The Ablett ECT unit in Wales

In the 2016 ECTAS newsletter, the Ablett electroconvulsive therapy unit at the Glan Clwyd Hospital near Rhyl in North Wales was congratulated on achieving a rating of excellent, complete with a smiley face, fireworks and stars. ECTAS is a voluntary accreditation scheme run by the Royal College of Psychiatrists.

In September 2021 an article in the Rhyl Journal quoted from an outline business case for a new £67m adult and older person’s mental health unit at Glan Clwyd Hospital saying that the Ablett unit had:

“an electroconvulsive therapy (ECT) facility that is not fit for purpose”

From excellent to not fit for purpose in five years?

I have been unable to find the outline business case, so don’t know if there are any more details about the ECT unit and why it is unfit for purpose.

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Lake Alice: the opinion of Basil James

Since he fled New Zealand in 1978, Selwyn Leeks has been living a comfortable life in Australia, having also spent some time in Canada. Until he gave up his licence, rather than face an inquiry, in 2006 he was practising psychiatry. By 2006 he was well into his seventies.

In order to continue his career unhindered, Leeks must have had the tacit support of his fellow psychiatrists. One psychiatrist who however gave more explicit support to Leeks was Dr Basil James. In 2001 he was asked by Crown Law to give an opinion about the treatment of children at the Lake Alice Unit in connection with legal claims of former patients. The opinion was quoted in solicitor-general Una Jagose’s evidence to the Royal Commission of Inquiry. It blamed under-funding for “any deficiencies in care” at Lake Alice and was sympathetic towards Leeks.

“On 12 March 2001, Dr Basil James, who personally knew Dr Leeks, provided Crown Law with an opinion regarding Lake Alice Hospital. He noted that any deficiencies in care may have resulted from a lack of adequate funding and training, and stretched resources. His opinion was that Dr Leeks would have made every effort to act in the patients’ best interests, with good faith towards them, and respecting the trust and confidence they placed in him. However, “it is difficult to do other than sympathise with [a Lake Alice patient’s] perception of the attitudes underlying some of the treatments she was given as being punitive; but I think it doubtful that such attitudes would have emanated from, or been fully perceived, by Dr Leeks.”

I have already written about Basil James (here). He was a British psychiatrist who moved to New Zealand and then to Australia. From 1977-79 he was president of Royal Australian and New Zealand College of Psychiatrists and in 1980 was appointed national director of mental health in the New Zealand Department of Health. 

I have been trying without success to find other examples of practices similar to those that went on at Lake Alice. There were elements to the regime at Lake Alice that are found elsewhere, but I have not been able to find anywhere else where they all came together. (That of course doesn’t mean to say that there isn’t anywhere – similar regimes may simply never have come to light.) Children were and still are given ECT. In her 1977 book, Child of a System, Noele Arden described being given ECT for no particular reason, which I was reminded of when reading about Lake Alice. ECT was still occasionally being used without anaesthesia in British Hospitals into the 1980s. ECT has been used to control and punish. I remember reading a monograph, probably published in the 1950s (unfortunately I cannot remember the details), which described how patients on a hospital ward were given weekly ECT in the hope of reducing violence on the ward. And nowadays it is used in an attempt to control the behaviour of people with dementia. American psychiatrist Lloyd Cotter used the threat of ECT to “motivate” patients in a Vietnamese mental hospital. His report was published by the American Journal of Psychiatry in 1967.

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Lake Alice: the children

The children who were treated at Lake Alice hospital in the 1970s are now men and women in their fifties and sixties. In June 2021 the The Abuse in Care Royal Commission of Inquiry in New Zealand heard evidence from 18 of them. In all about 300 children passed through the unit. The majority were boys, and Pacific and Māori children were over-represented. Many of the children had suffered abuse and disadvantage before their admission to Lake Alice.

Hake Halo came from the island of Niue to New Zealand with his grandparents when he was six years old. Unable to speak English, he got behind at school. After the death of his grandfather, he got into trouble, was taken to court for shoplifting, sent to Owairaka boys’ home and from there, aged 13, to Lake Alice. His sister was murdered by her boyfriend; the only person at Lake Alice who offered him any support after this tragedy was teacher Anna Natusch. Halo’s medical records show he was given a variety of major tranquillisers, and electroconvulsive therapy (ECT) on at least seven occasions, always unmodified. Selwyn Leeks referred to him as an “uncontrollable animal”; in his evidence to the Commission Halo said: “he’s just writing about his own self”. In his evidence Halo made a distinction between being given ECT as treatment, when he lost consciousness immediately, and being given ECT as punishment, when the current was increased gradually to inflict pain before consciousness was lost. He described Leeks as “a man full of hatred” and said that “the aftereffects of these shocks were headaches, loss of memory, bad anger and fear”. He also saw a return of epilepsy he had outgrown as a child. Halo described his life since Lake Alice: difficulties with work (caused by memory loss) and relationships, but support from his church and his family. He joined the Grant Cameron class action and was awarded  $76,023.39  ($40,000). Halo was the Niuean boy whose case was taken up by Dr  Oliver Sutherland of  the Auckland Committee on Racial Discrimination (ACORD) and featured in the Mitchell Report in 1977.

Tyrone Marks, of Māori and Italian descent, was removed from his family aged 8 after suffering physical abuse. He spent time in a number of children’s homes, where he continued to experience abuse, and was seriously injured when he was hit by a car. At Lake Alice, according to his records, he underwent ECT both with and without anaesthesia. (There is little dispute over what treatments the children at Lake Alice were given, as on the whole their medical records survive. As solicitor-general Una Jagose said: “the proof of what happened at Lake Alice was in the file.”) As for life after Lake Alice, Marks described having to teach himself to read and write as an adult. There were odd jobs as a labourer, time spent in jail, marriage, running a massage business with his wife, taking on sole parenthood of his four daughters and later two more children from another relationship. He was awarded $94,886 ($53,886 after legal fees) as one of the Grant Cameron claimants. Then he obtained a diploma in social work and counselling and started studying at Waikato University, only giving up when his second family came along. Looking back, he thought it would have been better to have left him with his family rather than taking him into care. His experiences left him with a mistrust of authority and difficulties with relationships; ECT left him with a fear of electricity and light switches. Like many of the children admitted to Lake Alice, he had never been diagnosed with a mental illness. “The trauma we all suffered, and continue to suffer, from being in Lake Alice is immeasurable” Marks said. “And, you know, the impacts of what’s happened, it doesn’t stop. When he stopped doing his stuff in 1977, it has to live with us all the way through”.

