happen the decision is not taken at all lightly. The decision is made by a group of professionals, and only happens under exceptional circumstances. I don't know the legal requirements though, a medical lawyer would know that kind of thing.
As Kevster pointed out ECT is only used as a last resort in very severe cases so is very rare. I would be interested to know what the law says about it though.

the legal requirements for someone to be given ect without their consent are:

1. they have to be detained in a psychiatric hospital

for this to be done, they will have been seen by a GP and a consultant psychiatrist

they then will be allocated a solicitor, and will have an independent consultant psychiatrist provide a report on their mental state

within 21 days they will have an independent tribunal, at which a panel consisting of a (third) consultant psychiatrist, a barrister and a lay person will review the detention. the patients solicitor will be present at this, and the patient can also be present, if they so wish.




all of the above applies to anyone who is detained against their will ina psychiatric institution.

for someone to then get ect:

another consultant psychiatrist has to see them and recommend that it's the best option at that point for them.

Odysseus

sam34 wrote: »

the legal requirements for someone to be given ect without their consent are:

1. they have to be detained in a psychiatric hospital

for this to be done, they will have been seen by a GP and a consultant psychiatrist

they then will be allocated a solicitor, and will have an independent consultant psychiatrist provide a report on their mental state

within 21 days they will have an independent tribunal, at which a panel consisting of a (third) consultant psychiatrist, a barrister and a lay person will review the detention. the patients solicitor will be present at this, and the patient can also be present, if they so wish.




all of the above applies to anyone who is detained against their will ina psychiatric institution.

for someone to then get ect:

another consultant psychiatrist has to see them and recommend that it's the best option at that point for them.

Cheers for that info Sam, what's your opinion on it professionally, any psychiatrist I have ever spoken to about it felt it was a valid treatment as a last resort and that in most cases it produced results justifying it as a treatment.

sam34

Odysseus wrote: »

Cheers for that info Sam, what's your opinion on it professionally, any psychiatrist I have ever spoken to about it felt it was a valid treatment as a last resort and that in most cases it produced results justifying it as a treatment.

i think it is literally a life-saver.

i'm not using that as hyperbole, i really mean it.

i've seen it work for people who were not eating and drinking, and had severe electrolyte imbalances, and were heading for renal failure

ditto for highly suicidal people

ditto for those who were in depressive stupors and were risking contractures and muscle breakdown

it's not first line treatment, but it's the most effective treatment we've got for resistant depression, and it certainly has its place.

i think the best endorsement i can give it is that i would have it myself, and likewise i would want a family member to have it if they needed it.


it does have side-effects, as does ANY medical intervention. panadol tablets have side-effects. it comes down to a risk-benefit analysis.

the detractors of ect are loun and vocal. they usually portray it as a barbaric treatment like what can be seen in "One flew over teh cuckoos nest", without acknowledging the advances made in its administration since those times.

the reality is that those who benefit from a treatment (and this does not just apply to ect or psychiatric treatment) will not be particularly vocal about it, they out the illness behind them and move on. they dont have an axe to grind. those who dont benefit (and they exist, ect is not 100% effective) and those who suffer side-effects, on the other hand, will be the ones who go to teh papers.

Odysseus

Cheers, I suppose your statemant about treatment for yourself or members of your family really says it all. I only have limited second hand experience of it as a treatment, an older chap I had in therapy had it years ago. If it the depression is that bad they are not going to be seeing me. But from that and discussions I have had with various psych's my own opinion would be similar to your own.

sam34

Odysseus wrote: »

Cheers, I suppose your statemant about treatment for yourself or members of your family really says it all.

yeah, and i dont say that lightly. i have a sibling with a major mental illness, who may well at soem stage require ect, and i would have no hesitation in recommending it to them, if it were indicated.

tudlytops

Kevster wrote: »

I think that it is an unfair comparison, and the two should never be considered in the same breath as they are fundamentally different. In this country, I imagine that the possible effects of ECT are indeed explained to the patient (or at least to his/her legal guardian). You must remember that ECT is used as a last resort too - i.e. when all other therapies have failed.

It is not a last resort, I was offered the "treatment" I've bi-polar and BPD, was told very little about and expected to make a decision in a few days.

I now save to see a privet psychiatrist every 6 weeks.

No you can not be forced.

And no I would not have it and I'm doing fine without it.

sam34

tudlytops wrote: »

It is not a last resort

generally it is, actually. the guidelines are that it is not a first line treatment, but that it is for treatment resistant depression.

tudlytops wrote: »

No you can not be forced.

while the term "forced" is a bit dramatic, people can be given ect without their consent, under teh Mental Health Act 2001. my first post on this thread outlines the requirements necessary to do that

tudlytops

sam34 wrote: »

generally it is, actually. the guidelines are that it is not a first line treatment, but that it is for treatment resistant depression.

