Friday 25 March 2011

Forced ECT (electroconvulsive therapy) continues in Ireland. Senate debate adjourned without vote.

Anyone who saw the film “One Flew over the Cuckoo’s Nest”  will remember the dreadful Nurse Ratched and a practice known as electroconvulsive therapy (ECT), whereby electrodes were applied to either side of a patient’s – or transgressor’s – cranium and a powerful electric current was shot through their skull.

Wiki summarises it thus:

Electroconvulsive therapy (ECT), formerly known as electroshock, is a psychiatric treatment in which seizures are electrically induced in anesthetized patients for therapeutic effect. Its mode of action is unknown. Today, ECT is most often recommended for use as a treatment for severe depression which has not responded to other treatment, and is also used in the treatment of mania and catatonia. It was first introduced in 1938 and gained widespread use as a form of treatment in the 1940s and 1950s.

Note the phrase, “its mode of action is unknown”.

As treatments go, it does not look terribly appealing – even less so when it invokes memories of Ratched and her strong-arm crew. So if running the blog and commenting on Ireland’s many depressing aspects ever got too much for me, I think I would prefer the Prozac option. Assuming, of course, that I had the option.

According to a report in The Irish Examiner, which a reader of the blog emailed, the forced use of ECT in Ireland was up for debate in the Senate this week.  It was proposed that the practice of using  ECT on patients "who are unwilling or unable to give consent" should be ended.  A practice, incidentally,  that Amnesty International describes as “a breach of human rights”.

The relevant section of Ireland’s Mental Health Act that allows it is Section 59b, which reads:

(b) where the patient is unable or unwilling to give such consent—

(i) the programme of therapy is approved (in a form specified by the Commission) by the consultant psychiatrist responsible for the care and treatment of the patient, and

(ii) the programme of therapy is also authorised (in a form specified by the Commission) by another consultant psychiatrist following referral of the matter to him or her by the first-mentioned psychiatrist.

According to another report in today’s Examiner, the Seanad debate was last night adjourned without a vote being taken.  Even if it had been, such a vote would only have referred the matter to the Dail (the Irish parliament).

A group called Delete 59b, one of whose members was once head of the Mental Health Commission, is currently campaigning to have the relevant wording of the Mental Heath Act changed.

It has an online petition here Delete 59b

Back to Gombeen Nation main page

19 comments:

ANNA said...

A GREEN PARTY SPONSORED BILL, AGAINST THIS THIS IS PROCEEDING THOUGH SEANAD; LOOK UP
www.kildarest.com- look up Seanad debates

Thursday, 24 March 2011

Mental Health (Involuntary Procedures) (Amendment) Bill 2008: Committee Stage (Resumed) and Remaining Stages

Dan Boyle" I wish to finish my brief comments before we make decisions on the amendments being discussed. The effect of the Bill is not to change the use of electroconvulsive therapy or even the law as it results in involuntary treatment but to pass a Bill in this House that needs further consideration in the other House. Reconsideration will also give the Minister of State time to come up with adequate legislative measures either by following this Bill through should the House approve it or by introducing a new mental health Bill. I hope the decisions today, with the debates that have preceded it, will help to inform the Minister of State in that process."

Ivana Bacik
"I welcome the Bill. I pay tribute to Senator Boyle and former Senator Déirdre de Búrca(Greens) who promoted the Bill. I also pay tribute to the campaigners who have highlighted the abuse of human rights as a result of the existing wording of section 59 of the 2001 Act. I am delighted the Minister of State has committed to changing the wording. We are all agreed that section 59 denies the right of a competent patient to refuse ECT and we all want to change that position. I am grateful to Amnesty International for its briefings, proposing that this needed to be changed. proper safeguards are needed in the administration of ECT in the very rare cases in which it continues to be performed.
The deletion of the words "or unwilling" from section 59(1)(b) of the Mental Health Act 2001 is critical and will ensure competent patients will have the right to refuse ECT, as they should be able to do under the Constitution. As Senator Boyle acknowledged, the provisions of the Bill are not enough to ensure adequate safeguards for mental health patients. The other human rights concerns raised by organisations such as Amnesty International about section 60 of the Act, the need for comprehensive capacity legislation, the right of appeal and the provision of a ban on the administration of ECT in the case of minors all need to be dealt with,so we will be in compliance with international standards and best practice.
In a spirit of co-operation, therefore, we can proceed to accept the Bill and I am very happy to support it.