Rangi Wickliffe, of Māori, Irish, Scottish and German descent, testified about a childhood in care, sexual abuse, and admission to Lake Alice, where he was given unmodified ECT. It was, he said, torture. The Commission Chair Coral Shaw said  you could hear a pin drop during his testimony.  Wickliffe has spent much of his adult life in prison. He said that his files always talked about what he had done to other people, referring to him as a sociopath and a liar, but never talked about what the State had done to him as a child. I looked for some evidence of his criminal history, but could only find something about a burglary and a two-year sentence for confessing to a murder he didn’t commit when the real culprit offered him money. There was also a story about Wickliffe volunteering in a community garden.

Kevin Banks was a talented drummer and played in his mother’s band before being admitted to Lake Alice aged fourteen, on account of conflict with his stepfather. He was given both modified and unmodified ECT, and also electric shocks on other parts of his body. Living with his second wife and two sons in Australia, he said he had not had a job since 1993 but lived on a disability pension. As a result of his time in Lake Alice he suffers from memory loss, depression, anxiety and PTSD.

Walton James Ngatai-Mathieson, who is of Māori descent, went nearly blind when he was five after being stung by bees and contracting an eye infection. He later developed epilepsy and was admitted to Lake Alice aged 12. He described being sexually abused and given unmodified ECT, but had positive things to say about the food. Altogether he spent fourteen years in psychiatric institutions and has also spent time in prison. He has had three mild strokes, has a brain tumour and lives in a rest home. “Despite the abuse and neglect I have experienced in State institutions and the barriers society has put in my way; I am a  strong, proudly independent and positive man.”

Bryon Malcolm Nicol described being a hyperactive child from a difficult family background. He was taken into care and was admitted to Lake Alice aged 12. He was raped and given unmodified ECT. “I had a disability. Instead of love and care and help with it, I got cruelty and torture and was made to feel a worthless human being.” His life was unsettled until he met his wife and found a job in dairy farming. He joined the Grant Cameron action and was awarded $64,912 from which $27,546.94 was subtracted in legal fees. Unfortunately, giving a statement for the legal case and taking part in a documentary led to a breakdown and he has not worked since. Nicol described how ECT had left him with a poor memory, how he had trust issues with people and had not been a good father. He added that, due to the unexciting diet (meat and three veg) in care, he was cautious about trying new food and it had taken 30 years to let his wife use garlic in cooking, let alone herbs and spices. Commission Chair Coral Shaw acknowledged the irony: “You suffered so badly, you succeeded in your life, your description of life on the farm and your success at that time, and yet it was all brought down by trying to seek justice.”

Donald Ku was taken into care and had two admissions to Lake Alice, one aged nine and the other aged 15. He was sexually and physically abused and given ECT by nurses (he said he never came across Leeks in the unit). “My whole life has been demeaned and destroyed by the anger and sorrow I feel from childhood experiences. I am traumatised every day from the terrible memories of how I was mistreated at Lake Alice.” In his witness statement he described how his Māori culture was disregarded. After Lake Alice he spent some time in prison, where he learnt to read and write, and became a gang member. His own two children were taken into care. 

Alan Hendricks was the son of a nurse at Lake Alice. In an unhappy situation at home with his father and stepmother, he was sent for counselling by Leeks. “The first impression I had of Leeks was that he was nice. But that was just a front, and I quickly learnt that he was actually a snake.” After his father mistakenly thought he was trying to start a fire in his bedroom, he was admitted, aged 13, to the unit at Lake Alice. Hendricks himself was not given ECT, but described living under the threat of it and how it was used as a punishment on other children. After Lake Alice he went to live with his mother.

Fred Rawiri, who is Māori and now lives in Australia with his family and works in the construction industry, was taken into care and, while he was in a children’s home aged 12 or 13, diagnosed by Leeks as having a possible “schizoid personality disorder”. “This was rubbish. I was young and I was lonely. Of course I was lonely. I hadn’t seen my family for three years, and for them to say these were symptoms of a mental disorder was ridiculous.” He spent three months in Lake Alice, where he was given unmodified ECT and paraldehyde injections as a punishment and also given electric shocks on his genitals. After Lake Alice he turned to gangs and (fairly minor) crime and spent time in prison. “For those who went to Lake Alice and survived, life afterwards was rough. It was a road of loneliness, a road of feeling betrayal, and a road of continued inhumane treatment. I have battled with depression my whole life and constantly feel overwhelmed by my emotions.” In 2020 he was offered  $59,356 through Cooper Legal.

The Commission heard from the widow of an anonymous survivor of Lake Alice. Her witness statement included extracts from her late husband’s statement as part of the Grant Cameron class action. From a Pacific background, her husband had been taken into care and later admitted to Lake Alice, where he was subjected to physical and sexual abuse, unmodified ECT and electric shocks on his arms and legs, some administered by other children. He was sexually abused by a member of staff, and in turn sexually assaulted other boys. Dr Pugmire, the superintendent of Lake Alice, wrote to magistrates saying that his reports of abuse by a staff member were “wild allegations”. After Lake Alice her husband spent time in prison, but Ms CC said that their marriage marked a turning point in his life.

Sharyn Collis, who is of European descent, was gang raped aged 14. The police and her family did not take it seriously. She started running away from home and missing school and was sent by her GP to Leeks for counselling. Aged 14, she was admitted to Lake Alice, where she was given ECT, antipsychotic drugs and paraldehyde, and raped by Leeks. One of the Grant Cameron claimants, she received $60,000 ($35,000 after legal costs). After leaving Lake Alice she became addicted to prescription drugs, could only get factory jobs although she had wanted to be an accountant, had six children and is now a great-grandmother. “I have been so depressed over the years, constantly reliving what happened to me in there” she said.

Next the Commission heard from a woman who was admitted to Lake Alice aged 14. By now the story is familiar, if no less shocking. The witness said: “I can Google my name and everything that happened to me is all over the internet. How do I tell my story but then deal with all these people judging me?” So I will not give the details and at least there will be one less place on the internet to see her name. One of her daughters gave evidence about the impact on her childhood of having a mother who was “out to lunch” and unable to care for her properly: “And I believe she was out to lunch because of her terrible experiences of drugs and electric shocks at Lake Alice.”

