On Tuesday The Age, a newspaper in Victoria (Australia), ran a story which began:
“Premier Ted Baillieu last night ordered a wide-ranging inquiry into dozens of patient deaths inside Victoria’s mental health system.
The inquiry follows a report in The Saturday Age exposing the high rates of unexpected and unnatural deaths in the state’s mental health wards, and raising serious questions about standards of care and allegations of cover-ups.”
The article went on to discuss the use of electroconvulsive (ECT) therapy in the state of Victoria.
In 2009-10, the article said, ECT was given to 1,111 people in public hospitals, and about 640 in private hospitals. This is a high use of ECT. Victoria has a population of about 5.5 million. In terms of population size it is similar to Scotland (population about 5.2 million) but it is using over four times as much ECT.
About one third – 377 – of the people receiving ECT in the public mental health system in Victoria were being treated without their consent. The Age had put in a freedom of information request and discovered that those 377 people were accounting for more than half the 12,968 individual treatments given. They were therefore receiving longer courses than consenting patients.
The article went on to say that ECT use in Victoria had increased by 12 per cent since 2003-04 in the public mental health system, and by 71 per cent in the private mental health system over the same period.
The inquiry into patient deaths announced by the premier of Victoria is to be conducted by Victoria’s chief psychiatrist, Dr Ruth Vine. An article in Friday’s edition of The Age is calling for her to be replaced as head of the inquiry by someone independent.
Ruth Vine was interviewed for Tuesday’s article:
Dr Vine recently attributed the rise in private ECT treatments to an increase in psychiatric beds in the private sector and more patients choosing to use the procedure to combat depression. Dr Vine said ECT was a safe and effective form of treatment.
”The biggest issue (with ECT) I have to say is the difficulty we have in shaking community perception about this being in some way negative when for many people it is a very effective treatment,” she told The Age.
”As a treating doctor, to see someone with a really severe melancholic depression who is absolutely convinced that they’re riddled with guilt and should be dead, to see that just melt away with a reasonably short course of ECT, it is one of the miracle treatments.”
Victoria is the only Australian state that doesn’t require authorisation from an independent psychiatrist before people can be given ECT without their consent. If someone is considered incapable of consent then their psychiatrist can go ahead and give them ECT; people considered capable of consent who don’t agree to have ECT can be treated if their psychiatrist thinks ECT is “urgently needed.”
Clinics which use ECT in Victoria have to be licensed and the requirements for licensing are set out in the government’s Electroconvulsive therapy manual. On page 17 it says:
“Every person, whether voluntary or involuntary, for whom ECT is proposed must be given a copy of the prescribed booklet Electroconvulsive therapy – About your rights available at www.health.vic.gov.au/mentalhealth/patientrights/downloads/ect.pdf
This applies whether the person is being treated by a private or public mental health service.”
If The Age’s figures are right, people undergoing ECT without their consent in Victoria are having on average over 15 treatments each. Yet the compulsory booklet says that “ECT usually consists of six to twelve treatments given 3 times a week over about a month”.