Rise in 120-volt ‘Cuckoo’s Nest’ shock therapy in hospitals
NHS Scotland is increasingly using a highly controversial form of electroshock treatment to ‘cure’ patients suffering from severe psychiatric disorders.
Electroconvulsive therapy (ECT) – which sees up to 120 volts of electric current channelled through the brain – has been used for almost a century to treat ailments such as severe depression, bipolar disorder, catatonia and schizophrenia.
The procedure, portrayed in the 1975 film One Flew over the Cuckoo’s Nest, starring Jack Nicholson, has been associated with permanent memory loss and facial recognition problems.
Yet it has also been hailed as a life-saving treatment, in some cases all but curing patients suffering from severe mental distress.
It is thought the electric current helps to reconfigure the brain and, as a result, reduces the number of depressive and psychotic thoughts a person has. Latest statistics show a growing number of the treatments are being administered by NHS Scotland – up from 3,966 in 2017 to 4,375 in 2018.
The most common group of patients prescribed ECT are women aged 50-59 years.
Under the procedure – which dates back to the 1930s – patients are put under a general anaesthetic, laid on a hospital bed and a ‘bit’ is put between their teeth to prevent their jaw breaking.
Electrodes are attached to their temples and 120 volts of electric current – the same amount needed to switch on a table lamp – is passed through their brain.
Due to the nature of the treatment, it is used only in the most severe cases of mental ill-health, often where informed consent cannot be given, and so it is the subject of fierce debate.
In July, more than 40 critics of the treatment, including doctors and patients, wrote to Health Secretary Matt Hancock demanding a review of the procedure.
One signatory, Dr Jim Geekie, a clinical psychologist for NHS Lothian and clinical tutor at Edinburgh University, last night questioned the evidence for the treatment’s efficacy, although he acknowledged that, in some cases, it worked well.
He said: ‘The evidence for its effectiveness and its safety is not sufficient to justify its use. I have heard stories of people who had had ECT, who struggle with memory, concentration and also a lack of confidence in themselves.
‘I admit that I’ve met a few people who have said ECT has helped them, but part of the problem is the decisions about ECT should not be based on the anecdotes of individuals.’
Dr Geekie added: ‘There’s part of me that thinks, do we want to live in a society that uses this kind of treatment on our most troubled individuals; is that the kind of society we want to live in?’
At its peak in the 1950s and 1960s, about 50,000 people were given ECT annually for myriad mental health problems but that number has since significantly declined. Between 2009 and 2018, 18 hospitals in Scotland performing an average of 4,200 sessions per year.
Medics say patients must agree to have the therapy with written consent, but according to the latest NHS Scotland audit report on the treatment, it is increasingly being given to people who do not offer their informed consent.
The document reads: ‘The majority (58 per cent) of all episodes of treatment with ECT in 2018 had the patient’s informed consent.’ But it added: ‘Over the last decade, the percentage of individuals who gave informed consent to ECT has declined from 73 per cent in 2009.’
A spokesman for the Scottish Government said: ‘Electroconvulsive therapy (ECT) is a safe and effective treatment.’
‘Do we want to live in this kind of society?’