Malcolm Richards gave evidence to the Commission about spending two months in Lake Alice and being given ECT (modified and unmodified) and an electric shock to his genitals. He spoke about the difficulties he faced in life after Lake Alice: an unsettled life moving from job to job always in fear of being returned to Lake Alice; a heart attack aged 32; a suicide attempt and a course of ECT against his will; his fight to obtain justice for the survivors of Lake Alice; and a fight to get the Accident Compensation Corporation (ACC) to recognise that ECT causes brain damage. “I have lifelong hideous effects from my time in Lake Alice, particularly from the ECT. It turned a 15 year old depressed boy in an unhappy home with a violent father into someone with life-long debilitating trauma, memory loss and huge difficulty retaining information.” 

JJ, of Māori and Irish descent,  spent two years in Cherry Farm Hospital, where he was given ECT, and was then admitted, aged 14, to Lake Alice. Pugmire wrote a report about him which JJ describes as “insulting to my race, my family, and me”. (It was so offensive it was not read out at the Inquiry.) At Lake Alice he was given ECT and drugs and sexually abused. Life after Lake Alice was difficult with an inability to work, five children in a marriage that broke down, and an injury when hit by a car that left him walking with sticks and living with a carer. He has problems with PTSD, depression,  anxiety, and socialising with other people. Witnesses were asked what they hoped for from the Royal Commission. JJ, like other witnesses, wanted the government to be accountable for what happened at Lake Alice, appropriate compensation, a public apology, and counselling. In addition he wanted to learn to read and write. Lastly, and poignantly, he said “I’d like my life to be made better than it is if that is at all possible”.

Deborah Dickson is younger than most Lake Alice survivors, having been admitted to the unit for two months aged nine in September 1978, by which time Leeks had already left. At the age of two she had meningitis, and, although she made a good recovery, her parents afterwards treated her as if she was brain-damaged. At Lake Alice she was given Largactil, Stelazine, Melleril, and Tofranil. She did not have ECT. Her notes contain a reference to having been sexually interfered with by a female patient. “I had a shitty adulthood following Lake Alice. I’m a loner, and I hate socialising.” She told the Commission that she felt “like a fraud” after hearing what others had gone through.

Ms Y read a statement written by her late mother, Ms LL, who had been sexually abused and admitted to Lake Alice aged 12. She was threatened with ECT. Ms Y also gave evidence about the intergenerational effects of her mother’s abuse at Lake Alice (a common theme of the survivors’ evidence). The statements of Ms LL and her daughter do not appear on the Commission’s website.

Mr AA, of Irish descent, told how he had been physically abused by his drunken father and  sexually abused when he caddied at the local golf club. He was then taken into care and abused in children’s homes. He spent three months in Lake Alice in 1975 when he was 13 years old. He was given ECT (modified and unmodified) and paraldehyde injections. ECT was given as punishment, for example if a child didn’t actively take part in the therapy group. The ECT ruined his memory. He described the community hall, with table tennis, movies, a tuck shop and socialising with girls, a reminder that life in the unit had elements of normality. AA has spent much of his adult life in prison and sees little of his two children. He received $26,000 after deduction of legal fees as part of the Grant Cameron claim. “I deeply regret the way my life has turned out. If only someone had listened to me when I was 9 and supported me through the trauma of being sexually abused and living in a violent family. I might have turned out very differently for me.” He quoted from a report, presumably written when he left care, that said he had failed to benefit from the ‘best specialist guidance’. Did they, he wondered, mean “abuse, ECT for punishment, paraldehyde drugs for punishment”. 

Charlie Maurice Symes was admitted to Lake Alice at the age of 15 in 1973 and for a second time the following year. He was a ward of the State and had been in children’s homes. At Lake Alice he was given a lot of drugs (phenothiazine, largactil, stelazine, melleril and paraldehyde) and ECT without anaesthesia. He was also given electric shocks on his genitals and believes this is why he never had children in spite of two marriages. After one session of ECT he had to be taken to Wanganui Hospital with heart and breathing problems. In 1996 he had a heart valve replacement and was told by the surgeon that he never should have had ECT as he had a hole in his heart (which had been diagnosed before he was admitted to Lake Alice). ECT left him with memory problems.  He admitted that he “had a mean violent streak” in him then, but says that Lake Alice made it worse. He received a payment of $42,000.

Andrew Morris Jane was taken into care as a child and sent to Holdsworth boys’ home. He was not formally admitted to Lake Alice, but taken there for ECT after running away from   when he was 12 years old. As a small child he had undergone heart surgery. ECT left him with a bad memory, and he suffers from PTSD from the abuse he underwent in care. His adult life has been spent in and out of jail and the longest he has ever held a job is 6 months. Relationships have been difficult and he is not married. “I am a real person, and I just want to be treated like one. I don’t want to be treated like I am just another crazy person who has gone through Lake Alice.”

Paul Zentveld was admitted to Lake Alice in 1974 when he was 13 years old, the first of five admissions. He had started getting into trouble when his parents split up. Even though a psychologist had found him to be a “personable, co-operative and friendly boy” without any sign of personality disturbance, Leeks had him admitted to Lake Alice. He was given paraldehyde and unmodified ECT as punishment for misbehaving and not speaking up in a therapy group. Due to a physiological problem that went undiagnosed at the time, Zentveld had a problem with wetting the bed and was given electric shocks on the genitals as punishment. He also received two courses of modified ECT – a total of 28 treatments. He finally left Lake Alice in 1977 with a diagnosis of a “paranoid schizophrenic condition”, made by Dr Siriwardena. “He failed to see that my deep-seated issues of distrust were largely born out of the psychiatric treatment and abuse I received at Lake Alice Hospital.” Zentveld credits the Salvation Army with getting him started in the fishing industry. He obtained his skipper’s certificate and works for a fishing company doing charter cruises. He joined the second round of claimants and received a payment of $114,912.28. Initially the government wanted to deduct 30 per cent to put the second round claimants on a parity with the Grant Cameron claimants who had had legal fees deducted. Zentveld challenged this in court and the decision was reversed. This however has left the Grant Cameron claimants feeling aggrieved. Zentveld was one of the Lake Alice survivors who in 2003  filed a complaint with the Medical Board of Victoria,where Leeks was then practising. Leeks gave up his medical licence rather than face a hearing. A claim to ACC was turned down on the advice of two psychiatrists who said that Zentveld’s treatment would not have caused lasting psychological damage and that unmodified ECT is used extensively in some countries. “They did not want to open that floodgate door because to do so would be to admit that the psychiatric treatment at Lake Alice, with drugs and ECT, caused lasting damage” said Zentveld. He joined other survivors in filing a complaint to the New Zealand Police, who ultimately decided not to bring charges against Leeks. Undeterred, Zentveld, with the help of CCHR, took his case to the United Nations Committee Against Torture (UNCAT). A formal complaint was filed on 10 July 2017, “stating that the treatments at Lake Alice were degrading and torturous and that the NZ Government had failed to properly investigate these”. The complaint was upheld; NZ was found to have breached the Convention against Torture and was asked to remedy the breach.