Read more on that site- GOOD DEBATES-There ARE competent people in the Seanad-
as well as USELESS IVOR CALLEY - WHO Interrupted debate on one of the stages of this bill yesterday ( last Day Seanad sat!) to complain about how he was villifed! and said the country had a RIGHT to hear the truth from him!!
Yes I hope this bill succeeds...but Ivor demonstrated WELL a bit of shock treatment should be reserved for those who misuse and betray their country's parliament and people .....

Anonymous said...

Is God Dead in Ireland?

In England and Wales 1959 Mental Health Act, and in Scotland 1960 Mental Health Act it was illegal to give Electro Convulsive Therapy (ECT) to any informal patient without consent. If the person was detained and sectioned under the Mental Health Act there were very stringent conditions about the giving ECT against the patients’ will.

Josef Rudolf Mengele, The Angel of Death gave ECT without anaesthetic as a punishment in Nazi's concentration camps. The Irish Health Service allows psychiatrists to give ECT to patients because it is cheaper than giving costly antidepressant, anti psychotic or other tranquillising psychiatric medication.

Where are the College of Psychiatrists Medical Ethics that still allow this outrage to continue? The Minister for Health and Minister for Justice and the Roman Catholic Church (for the love of God) are doing to stop this. In the US and UK the doctor who did this could be indicted and charged with a crime, but not in Ireland. What the hell sort of people are we!, who allow Pain and Cruelty to the mentally ill and vulnerable children year after year?

There is no point in asking 'how and why' the government would allow this barbaric treatment to continue, because the government (Irish Catholic Politicians) would stoop to anything no matter how low. In Ireland there are 200,000 patients on the waiting list for treatment. These are today's figures.

My question is: Is God Dead in Ireland? Any country that will still allow ECT to given without the patients consent deserves the "Wrath of God". No wonder Ireland has had such bad luck over the centuries, especially the last century and it must be cursed by God.

DBMG

Anonymous said...

There is no modern civilized country that has allowed ECT to be given to patients against their will in the last fifty years. Yes, ECT is of some use in about 0.02 % of depression in the elderly, but the effect is only temporary and is usually short lived.

Even though this is known and there are tons of documents to show that ECT is not a moral and justified treatment. It is astounding that the Government, and the Church have done nothing to prevent this. Where are the medical ethics and the church’s integrity that still allow exploitation of the most vulnerable people in society. Where is the Love of God.

Ella said...

I hope I don't lose any more marbles or else, f..k know what could happen to me.

@DBMG & Anonymous, amazed you would think that the RC Church would intervene, this is an organization whose response to child abuse by its priests was to move them to another parish where they could do it again and again.

Anonymous said...

great movie GM tis agrand soft day tang god here in beverly hills. bh

anna said...

I found this site www.mentalhealthreform.ie-
just a small extract from it-
Mental Health Reform campaigns for improved and prioritised mental health services in Ireland. Our campaign aims to increase the pressure on those with the power to improve mental health services. With your help, our concerted action can make a difference.

Mental Health Reform is a coalition of organisations committed to specific mental health reform objectives. The coalition seeks to improve the lives of people with mental health difficulties by advocating for people’s rights to the highest attainable standard of mental health and mental healthcare. We aim to leverage the knowledge and networks of our members and our partners to create a credible, audible and informed voice for change.

Background to Mental Health Reform
In February 2011 the Irish Mental Health Coalition (IMHC) was renamed Mental Health Reform. The IMHC was founded in 2006 by five founding members in response to the need to create a focal point for national-level mental health campaigns aimed at creating a first class mental health system in Ireland that adopts a holistic model of support for those with mental health difficulties, i.e. one that recognises and responds to the personal, social and health needs of those experiencing mental health difficulties.

