Published

07 October 2021

A newly-published study of NHS mental health trusts has concluded that both the administration and monitoring of electroconvulsive therapy (ECT) in England are failing to guarantee the safety of patients according to the University of East London-led review.

Lead researcher Dr John Read, professor of clinical psychology in the School of Psychology at UEL, believes the procedure should be completely suspended pending decent research.

ECT involves the passing of sufficient electricity through the brain, under general anaesthesia, to cause a seizure. While some claim the therapy is a safe and effective treatment for severe depression, some patients report that it causes persistent or permanent memory loss.

The recently-published A Second Independent Audit of Electroconvulsive Therapy in England, published in a British Psychological Society journal, confirmed that about 2,500 people are given ECT annually in England. The majority continue to be women (67%), and over 60 (58%). More than one in three (37%) are being given ECT against their will.

 

ECT is a potentially very dangerous procedure which, if it is to be used at all, requires the most stringent scrutiny. Relying on the Royal College of Psychiatry to monitor ECT clinics is not working because of their obvious conflict of interest. It is hard for them to acknowledge that a treatment used by some of their members causes high rates of memory loss, and is largely ineffective, so their monitoring is half-hearted and tokenistic."

           Dr John Read, UEL professor of clinical psychology, said.

The majority of trusts were unable to provide any data for positive outcomes or for adverse effects during treatment (usually a three week period involving about 10 electroshocks). None provided data on efficacy or adverse effects beyond end of treatment.

ECT in England is supposed to be monitored by the Royal College of Psychiatrists via their 'ECT Accreditation Service' (ECTAS). But ECTAS does not monitor some of the issues addressed in the independent audit, such as how many trusts are using proper assessment measures, how many are complying with the Mental Health Act regarding second opinions for forced treatment, and how many ECT patients had first been offered psychological treatment in compliance with NICE (National Institute for Health and Care Excellence) guidelines. ECTAS has no powers to sanction ECT clinics that fail to meet even their limited set of standards, and has never disaccredited an ECT clinic. About 20% of ECT clinics do not bother to sign up to the ECTAS process at all.

The audit concluded:

Given the apparent failure of current monitoring and accrediting ECT clinics in England, by the Royal College of Psychiatrists' ECT Accreditation Service (ECTAS), an independent government sponsored review is urgently needed. A group of clinicians, researchers and ECT recipients have written to the Minister for Health and Social Care to ask for an independent review of ECT. They are supported by Mind, the Royal College of Nursing, the Association of Clinical Psychologists and Headway, the brain injury association, plus many MPs."

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