Zentveld’s evidence to the Commission received a standing ovation. Commissioner Alofivae said she was impressed with his warrior spirit. 

Posted in 1970s, ECT and memory loss, ECT and young people, ECT without consent, ECT worldwide, Legal cases | Leave a comment

Lake Alice: seeking redress

In June 2021 the The Abuse in Care Royal Commission of Inquiry in New Zealand heard evidence from 18 former patients, and the widow of a former patient, of the Lake Alice child and adolescent unit. But two former patients had already given evidence to the Inquiry when it was looking at state redress in September to October 2020: Leoni McInroe was the first person to file a claim relating to their treatment at Lake Alice, while “Patrick Stevens” (an anonymised name) was one of the most recent.

McInroe’s witness statement described how she was adopted at one week old, had lost both her adoptive parents by the age of four, spent a year in an orphanage and was then placed in a foster home where she was  ill-treated. At the age of 12 her foster mother took her to see Dr Leeks and in July 1975 she was admitted to Lake Alice, where she spent a total of 18 months in two periods and was diagnosed as having “borderline schizophrenia”.  Her records show that at Lake Alice she was given drugs and electroconvulsive therapy (ECT) or put in seclusion for misbehaviour, for example an entry for 12 November 1975 reads  “disobedient – ran over scoria bed. 50 mgs of Largactil”. She was given one session of ECT without anaesthetic in December 1975, and then two treatments with anaesthetic in December 1976.

In 1992 McInroe consulted lawyer Philippa Cunningham about her divorce and mentioned Lake Alice. The lawyer told her she had a claim and took on the case.

“I was so damaged from my time at Lake Alice and earlier childhood with my foster mother that I entered my adult years with a chronic lack of confidence and huge fear of authority. I would never have had the courage or wherewithal to contact anyone and make a complaint about Dr Leeks, but for the fact that my marriage had broken down and I needed a lawyer to finalise my divorce…. I would never have had the courage to make any claim against Dr Leeks if it had not been for the wonderful support, persistence encouragement I got from Philippa.”

McInroe had to go through the compulsory Accident Compensation Corporation (ACC) scheme before filing a claim. She recalled correspondence with the ACC:

“I was sickened and repulsed at the continued letters, correspondence with the subject heading that you could see through the window of the envelope, ‘Mental Nervous Shock Head'”

In 1994 she filed her claim against Dr Leeks and the Crown. There followed 9 years of litigation with Crown Law deploying delaying tactics in an attempt to limit their financial liability:

“The process of seeking justice and compensation was to me an additional on-going and sustained abuse to what I had suffered in Lake Alice at the hands of Dr Leeks and hospital management. This time, though, the abuser was the Crown.”

McInroe’s barrister, Robert Chambers QC, was holding out for large sums of money for McInroe and an anonymous claimant who had joined the suit. In McInroe’s case it was 1.5 million NZ dollars – a ruined life rather than a bad experience sort of sum. The first award would set the standard for future claimants, and the Crown delayed in the hope that McInroe would be overtaken by claimants who were prepared to settle for much less. This is indeed what happened, with lawyer Grant Cameron’s group action claimants, whose claims were filed after McInroe’s, settling for modest sums. Eventually, in 2002, McInroe settled for a similarly modest sum, something which she later regretted.

“I received nine gruelling years of emotional battering, abuse and bullying from the Crown.  Without Philippa and Robert it would have been impossible for me to withstand… I found the Crown’s behaviour appalling and indefensible. I eventually came to believe the Crown behaved in a way described best as trickery”. 

.She spoke about the long-lasting and intergenerational effects of trauma, and her hope that Dr Leeks, in spite of his age, might be brought to justice

It is not that I do not try and put my experiences in the past. I recall a friend made me laugh at  the ACC letters with the headings “Mental Nervous Shock Head”. It helped. But no matter how hard I work at working on improving that I am normal, the impact of years of trauma is never far away. As well as I manage the most wonderfully ordinary life that I now have, no matter that my darling children are smart and brave and incredibly loving, proud and supportive of their mum and as far as I have come in healing from my history there are still things that cause me distress”. 

The witness statement of McInroe, who has raised four children and works as an anaesthesia technician, was a compelling read. I wonder if there is the equivalent of a Pulitzer Prize for witness statements? If so, I would definitely nominate McInroe.

“Patrick Stevens” filed his claim more than 20 years after McInroe. In his witness statement he described childhood  neglect and sexual abuse. He became addicted to petrol sniffing and got into trouble with the police. In December 1975 he spent a week in the Manawaroa psychiatric unit at Palmerston North Hospital before spending four months in the Lake Alice unit, where he was physically and sexually abused, given paraldehyde and largactil and threatened with ECT. 

“The things that happened to me as a child were really bad. My experiences were so hard to deal with that I shut myself off from a lot of things as an adult”

He approached the law firm Cooper Legal in 2017 and his claim was fast-tracked due to his diagnosis of cancer. He received $6,000 for the Manawaroa claim, $10,000 from the Ministry of Social Development and, after some delays, $81,579 in July 2019 for the Lake Alice claim. “Stevens” was able to buy an RV with his compensation so he could be near the hospital for treatment. He died in April 2020 during Covid lockdown and his witness statement was read to the inquiry by his lawyer.

Solicitor-general Una Jagose QC gave evidence to the inquiry regarding the role of Crown Law in historic abuse litigation. 

Jagose and McInroe were both born in the 1960s, with McInroe being seven years older than Jagose. They came from very different backgrounds. McInroe was adopted at a week old, lost her adoptive parents, spent a year in an orphanage, was fostered and then sent to Lake Alice, while Jagose, the daughter of a doctor and a nurse, had a more privileged childhood. Jagose was educated at Sacred Hearts Girls College, Hamilton, where her mother was on the Board of Governors, followed by the University of Otago and Victoria University of Wellington.

In spite of their very different childhoods, McInroe and Jagose had something in common – they both got into trouble as children for talking and laughing too much. In her witness statement McInroe described how she was given her first ECT treatment because  she had giggled and been cheeky in a group therapy session in front of Dr Leeks. Meanwhile Jagose recalled on a visit to her old school:

“I remember laughing all the time. I also remember getting in trouble for laughing and talking all the time, but looking back on this it shows we were always allowed some freedoms to have a good time.”

