Global study finds key causes of distress overlooked
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Published
12 December 2025
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A major new study led by Professor John Read of the University of East London has found that people receiving electroconvulsive therapy (ECT) are rarely asked about the childhood adversities or recent life stressors they believe lie behind their mental health difficulties.
The findings emerge from the largest international survey of its kind and form part of Professor Read’s long-running research programme examining the experiences and outcomes of people who undergo ECT.
The survey, published in the International Journal of Mental Health Nursing, suggests that people across the world are being prescribed ECT, often involuntarily, without the underlying causes of their distress being explored or addressed through other forms of support.
The international research team, made up of three ECT recipients and three psychologists including Professor Read, gathered responses from 858 ECT recipients and 286 family members and friends across 44 countries.
The findings show that 84 percent of ECT recipients reported childhood adversities, including emotional neglect and physical or sexual abuse. Of those, 78 percent believed these experiences contributed to the problems for which ECT was prescribed. Only 32 percent said mental health services had asked about these adversities, and just 30 percent felt they had been “therapeutically addressed”.
Recent life stressors were also overlooked. A total of 81 per cent of recipients reported at least one significant stressor in the six months before treatment, most commonly loneliness or coercive and emotional abuse. Although 67 per cent felt these events played a role in their difficulties, only 34 percent were asked about them, and only 21 per cent believed they had been addressed.
What they say
The researchers conclude:
“Mental health professionals should ensure that patients are asked about the life events and circumstances they believe contributed to the difficulties for which ECT is being considered and offered some help with them.”
Professor Read, of the School of Childhood and Social Care, said:
This is a disturbing example of what happens when you medicalise human distress. How can electricity possibly address child abuse or domestic violence? These findings are a stark wake up call for a system urgently in need of a fundamental paradigm shift. The survey insights also align with United Nations and World Health Organization concerns that mental health systems are neglecting social determinants such as poverty, violence and discrimination.
“At the University of East London, we are determined to use our academic research to address these social inequalities. We hope these findings will encourage a radical rethink of mental health support, one that moves beyond diagnosis and invasive procedures to a more holistic, trauma-informed approach to addressing the social context of distress.”
Co-author Sue Cunliffe, herself an ECT recipient, said:
“The hopelessness and entrapment caused by domestic abuse gave me just one option, suicide, to ease the pain. For that I was given ECT and ended up so brain damaged I had to give up my job as a doctor. In a recent report my GP wrote ‘domestic abuse misdiagnosed and ECT given in error … causing brain damage’.”
Co-author Sarah Hancock, also an ECT recipient, added:
“The results of our ECT patient survey highlight the absence of routine identification and treatment of the real causes of our symptoms. These results demonstrate I am far from the only person prematurely prescribed ECT without finding out what was really going on and what I really needed.”
Rosie Weatherley, Information Content Manager at Mind, said:
“Mind echoes concerns raised by this research – the evidence base for ECT has never been fit for purpose and this latest study further substantiates the need for a re-think about whether and when this treatment is offered to patients.”
Growing body of research
This study forms part of Professor Read’s wider body of research.
This new paper continues Professor Read’s extensive research into the experiences of people receiving ECT. His recent work has included:
- An international study showing that women receive ECT more often than men and experience more adverse effects
- A survey identifying seventeen adverse effects reported by more than half of ECT recipients
- Research revealing that most recipients feel the information they were given before treatment was inadequate
- A large international study finding that most respondents reported ECT made no difference or made matters worse
- Research showing that most people who reported memory loss experienced it for more than three years
Collectively, these studies highlight major gaps in how ECT is prescribed, explained and evaluated, and continue to raise important questions about the role of trauma and social adversity in mental health treatment.