Use of electro-convulsive therapy in psychiatric care rises

The use of electro-convulsive therapy (ECT), seclusion and physical restraint in the treatment of psychiatric patients have all increased for the first time in years, according to the Mental Health Commission.

Data published for treatment facilities in 2013 show seclusion techniques rose for the first time in six years, by 12 per cent. The commission described the increase as “very worrying”.

Physical restraint was up by 8 per cent on 2012 and ECT by 2 per cent. The latter is a treatment formally known as electroshock therapy which involves the administration of small currents to the brain in order to relieve symptoms of psychiatric illness.

ECT is a divisive approach to patient care with medical professionals both in support and opposition of its use. Currently, it can be applied without the consent of a patient.

"Over the past number of years we have seen a steady reduction in the use of practices such as seclusion and restraint," said commission chairman John Saunders.

“However, the increase in their use of during 2013 is very worrying. I would urge those providing mental health services to study the rules and codes of practices in these areas to ensure they are delivering the most appropriate level of care.

Emergency measures

“Seclusion and restraint are emergency measures and should only be used in exceptional circumstances and only when in the best interests of the patient.”

Of particular concern, Mr Saunders said, was a 70 per cent rise in the number of ECT programmes given to patients who were either unwilling to receive it or unable to consent.

The commission is seeking a change in the law regarding the administration of ECT in these circumstances, a view the Department of Health is currently considering through legislative amendment.

The statistics show that 257 individual patients received this treatment in 2013. Those who receive ECT range in age, the average being 60 but the eldest recorded at 93.

The majority of recipients suffer from depressive disorders and are often resistant to medication, and in most cases, according to psychiatrists, improvements were noted.

The Mental Health Commission is an independent body whose primary function is to foster high standards of care in the treatment of patients.