ECT report does not acknowledge risk, says Commission

The Mental Health Commission has said a report into electro-convulsive therapy (ECT) does not go far enough to protect the rights of mental health service users or acknowledge the level of risk as a treatment.

The independent report -- released yesterday -- recommended the continued use of ECT as a safe and effective treatment for severe depression, although it says there should be some regulatory changes.

The report was welcomed by Dr Jeremy Skipworth, the Health Ministry's deputy director of mental health, who said: "I am pleased that this important and sometimes life-saving means of treating some forms of serious mental illness continues to be recognised as effective and is being delivered safely in New Zealand."

However, Mental Health Commissioner Mary O'Hagan today said in a statement she is sceptical about the review's interpretation of the level of risk posed by ECT.

"There are other interpretations of the international research which give ECT a poorer picture than those expressed in the report. People for whom ECT is a treatment option should be told about the full extent of the risks."

She said risks include serious and irreversible memory loss, with some people reporting loss of huge volumes of their memory -- including their entire childhood, and their ability to perform skills like music, art and writing.

Ms O'Hagan said past experience of ECT and preferences of service users must be a top consideration when ECT is being considered as a treatment option.

"We support further discussion on changes to the Act to include the competency test, so people who are mentally competent, but being treated compulsorily under the Mental Health Act, can refuse ECT.

"We also strongly support advance directives, where people can specify what treatments they do and don't want to receive in the event that they become incompetent. These need to be widely promoted and should be respected and used by doctors."

Ms O'Hagan said the commission's view was that ECT should not be banned -- it should remain as a treatment option as some service users had found it a life saver.

The report also concluded that ECT's use is appropriate for treating some serious mental disorders, and banning its use would deprive some seriously ill patients a potentially effective and sometimes life-saving means of treatment.

Meanwhile, Auckland University senior lecturer in psychology John Read today said the report was seriously flawed and its recommendations will do little to protect people.

Mr Read took grievance with the report's conclusion that ECT is both safe and effective.

"There is not a single research study showing that ECT has any benefits that last longer than a few weeks," he said in a statement.

The Government agreed to a review of the safety and effectiveness of ECT in February 2003 after receiving a 3000-signature petition from the Patients Advocacy Group in Hamilton.

ECT is administered under general anaesthetic and patients are given a muscle relaxant. An electric pulse applied to the temples induces a brain seizure.

- NZPA