Mental Health

[jazbug5]

Dr Fiona Blake, consultant psychiatrist, said all patients were fully informed before undergoing treatment.

She said: “ECT is an effective treatment for depression, but our consultants take great care to ensure it is only offered in cases where it is likely to be clinically effective.

“The treatment is always discussed and explained, and we have good-quality information leaflets to support clinical consultations and a robust consent procedure.

“ECT treatment is a ‘last resort’ for depression when the patient has symptoms that indicate a likely good response and when other strategies have failed.”

She said it was sometimes the preferred treatment, for example for someone intensely suicidal, or too depressed to eat or drink.

So if someone is ill enough to need to be sectioned and/or given ECT, then how are they supposed to take on board the 'discussion' of the treatment, and what it says in the leaflet? And what, pray, is a 'robust consent procedure'?
I don't know if things have changed since the 80s/90s, but in the experience of my family it was certainly used then as punishment and as a form of restraint and control, with long lasting brain damage as a result.
However, I'm sure that nothing of the sort would happen now that there is 'robust consent'. Or... something.

[Disco Dan]

So if someone is ill enough to need to be sectioned and/or given ECT, then how are they supposed to take on board the 'discussion' of the treatment, and what it says in the leaflet? And what, pray, is a 'robust consent procedure'?
I don't know if things have changed since the 80s/90s, but in the experience of my family it was certainly used then as punishment and as a form of restraint and control, with long lasting brain damage as a result.
However, I'm sure that nothing of the sort would happen now that there is 'robust consent'. Or... something.

Careful using the phrase 'punishment' in that way.

A grown man/woman with very challenging behaviours is a lot different to say a 5 year old boy/girl with challenging behaviours.

It is a corrective tool still in use in this country today.

I support it's usage, I have worked with clients whom have had electrotherapy and even the client is now able to reflect upon it and speak highly of it.

"Clinical discussions" usually refers to qualified and experienced psychotherapists and trained nursing staff as well as family members and/or support persons (identified by client).


Let me put it to you in plain simple terms -

Client XY is clinically depressed to the point of self harm and has demonstrated 'planning' in terms of suicide and/or has made attempt/s already to take his/her life.

This client has would have been in the 'system' and have gone through intensive psychotherapy and support staff would have been working closely with him/her using the Boston Recovery Model (widely used throughout NZ).

All of this would have had to have failed as well as a mental state deterioration to the point of hospitalisation before electrotherapy would even be brought up into conversation.

It is not used lightly as a lot of its effects (especially long term) are still unknown - but it IS still in use today as it DOES work in certain situations.

[jazbug5]

Dan, I think I know what I'm saying.

In the case which I am referring to it was used to punish an escape attempt, and to pacify the patient for the convenience of the hospital. I mention it only to point out that historically it has been used in this way- not that it always is, or even that such use is common.

Perhaps the application was, in this case, also more severe, since it did result in quantifiable brain damage.

At any rate- having seen my family go through this at very close range, I hope you will understand my reservations on this treatment.

Oh, and also- human nature being human nature, and short staffing being endemic- I am cynical about the possible use of it in the way I mention, even if there are best practice procedure manuals coming out of eveyone's ears...
but then I have no experience of the system in NZ.

[Disco Dan]

Dan, I think I know what I'm saying.

In the case which I am referring to it was used to punish an escape attempt, and to pacify the patient for the convenience of the hospital. I mention it only to point out that historically it has been used in this way- not that it always is, or even that such use is common.

Perhaps the application was, in this case, also more severe, since it did result in quantifiable brain damage.

At any rate- having seen my family go through this at very close range, I hope you will understand my reservations on this treatment.

I would have to say that there would have been more to it than that, but I am not nieve, in the sense that I know there is malpractice in the industry and misuse of such treatments does happen.

It is most unfortunate that you have had to witness this treatment within your family. I only hope that some good came of it - and that you were not in the room at the time! It is certainly a very traumatic thing to watch - when I worked in a MH Hospital I got to see it first hand. I would not wish it upon anyone, but in saying that there is uses for it!

