Electro-therapy decreases in treatment of psychiatric patients

The Mental Health Commission has welcomed a further reduction in the use of electro-convulsive therapy (ECT) on psychiatric patients but has said it should no longer be possible to administer without an individual's consent.

ECT is a medical procedure in which an electrical current is passed briefly through the brain via electrodes applied to the scalp and which induces “generalised seizure activity”.

The publication today of the MHC’s report on ECT and other activity in approved centres in 2012 welcomed a fifth consecutive annual decrease in the procedure as well as in cases of seclusion (where a patient is held alone in a room for a period), and a very small decrease in the use of restraint.

It recorded 311 programmes of ECT, which refers to a block of up to 12 sessions prescribed by a consultant psychiatrist, and amounts to 2,152 single treatments in 244 patients. This represented a decrease of 6.3 per cent on the 332 patients treated in 2011.

Although the majority who received ECT had consented, 27 did not.

"While the number of those who do not consent to ECT treatment is in decline, it is still the commission's view that it should not be possible to administer ECT to a patient who is unwilling to receive it," said commission chairman John Saunders.

The report showed a level of improvement in patient wellbeing in most cases of ECT administration.

Some 39 per cent of cases led to complete recovery, while there was “significant improvement” in 36.5 per cent and a moderate level of improvement in 17 per cent of cases.

The practice of seclusion has also declined. In 2012 there were 1,403 episodes of seclusion involving 505 individual patients, although this was a 16.6 per cent decrease on the previous year.

Over two thirds of incidents lasted less than eight hours.

Physical restraint, in cases where there is a threat to the safety of the patient or to others, only declined by nine separate incidents, with 3,063 recorded in 2012 involving 993 patients.

“The year-on-year decline in the use of ECT and seclusion, as well as the small decline in the use of restraint, is very much welcomed and is a testament to the hard work undertaken by mental health practitioners and their commitment to building and delivering a truly modern mental health service for the Irish public,” said Mr Saunders.