I didn't say it was first line treatment, i said it wasn't last resort.
I do not suffer from depression, I do have cycles of depression but that is not my main illness.
Did not get the treatment, change doctor, I'm doing fine.

sam34 wrote: »

while the term "forced" is a bit dramatic, people can be given ect without their consent, under teh Mental Health Act 2001. my first post on this thread outlines the requirements necessary to do that

Again i replaid to the term "forced" and the the Mental Health Act 2001 is a very complex last resort and if the patient opposes to the treatment it can only be used in the ECT case when every other form of treatment as been explored and not worked.

sam34

tudlytops wrote: »

I didn't say it was first line treatment, i said it wasn't last resort

and i said that it is considered as a last resort treatment (although that term is not a medical one, and has more than a degree of poetic licence about it).

its primary indication is for treatment resistant depression (not its only indication, but its primary one). treatment resistance is defined as non response to an adequate trial of an adequate dose of two or more anti-depressants.

tudlytops wrote: »

tudlytops wrote: »

I do not suffer from depression, I do have cycles of depression but that is not my main illness.
Did not get the treatment, change doctor, I'm doing fine..

good for you.

tudlytops wrote: »

sam34 wrote: »

while the term "forced" is a bit dramatic, people can be given ect without their consent, under teh Mental Health Act 2001. my first post on this thread outlines the requirements necessary to do that

Again i replaid to the term "forced" and the the Mental Health Act 2001 is a very complex last resort and if the patient opposes to the treatment it can only be used in the ECT case when every other form of treatment as been explored and not worked.

nope, thats not what is stated in the mental health act.

for example, if someone was in danger of imminent death because of the severity of their depression, it would not be necessary, and in fact would be negligent, to try tablets on them first and wait around a few weeks to see if they work.

tudlytops

sam34 wrote: »

and i said that it is considered as a last resort treatment (although that term is not a medical one, and has more than a degree of poetic licence about it).

its primary indication is for treatment resistant depression (not its only indication, but its primary one). treatment resistance is defined as non response to an adequate trial of an adequate dose of two or more anti-depressants.

tudlytops wrote: »

good for you.

tudlytops wrote: »

nope, thats not what is stated in the mental health act.

for example, if someone was in danger of imminent death because of the severity of their depression, it would not be necessary, and in fact would be negligent, to try tablets on them first and wait around a few weeks to see if they work.

I'm really not going to discuss the act, there are many ways to supervise people while trying different treatments.
I can only tell you, they tried it, I won, I'm seeing a privet psychiatrist now and I'm doing much better and no ECT.

Odysseus

tudlytops wrote: »

good for you.





I'm really not going to discuss the act, there are many ways to supervise people while trying different treatments.
I can only tell you, they tried it, I won, I'm seeing a privet psychiatrist now and I'm doing much better and no ECT.

Like Sam sais good for you, and I'm sure most of the regular posters would agree will you. You went and said you did not believe you needed that treatment [this is me reading between the lines correct me if I'm wrong]. You sought out a professionally treatment that works for you. I think this is excellent and it shows a show motivation to address the issue on your behalf and by yourself

None of the regular posters here see their way as the only way, I'm delighted when a patient tells me tell me he feels my work with hin is not getting him what he want in order live, but bare in mind I have some clients in therapy for years. My fear is they will get a lot of promises which will not hit the mark

I might not agree with the methods used when they switch therapist, but if the person is better able to engage in life; that its the main thing.


I hope your treatment keeps improving you quality of life, and the best if luck with it

tudlytops

Odysseus wrote: »

Like Sam say good for you, and I'm sure most of the regular posters would agree will you. You went and said you did not believe you need that treatment [this is me reading between the lines correct me if I'm wrong]. You sought out a professionally treatment that works for you. I think this is excellent and it shows a show motivation to address the issue on your behalf and by yourself

None of the regular posters here see their way as the only way, I'm delighted when a patient tell me tell me he feels my work with hin is noi gitting him what he want in order live, but bare in ming I have some clients in therapy for years. My fear is the will get a lot of promises which will not hit thr mark

I might not agree with the methods used when they switch therapist, but if the person is better able to engage in life; that its the main thing.


I hope your treatment keeps improving you quality of life, and the best if luck with it

Thank you and I do apreciate what you saying, much better wording then mine, but that is exacly what I ment when I commented, to explore all options before undertaking just a treatment.