[YellowDog]

There are many nutters on the streets. In fact I would say that every human being has their own personal psychiatric issues, however minor these may be. Some call this a personality, which has developed or not developed based upon their life experiences.

Perhaps there needs to be some acceptance that not everyone can be fixed. Though I know nothing about electrotherapy, it scares me that this may be considered a potential remedy.

The paedofile with the elastic band around his wrist to 'Ping' himself everytime he has an impure thought about children really should not be on the streets (or allowed into Parliament :-) ).

And what about women? Because they are considered the weaker of the specis, we let more mentally ill women roam the streets.

My point is that some balance is required and that there is a need for 'special envirionments' to support people who are beyond help.

[Disco Dan]

T
The paedofile with the elastic band around his wrist to 'Ping' himself everytime he has an impure thought about children really should not be on the streets (or allowed into Parliament :-) ).

I always laugh when I hear that one!!!

When you have seen a persons wrist dripping in blood, swollen and the person still 'pinging' because he/she has been "trained" you will know it is bad news. Extreme case though, has a very good "placebo" effect on a basic level behavioral scale.

I used to look after pedophiles in supported accommodation. We would do room searches once a month - one time we found 3 dead cats in his cupboard and no they were not pets. No puncture repair kit needed for those poor cats.

[James Deuce]

Control your own destiny and don't blame others.

I'm pretty certain you're either not reading the same words that people are typing or English is a second language. You are VERY good at reading conclusions into things that aren't there.

I blame no one, I ask for no help, I'm not on a sickness benefit despite being disabled enough by my spinal injuries to to be able to.

People honestly talk about their issues in a thread designed specifically for that and you leap to a collection of exaggerated conclusions about things and people you know nothing about.

It was definitely a massive mistake on my part to have said anything.

[YellowDog]

Dan mate, as you have already suggested, most of us know bugger all about this complex subject. Like most of the posters on this sight, I admire and respect you for the work that you do.

The phrase "Ignorance is Bliss" is quite appropriate for this subject.

[Ixion]

,,

ECT “resets” the brain with an electric pulse.

Opponents say there is little evidence it works. They claim it can have severe side-effects and is a form of torture.

,,
Dr Fiona Blake, consultant psychiatrist, said all patients were fully informed before undergoing treatment.

She said: “ECT is an effective treatment for depression, but our consultants take great care to ensure it is only offered in cases where it is likely to be clinically effective.

“The treatment is always discussed and explained, and we have good-quality information leaflets to support clinical consultations and a robust consent procedure.

,,

I cannot speak for Cambridgeshire. But it is certain that in NZ there is most definately not a "robust consent procedure" for ECT. By the DHBs own figures 22% of treatments are without consent, ie by force. In Manakau the figure is 58%. And in a very large number of those nominally 'consenting' the 'consent' is obtained by intimidation or deception.

I cannot say whether ECT is still used as a punishment regime. The revelations about Lake Alice make it plain that is has been used thus in the past , and routinely so. I see no reason to suppose that the trick-cyclists have changed their spots.

ECT is horrendously damaging to those forced to undergo it. It is claimed that it is "beneficial' in some cases. These claims are rather like the classic medical statement "the operation was a success, pity the patient died".

In these claimed successful cases, typically the victim was previously depressed or suicidal (which of course brings up the whole question of whether a determination to end ones own life should be be regarded as ipso facto evidence of mental illness. But that is another story). It is claimed that, afterwards the patient does not have such suicidal intent. That may be true, but it is only because the electric shock causes such significant brain damage that the victim is unable to muster sufficient mental capability to determine upon anything at all. They eliminate the 'patients' depression by turning her (it is usually a her) into a vegetable. Vegetables are never depressed. Or otherwise.

It is a very cruel and barbaric abuse which should not be tolerated. And an indictment upon a health system which shows , yet again, that where the elderly or vulnerable are concerned, the myth of treatement by consent is just that - a myth.

[jazbug5]

Good post, Ixion- but it's worth pointing out ECT does not generally render the patient a 'vegetable' permanently. If it did, then there would have been more of an outcry about it before now.

Other than that, some good points.