While I was looking for examples of psychiatrists who refer to the current used in electroconvulsive therapy (ECT) as small, in spite of the fact that it is actually in the region of 750-900 mA, I came across this publication from the West London Mental Health Trust (WLMHT). The WLMHT is based at the St Bernard’s Hospital site in Ealing (what used to be Hanwell Asylum).
The leaflet starts off by describing ECT as a treatment for schizophrenia:
“In spite of having had a bad press in the past, electroconvulsive therapy (ECT) can be very effective at relieving symptoms for people with strong and persistent negative symptoms of schizophrenia. Some people with schizophrenia are determined to take their own lives, and in such situations the treatment can have a very rapid and positive effect”.
A small percentage of ECT patients in England (about 7 per cent in 2002) do have a diagnosis of schizophrenia, but in the UK ECT is most commonly used in the treatment of depression. And even when ECT was used more widely for the treatment of schizophrenia it was thought to be useful in treating positive, rather than negative symptoms.
The next bit of the leaflet is taken from the Royal College of Psychiatrists’ leaflet on ECT and the Care Quality Commission’s leaflet on consent to treatment. At least it is reasonable for a hospital in England to use publications from the Royal College of Psychiatrists or the Care Quality Commission as a template for their patient information publications. It is the second half of the leaflet that is the real problem.
“Electroconvulsive therapy is usually given three times a week“. In England ECT is usually given twice a week. Perhaps WLMHT is unusual and actually does give people ECT 3 times a week.
“Up to half of those having electroconvulsive therapy experience a relapse within six months. Consequently, the WLMHT care team may also prescribe antidepressants, lithium or further electroconvulsive therapy at monthly or six-weekly intervals“.
Maintenance or continuation ECT is used by a few psychiatrists in England – perhaps it is used at WLMHT. But the problem with all this is that it was taken from this website and comes from a book by Demitri Papolos published in the 1980s in the United States, where ECT is usually given 3 times a week and maintenance or continuation ECT is more common. Different countries have different practices when it comes to ECT, and what happens in America isn’t necessarily what happens in the United Kingdom.
“WLMHT is audited and has been commended for the quality of its ECT treatment“, they tell us twice, but I wonder if the auditors looked at the information leaflet?
At least the leaflet isn’t illustrated with a picture of American models. Instead there is a picture of a machine, but I am not sure that it is an ECT machine. It appears to have an air pressure gauge (perhaps ECT machines do have air pressure gauges – I don’t know).