Membership
The founding members are:

•Amnesty International Ireland
•Bodywhys – The Eating Disorders Association
•Grow
•The Irish Advocacy Network
•Shine (formerly Schizophrenia Ireland).

There is a lot more on it- campaign etc- I ALWAYS think irish governments and offcial organisations can be WOEFUL- while Irish Individuals and voluntary organisatiosn can be WONDERFUL- this site proably proves it - campigning for better mental health while HSE pretends nothing is wrong.
actaully I never saw anything like the level of verbal aggression in this country - and I put it down to lack of easily available , free and quick mental services at an early stage in peoples lives

russell said...

Here in Ameri-cay we toss the mentally ill onto the streets where they starve and/or freeze. Awesome!

The Gombeen Man said...

True Anna. Voluntary organisations and individuals in frontline health are the best thing we have here.

As for the rest? I think the Irish State itelf has suffered from a severe form of delusional disorder, which first manifested itself in 1922. The patient is unable to differentiate between imagination and reality, and often reports hearing the voices of fallen dead.

The prognosis is that the patient is unlikey to make any meaningful recovery, even in the long term, and full-time care and observation are required to prevent further self-harm.

You know, Russell, I think that happens here too... only it isn't talked about.

Anonymous said...

GM, As someone who has suffered from Mental Health issues and still does to this day, I might welcome this.

Problem is, that even though all these groups have the best of intention against an outdated practice, its a campaign that can easily be co-opted by groups who have the worst of intentions. I have seen the Scientology front group the "Citizens Commission for Human Rights" endlessly use this practice as an example of why all mental health treatment is torture and the "Evils of psychiatry" is the equivalent to the Nazi eugenics projects . A reactionary, kneejerk approach to this gives scum like these groups ammunition against the actual professionals who want to help and tarnishes their reputation.

If anything, this campaign should be lead by mental health professionals giving their scientific analysis on why it must be deleted alongside public pressure and hopefully the MHI can realise this and not pander to base instincts which gives scum like the CCHR the oxygen to survive and peddle their poisonous views.

Dakota said...

Nice hey? The most vulnerable again. Is there a pattern there. Oh I think there is....

anna said...

NB- don't forget a certain IVOR CALLELY interrrupted last day of Seanad, which were debating on this bill, to say on Behalf of the Nation he had to clear his name!!!!!! That's why this bill didnt get to any further stages,
That's why I say a certain amount of shock should be kept for his ilk, or cattle prods anyway . Repeal of a clause in mental health health bill ( which would have been for good of the nation) interrupted by a Gombeen - arguing for the good of himself!! NO, I did NOT make this up- and he is Rightly on his way out- hurrah! another gombeen falls.
YES- I( signed the petition- hope all readers do the same.

Anonymous said...

I know of a severely depressed elderly person who received ECT last year, all I can say is their mood and ability to cope with everyday life improved afterwards. I don't know what the total effects are but 'heavy medication' ain't particularly the 'better' option either in very severe cases, the effects can sometimes be worse and with dire consequences.

Unfortunately in hopeless cases there is no ideal therapy we currently practice.

The Gombeen Man said...

In response to the comments by Anons 12:05 yesterday and 12:52 today, I have to put hand on heart and say that I do not know anyone who has undergone ECT. And to be honest, I don't know enough about it to argue about its effectiveness/lack of effectiveness. I suppose that's another debate, but thanks for raising those points.

I think the issue here, though, is the fact that it is practiced on unwilling patients. The group behind the petition isn't calling for the scrapping of ECT, but just its involunatry application on - as Dakota says - the most vulnerable who do not have a say.


In response to Anna's point - yes... telling that a self-serving gombeen like Callely should disrupt such an important debate in an attempt to save his own sorry ass.

Anonymous said...

Severe depression is just a lousy situation and its hard to know what to do when a person is bent on killing themselves. This is where ECT comes in as it directkly causes the release of the neurotransmitters that prozac takes months to release.
We have an awful lot of hidden inbreeding in our country that will only be solved when our kids and the kids of immigrants to Ireland breed together but until then everyone Irish should take things easy and not stress themselves too much or drink too much and get off the drugs

One flew east Boy said...