Jagose didn’t say what the punishment at her school for laughing and talking was – extra homework perhaps? It certainly wasn’t largactil and ECT.

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Lake Alice: authorities apologise

The  Royal Commission into Abuse in Care has heard various apologies from the authorities to the former patients of the child and adolescent unit at Lake Alice Hospital.

Detective Superintendent Thomas Fitzgerald apologised on behalf of the police:

“Like all people reporting serious offending to Police that has significantly impacted their lives, the survivors of Lake Alice would have benefited from receiving a decision sooner. I acknowledge that delays in Police decision making, in the context of this type of offending, can be very difficult for victims, and I apologise to them on behalf of Police.”

DS Fitzgerald was referring to the fact that it took the police eight years, from 2002 to 2010, to decide not to lay any charges against the perpetrators of abuse at Lake Alice. An earlier investigation in 1977 had also resulted in no charges. However I wonder if the 1977 investigation may have been behind the decision of Selwyn Leeks, the psychiatrist in charge of Lake Alice, to flee to Australia in 1977 and the decision to close the unit the following year? I have been unable to find any discussion of the closure of the unit.

A further police investigation was opened in response to a December 2019 report by the United Nations Committee against Torture  and was due to report in July 2021. It was a former patient of Lake Alice, Paul Zentveld, who took his case to the United Nations. He was supported by the CCHR (Citizens Commission on Human Rights, established by the Church of Scientology), which leaves me experiencing a bit of cognitive dissonance. Where was everyone else?

Aleyna Hall was reported to have apologised on behalf of the Medical Council of New Zealand. 

“The Medical Council acknowledges the hurt that you have experienced and apologises for any actions that the Medical Council of the time should have taken but did not…”

There had been at least three complaints made about Leeks, the first dating back to 1977, but no action was taken against him and he requested, and was given, a certificate of good standing to take with him to Australia. Most of Aleyna Hall’s witness statement was taken up with explaining that the Medical Council had not retained records relating to the complaints.

The Government had issued a letter of apology to former Lake Alice patients in 2001. It was signed by prime minister Helen Clark and minister of health Annette King. At the time of the reports of abuse at Lake Alice in the 1970s, the director of mental health in the department of health was psychiatrist Stanley Mirams. When Mirams died in 1987 an obituary in the Australian and New Zealand Journal of Psychiatry said:

“It can be an uphill battle sustaining people’s interest in the mentally ill, but in Stanley Mirams, this sad group in society had over the years a very fine champion of their rights and needs.”

According to a Newsroom article, Mirams removed the ECT machine from the Lake Alice unit in 1977 and commissioned lawyer and mental health inspector Gordon Vial to investigate. Vial’s report was then referred to police.

“Mirams felt using electric stimuli as aversion therapy was “quite acceptable”, it emerged later. He only involved police to decide whether nursing staff were medically supervised and had authority to deliver shocks punitively.” (David Williams, First they were tortured, then the state failed them, Newsroom, 28 June 2021)

The Royal Commission, however, heard from psychologist Barry Parsonon who explained why Leeks’ techniques did not meet the criteria for either aversion therapy or punishment as part of a behavioural modification programme.

Also giving evidence was psychiatrist David Baron who had run the Sunnyside child and adolescent unit in Christchurch in the 1970s. He recalled how In those days “psychiatrists used to have a lot of unspoken power with respect to how we managed patients and it is fair to say medical practice was more freewheeling in nature than it is today”. ECT was not, he said, used on young people at Sunnyside. Baron went on to say: “Working with distressed children requires exceptional levels of skill, training, endless patience and a special type of person.” Was it, I wonder, the lack of those qualities that led Leeks to take out his frustration  on the children in his care?

In answer to a question at the hearing as to why no-one in the medical profession had spoken out about what was going on at Lake Alice, Baron replied: “’When you look at it you think how on earth did that happen. Why did nobody say anything.You couldn’t, you know you couldn’t.” He agreed with the Crown’s lawyer that it was a question of the medical profession closing ranks.

I have been trying, unsuccessfully, to find some clue as to what motivated Leeks to behave as he did. In particular I wondered if he had encountered any similar practices in England, where he spent some time prior to working at Lake Alice, but I have been unable to find any evidence of such regimes in British hospitals. That, of course, does not necessarily mean they didn’t exist. The only possible, albeit tenuous, clue I have found is that Leeks was an assistant psychiatrist at Shenley Hospital in Hertfordshire, just down the road from Letchworth Garden City, where Robert Russell was manufacturing the Ectonus machine that Leeks would come to use at Lake Alice. Whatever Leeks thought he was doing by giving children painful electric shocks on their legs or genitals, or deliberately giving ECT in a painful way, he certainly wasn’t doing research and never committed his ideas to paper. 

In a previous post I mentioned that Leeks, as a young man, had sustained a head injury while playing rugby. A heart surgeon, writing in the Daily Mail in 2019, described how a similar rugby injury had left him with a high score on the “psychopathic personality inventory”, a change in personality that he credited with helping him become a successful surgeon. But a psychiatrist who is working with children certainly doesn’t need psychopathic traits. (Head injuries of course affect different people in different way; I remember reading in a newspaper about a case where a head injury left someone too nice to pursue his career as a salesman.)

The Royal Commission also heard from Aaron Smale, a journalist and PhD candidate researching  Māori children in state custody, who likened the behaviour of the state towards survivors of historic abuse to that of a psychopath.

From what I have found, I can see that the state’s behaviour towards the survivors fits into many of these criteria – Lack of remorse or guilt. Manipulative. No insight into the offending. Inflated ego. Lying. Callous. Shallow emotions. Insincere speech. Arrogant and selfish. Violent. High risk of reoffending. 

I am not accusing individual employees of being psychopaths, but many of their decisions, taken collectively, add up to a pattern of behaviour that is about putting the interests of the state ahead of the interests of victims in ways both subtle and stark.

Amongst the apologies, one was noticeably absent. There has never been an apology from Leeks. At the inquiry, Leeks’ lawyer Hayden Rattry, on video link from Melbourne, Australia, where Leeks lives, said that his client was 92 years old and suffering from cancer, heart disease and kidney dysfunction. He said that neuropsychological testing showed that Leeks’ cognitive function was “most likely suggestive of Alzheimer’s disease”. This was enough to excuse him from appearing before the Royal Commission.

Posted in 1970s, ECT and young people, ECT in the media, ECT without consent, ECT worldwide, Legal cases | Leave a comment

Lake Alice: the West Malling connection

In my last post I mentioned that Selwyn Leeks, who ran the child and adolescent unit at Lake Alice Hospital in New Zealand, had a great-grandfather who was the proprietor of a private asylum in West Malling, Kent, England. In fact, the licence for the asylum was held at different times by Leeks’ great-grandfather, his great-grandmother, his great-great-grandfather and his great-great-grandmother. (In those days women, although not allowed to enter the medical profession, could hold asylum licences, just as they could hold licences of beerhouses and public houses.)

Anne Goad has recently written a PhD thesis that “examines lunacy provision in Kent between 1774 and 1874 from the perspective of the anti-psychiatrists of the 1960s and 70s.” (Managing the Mad: Lunacy Provision and Social Control in Kent, 1774–1874, Anne Elizabeth Goad, Submitted in partial fulfilment of the requirements of the degree of Doctor of Philosophy at Queen Mary University of London in September 2020). The author has herself experienced psychiatric treatment in Kent:

“In this thesis I have found it helpful and productive to use my modern experiences to examine and understand the nineteenth century context. Thus regarding the role of staff I found the maintenance of order far more important than any show of empathy. Mental health nurses facilitate the smooth running of the ward and ensure patients dress, eat and attend doctors’ appointments where instead of understanding they are once again fobbed off with often large doses of mind-altering medication.” (page 14)

The thesis is dedicated to, amongst others, my great-great-grandfather who spent some time in Barming Heath, the public asylum in Kent:

“This thesis is dedicated to all the patients incarcerated in the Kent County Lunatic Asylum at Barming Heath from its opening in 1833 to 1874, especially those whose names feature in the text.” (page 5)

Presumably my ancestor was not interesting enough to feature in the text. 

The thesis contains a 17 page section on West Malling asylum (pages 39-56). It was set up in the 1760s by the influential physician William Perfect, who was not an ancestor or blood relative of Leeks. Goad describes how Perfect used galvanic electrical treatment in his asylum:

“Also a novelty in the eighteenth century was the use of electricity to treat lunatics and Perfect owned a machine which he made use of when all other treatments had failed. He described some cases of treatment by electricity in the latter chapters of Annals of Insanity, suggesting his acquisition of the device was made towards the close of the century. Although he conceded that electricity afforded usually only partial or temporary relief, he gave details of three cases where the cure had been total. Thus, Mrs E.W., who had been reduced to a miserable state of melancholy by the death of her husband, had not responded to any of the usual methods of treatment. Electricity was tried as a last resort with shocks passed through her cranium once a day for a month. This produced an improvement, allowing the patient to dress and feed herself. The shocks were then increased every second, third or fourth day, but not confined to the head, for a month longer, after which she was released home cured with no return of her disorder.” (page 41)

Goad traces a line, albeit not a straight one, from these early experiments with electricity to the invention of electroconvulsive therapy (ECT) by Cerletti and Bini in 1938. (page 41-42)

After Perfect’s death, the West Malling asylum passed into the hands of his son George, who became bankrupt in 1815, and the asylum was then bought by Leeks’ great-great-grandparents Jane and Robert Rix. Jane had worked as an attendant at the asylum for 25 years. (page 49-50) 

Jane and Robert’s daughter, Mary Ann Rix (Leeks’ great-grandmother) married William Perfect’s grandson and was widowed young. In 1850 she married naval surgeon Thomas Harvey (Leeks’ great-grandfather), whose father, James Lowry, originally from Ireland, was also a naval surgeon. James Lowry left a memoir of his naval service, which has recently been published by descendants under the title of “Fiddlers and Whores”. Leeks’ grandmother, Minnie Lowry, was born in 1861.

It was while Jane Rix (Leeks’ great-great-grandmother) held the license, in 1844, that the West Malling asylum was criticised by the Metropolitan Commissioners in Lunacy, when an inspection discovered six patients sleeping in an outhouse. This episode “gave rise to section 63 of the Lunatics Act 1845 which made it an offence to conceal from or neglect to show to the visitors any part of a licensed house.” (page 52)

The 1881 census sees Leeks’ grandmother, 19-year-old Minnie Lowry, living in the asylum with her father and stepmother. (It was common practice in those days for the proprietors of private lunatic asylums to live on the premises.) Patients included two clergymen, a solicitor, a sculptor, a silk merchant, an army captain, and a shipbuilder.

In 1883 Minnie Lowry married her first cousin, Edward Lowry Leeks. Edward was the son of a solicitor and had entered the Middle Temple after graduating from Trinity Hall, Cambridge. But he evidently decided the law was not for him, as his occupation is given as medical student on the 1881 census. He doesn’t appear to have become a doctor either, and describes himself as “gentleman” on his marriage certificate. At some time between 1883 and 1896 Minnie and Edward emigrated to New Zealand; a bankruptcy notice sees them living in Masterton in 1996, with Edward’s occupation given as clerk. An article about the bankruptcy in the Wairarapa Daily Times (13 March 1996) said that Edward had “never had permanent employment since he came to the colony”. The couple had two daughters, one of whom died in infancy, and eight sons. Three sons, and their son-in-law, were lost in WWI.

Had Leeks, I wonder, heard stories as a small boy from his grandmother about growing up in the family asylum, stories that might have inspired him to take up psychiatry – with such disastrous results?

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Lake Alice: who was Selwyn Leeks?

Who was Selwyn Leeks, the psychiatrist who ran the Lake Alice child and adolescent unit during its short existence from 1972 to 1978? Was there, I wondered, anything in his background that would throw light on his subsequent career and mistreatment of child patients?

Leeks, who is aged 92, was born in 1928 or 1929. He appears to have come from a modest background; his father, who died when Leeks was a young man, was a carpenter. His paternal grandparents however, who had emigrated to New Zealand from England, both came from quite wealthy families. Leeks’ great-grandfather, Thomas Harvey Lowry, was a physician and proprietor of a private lunatic asylum in West Malling, Kent. Leeks’ wife, Priscilla Morgan, came from a family of doctors on her mother’s side. Both Leeks and his wife had lost a brother in WWII.

According to the New Zealand Medical Register, Leeks graduated in medicine in 1960 and obtained his conditional registration in 1961. By the time he graduated he was in his early thirties and already married with a daughter (two more daughters would follow). What had he been doing before studying medicine? He appears to have alternated time spent at University with time spent working as an insurance clerk.

In 1950 he featured in the Otago Daily Times (17 April) under the heading “Student injured at rugby”

“Head injuries and concussion were received by Selwyn Leeks, a student at Carrington Hall, aged 21, while he was playing Rugby football on Saturday for the University C Team in a match against Training College at the University Oval. It is understood that Leeks was knocked out in a scrum. He was admitted to Dunedin Public Hospital at 4.45 pm on Saturday, and last night his condition was reported to be satisfactory.”