Nice piece of mind control there GM - That pic of Nurse Ratshit - I couldn't stop myself and ended up downloading the movie and spent the rest of the night watching it. Still fucking brilliant after all these years. I grew up in a town which had a massive "Asylum" Just about everyone worked there in some capacity or other. My best friend was considered uncontrollable insofar as the clergy at our high school deemed him to be. Me too by the way. Our problem was that we just were part of a generation that didn't take it all as gospel and weren't afraid to ask questions. The upshot in my friends case was that the principal of the school went to speak to his parents about his behaviour and lack of respect for their authority and suggested that they should sign him into the Asylum for treatment. Apparently they could back in the day. Only spanner in the works was that my friend's dad worked there all his life and knew damn well what the difference between youthful exuberance and mental illness was and so my friend and I continued our carefree lives until we grew up and did all the things that responsible peopleend up doing. I've never forgotten the power that can be wielded by individuals like this nutty priest. If anyone needed committing it was him. PB

Anonymous said...

Mr GM has pointed out that the therapeutic effects of ECT are not in question. There are medical statistics to show that in 0.02% improvement has been recorded in depression of the elderly.

The question is the ethics of a giving ECT to people without consent. When the patient is detained under the Mental Health Act very stringent rules apply in all other modern civilised countries, but not Ireland, which suggests that in Ireland doctors, psychiatrists and Health Authority Managers can act carte blanche, and with impunity a bit like God.

They could be using human beings as research subjects in drug trials or, selling body organs that is very lucrative. Irish politicians and doctors would do things like this for money, without a second thought for human dignity, like they did with the Industrial Schools and Magdalene Laundries.

If there is no morality and no medical ethics, then that suggests serious long term corruption. God only knows what else that are covering up. God would probably not want to know who these people are.

DBMG

The Gombeen Man said...

A near miss PB. And how such people can ever have had such power.

Anon. I expressed no opinion one way or the other on the "effectiveness" or otherwise of ECT. What I am against is its involuntary use.

Anonymous said...

http://www.youtube.com/watch?v=oEZrAGdZ1i8

barbarian said...

I think it would be important that people realise the difference between unable and unwilling.
The college of psychiatry supported the amendment to the Act that the Seanad now has proposed.
No one is in support of giving someone ECT unwillingly.
However, what you may not realise is that there is a minority of severely depressed patients who are not drinking, eating and who may die if they do not get ECT.
These people are UNABLE to give consent, and therefore need to be treated as an involuntary patient. This is miles away from what is being described in the film .
So the medical ethics are well aware of this and supported the change.

With regard to the poster who says that no other country gives involuntary ect then they are poorly informed.
In England and Wales, the Mental Health Act of 1983 allows the use of ECT on detained patients, if authorised by a psychiatrist from the Mental Health Act Commission's panel; if the psychiatrist thinks the treatment is needed urgently they may begin ECT before authorisation. About 2,000 people a year are treated without their consent in this way.[20] In Scotland, the Mental Health (Care and Treatment) (Scotland) Act 2003 gives patients with capacity the right to refuse ECT.
(note the statement WITH CAPACITY) those without capacity can be treated.
In Ireland there is no Capacity act and it is this lack which makes us more of a gombeen nation, not the fact that we give ECT , a potentially life saving treatment to the people who are in the greatest need for it.
the fact is these people are the most vulnerable and ECT can work for them.


In the USA a court typically decides if a person can receive involuntary ECT.
Countries that give involuntary ECT in strictly defined circumstances include australia, new zealand, england, wales, scotland, ireland and the scandinavian countries.

As for Nazis using ECT as punishment, well they also performed surgeries and other atrocities on their victims. That does not mean we should ban surgery.

ECT has one of the clearest evidence bases and is the most effective acute treatment for severe depression. This is based on an analysis of all well designed trials on ECT.

ECT has disadvantages and side effects but so do most effective treatments of serious illnesses.
it would be helpful if people attempted to look at things with a more critical and balanced view rather than basing opinions purely on hollywood movies .
oh and i put the link to the sherwin nuland clip.