Is it possible that this head injury could go some way towards explaining his subsequent behaviour? 

The electoral roll shows the family living at Hawkes Bay Memorial Hospital in 1963 and then Leeks spent some time in England. I have only been able to find one sighting of him in England, and that was in the British Journal of Psychiatry in April 1971 when he was listed as having become a member of the Royal Medico-Psychological Association. He was described as an assistant psychiatrist at Shenley Hospital in Hertfordshire. However, by the time the list was published, he was back in New Zealand. The Manawatu Heritage website, where there is a photograph of a smiling Leeks, says: 

“Dr Leeks took up employment with the Palmerston North Hospital Board in January 1971, after returning to New Zealand from studying overseas. As part of his work, Dr Leeks was in charge of the adolescent unit at Lake Alice mental hospital. In January 1978, Dr Leeks left Palmerston North to go to Melbourne to take up a position as a child psychiatrist.”

He left without his wife, who stayed in New Zealand. 

Leeks appears to have published very little; I could only find one case report about something unrelated to his time at Lake Alice. So it is impossible to say where his ideas about giving young people ECT or painful electric shocks came from. I did however find him quoted as saying: “If you want to get people back as economic units of society then you get on with treating them — you don’t play therapeutic games with them.”*

Was this what he was trying to do at Lake Alice? If so, he was singularly unsuccessful. He should have heeded the proverb, “Physician, heal thyself”. Investigations and inquiries don’t come cheap, quite apart from the 12.8 million NZ dollars paid out in compensation to survivors of Lake Alice. If you must reduce people to economic units of society, then Leeks definitely comes out on the debit side.

*New Zealand Herald, 20 December 1976, quoted in Hilary Haines, Women, psychiatry and shock treatment, Broadsheet, April 1978 

Posted in 1970s, ECT and young people, ECT worldwide | 1 Comment

Lake Alice: history

In June 2021 the Royal Commission of Inquiry into Abuse in Care in New Zealand between 1950 and 1999 spent two weeks hearing evidence about what occurred at the Lake Alice Child and Adolescent Unit in the 1970s. 

“The Inquiry will investigate what happened to children and young people at the unit, and why it happened. It will investigate what the Government, Police and professional bodies did to prevent and respond to abuse of children and adolescents in the unit.”

Lake Alice (1950-1999) was a rural psychiatric hospital near the town of Bulls in the Rangatikei district of the Manawatū-​Whanganui region of New Zealand’s North Island. In 1987 it had 250 patients. It included a maximum security unit and, from 1972-1978, a unit for children and adolescents, run by Dr Selwyn Leeks. The unit was described by MP Jonathan Hunt in House of Representatives in 1977:

“The unit is housed in an old building which has been adapted for children. It does not give the appearance of being a supportive environment for severely disturbed children. It is staffed by a psychiatrist, Dr Selwyn Leeks, employed by the Palmerston North Hospital Board; a psychotherapist employed full-time – Mrs Priscilla Leeks; three other therapists, who do eight part-time sessions; and 8 nurses rostered to care for 46 children…. The unit was opened in 1972 with 12 beds, and now caters for 46 disturbed children aged between 8 and 15 – which makes it the largest residential unit in New Zealand. It takes patients on a national basis. One-fifth of the children are psychotic, one-third are neurotic, and the rest are behaviourally disturbed, according to statements made by Dr Leeks in the Auckland Star on 15 December 1976. The majority of the children are in the unit because of family problems, expulsion from schools, and what are referred to as ‘character disorders’.”

As early as 1974, concerns had been raised by an educational psychologist, Craig Jackson, about the use of ECT at the unit. The Royal Commission heard how the superintendent of Lake Alice Hospital, Dr Sydney Pugmire, had responded with a letter to Craig Jackson’s boss, the chief educational psychologist, saying he had investigated the unit’s therapeutic techniques and found the “anxieties of the educational psychologists were completely unfounded”. However he said that Dr Leeks had agreed to discontinue the use of ECT without anaesthesia and the use of ectonus (a technique which delivered smaller, painful, sub-convulsive shocks). Craig Jackson continued to raise concerns about the punitive use of ECT at the unit.

In 1976 the media were calling for an investigation into the unit. In 1977 there was an inquiry by magistrate William  Mitchell into the treatment of a Niuean boy, who had been given ECT both with and without anaesthesia at Lake Alice. The report exonerated the staff at Lake Alice, saying that the treatment was necessary because of the boy’s “acute psychotic depression”. 

The Mitchell Report was quickly followed by a report by ombudsman Sir Guy Powles into the treatment of a 15-year-old boy at the unit. This report was more critical of the treatment given at the unit, saying that the boy had been subjected to a “grave injustice” and that ECT should only be used in exceptional circumstances, and with anaesthesia.

Meanwhile the Medical Council investigated a complaint against Leeks but took no action against him. The unit was closed in 1978, Leeks having moved to Australia, taking with him a certificate of good standing from the Medical Council.

In the 1990s two former patients of the Lake Alice unit took legal action and were eventually awarded an out-of-court settlement. In the meantime a class action had been initiated and an apology and ex-gratia payment was given to 95 former patients. Judge Sir Rodney Gallen was appointed to apportion compensation between claimants and wrote a damning report about the unit. The government tried unsuccessfully to prevent publication of the report.  A further group of claimants came forward and also received settlements. In all $12.8 million in compensation was paid to 195 victims, although some of this money went to lawyers.

The police decided in 2010 to take no action against former staff at Lake Alice, including Leeks. But a survivor took their case to the United Nations Committee on Torture, whose report persuaded the New Zealand Government to re-open the case and include a case study of Lake Alice in the Royal Commission of Inquiry into Abuse in Care.

In future posts I will look at testimony given to the Royal Commission, and at the career of Selwyn Leeks.

The information in this post comes from:

House of Representatives Parliamentary Debates 1977 pp 416-17

David Williams: First they were tortured, then the state failed them, 28 June 2021, Newsroom website

Anniversary of United Nations Committee against Torture decision, 23 January 2021, NZ Human Rights Commission

Posted in 1970s, ECT and young people, ECT in the media, ECT worldwide, Legal cases | Leave a comment

ECT: what do you wake up from?

When someone undergoes electroconvulsive therapy (ECT), what do they wake up or come round from afterwards? Some patient information leaflets are explicit: 

“They [qualified staff] can help you with the process of waking up from the anaesthetic…” (Royal College of Psychiatrists 2020 leaflet)

“After your treatment, and while you’re still under the anaesthetic, you’ll be moved to the recovery area. You’ll be given oxygen and monitored closely by a nurse until you come round from the anaesthetic safely.” (Southern Health NHS Foundation Trust leaflet)

“You will then be moved to the recovery ward to wake up from the anaesthetic… “ (The Royal Australian & New Zealand College of Psychiatrists leaflet)

At first sight it makes sense. We are all familiar with the concept of anaesthesia: you are given an anaesthetic, have your medical procedure and then come round from the anaesthesia. Why should ECT be any different?

I was left pondering this question after reading an article published in the British Journal of Psychiatry in 1968 (“A comparison of techniques in electro-convulsive therapy” by M. Valentine, K.M. Keddie and D. Dunne) which compared bilateral/unilateral and sinewave/brief pulse ECT. The patients being given bilateral sinewave ECT took four times as long to regain consciousness as those being given unilateral brief pulse ECT. If it had been the anaesthetic keeping them unconscious, then there would have been no difference between the groups.

In fact, the anaesthetic is only intended to keep you unconscious for just long enough to administer a muscle paralysing drug and electric shock. This is made clear in an ECT policy document from Western Health and Social Care (Northern Ireland) when it says, in the section on anaesthetics, that further anaesthesia may be required if the first electric shock does not produce a seizure:

“If the response to stimulation is not sufficient then the psychiatrist may wish to restimulate. This may require a further bolus of Propofol and may require another bolus of Suxamethonium if spontaneous ventilation has returned”.

In the section on guidance for nursing staff, however, the document reverts to the usual talk about coming round from the anaesthetic:

“Once the patient has come round from the anaesthetic they hand the care of the patient back to the escort nurse.” 

When ECT is given without anaesthesia there is still a period of unconsciousness following the seizure. Writing in the journal Heart in 1948, R. Kauntze and G. Parsons-Smith say: “consciousness is recovered in from four to fifteen minutes minutes – a consciousness clouded by disorientation and amnesia.”

Quite what you call this period of unconsciousness following the electric shock and seizure, I don’t know – a post-ictal coma, or post-ictal state? Whatever you call it, the question arises: why have psychiatrists tried to write it out of descriptions of ECT?

Posted in 1940s, Miscellaneous, Techniques | 2 Comments

ECT patient information leaflets

Psychologist Christopher Harrop and colleagues have recently (June 2021) published an article in the journal Ethical Human Psychology and Psychiatry: “How accurate are ECT patient information leaflets provided by mental health services in England and the Royal College of Psychiatrists? An independent audit.”*

The authors looked at 36 patient information leaflets about electroconvulsive therapy (ECT) that they obtained via the Freedom of Information Act. A further 15 trusts that use ECT did not, for one reason or another, provide a leaflet. They also looked at two leaflets (2019 and 2016) from the charity Mind, and three leaflets (2007, 2012 and 2019) from the Royal College of Psychiatrists.

An accuracy score was devised by giving leaflets a point for any of 29 accurate statements and deducting a point for any of 11 inaccurate statements.

Firstly the authors looked at how many trust leaflets included each of the statements. At this stage the Mind and Royal College leaflets were excluded.

The most common statement to be included was “Average number of ECTs in a series stated
(about ten)”, found in 35 of the 36 leaflets. A mention of general anaesthetic was included in 34 leaflets, mention of electricity/current applied to the head/brain was included in 34 leaflets, so too was mention of a seizure/fit/convulsion. How, I wonder, did two trusts manage to write a patient information leaflet without mentioning electricity? Or perhaps they were vague about where it was applied. All the above were positive-scoring statements. As far as negative-scoring, or inaccurate, statements were concerned, the most common were “Unevidenced claims of very low mortality rates” (28 leaflets), and “Any minimization/denial of memory loss in terms of severity or prevalence…” (23 leaflets).

By combining the positive and negative scores, the authors produced a league table of leaflets. The top two places went to the two Mind leaflets, scoring 19 and 16. The authors say: “The current Mind leaflet (2019) is the only leaflet to include none of the 11 inaccurate statements.” I would take issue with the authors here as I think the Mind leaflet’s statement “The ECT machine will deliver a series of brief, high-voltage electrical pulses” qualifies as minimizing size/strength of current in so far as it refers to brief electrical pulses, as in fact machines deliver one electric shock rather than pulses, which is just a reference to the wave form of the current – a very technical detail. High-voltage incidentally, while certainly not minimising, is not a particularly useful description as the term has no commonly accepted single definition. None of the leaflets included information about electrical parameters (volts, milliamps, etc).

Leicestershire was the highest placed trust, with 15 points. At the bottom of the table was Oxleas, with minus two points. Neither trust’s leaflet is available online. However, I did find an on-line leaflet from the Cornwall Partnership (joint second to last). The introduction to the leaflet says:

During treatment, a tiny amount of electric current is sent to the brain. This affects the entire brain and repeated treatments alter the brains chemical messages bringing them back to normal.

The leaflet itself continues in similar vein. It looked familiar; my guess would be that it was cloned from an old Royal College leaflet, one that pre-dates the 2007, 2012, and 2020 Royal College leaflets cited in the audit. I searched for one particular phrase in the leaflet, about patients recovering their ability to work and “lead a productive life”. What I wonder is a productive life? Is there a rating scale? And has anyone ever counted how many people recover their ability to work after ECT? Not surprisingly, a search for the productive life phrase took me to an Oxleas magazine article, where I also found an almost identical sentence about chemical messages being brought back to normal. More surprisingly it took me to 2004/05 ECT statistics from New Zealand and a 1994 written answer in the United Kingdom Parliament. Eventually I found the original – a 1993 leaflet from the Royal College.

The authors of the audit conclude:

While there were many instances of exaggerating positive outcomes and minimizing negative outcomes, there was not a single instance of minimizing positives or exaggerating negatives. The bias was unidirectional and consistent. This implies that the inaccuracies represent systemic, institutional bias. Perhaps one motivation for this bias is a fear that if people are told the whole truth even fewer will voluntarily accept the treatment.

*Christopher Harrop, John Read, Jim Geekie, Julia Renton, “How accurate are ECT patient information leaflets provided by mental health services in England and the Royal College of Psychiatrists? An independent audit.” Ethical Human Psychology and Psychiatry, Volume 23, Number 1, 2021.

Posted in ECT in the UK, Miscellaneous | Leave a comment