This month has seen three articles about electroconvulsive therapy (ECT) on the Stuff website in New Zealand. One article (Electroconvulsive therapy endures by Michelle Cook) featured a woman who had undergone ECT at Porirua Hospital 56 years ago when she was 18 and had been left unable to remember her childhood.
“She is one of several people to have filed claims against Porirua Hospital for abuse, but says the courts would not look at the use of ECT on her “because it’s allowed”.
“It handicapped me. Before I had it, I felt normal, like everyone else, and afterwards I didn’t feel whole, completely washed out. I was incapable of doing anything and couldn’t talk to anybody any more.” “
The article mentioned some of the main points concerning ECT use in New Zealand: a low and falling rate of use; variation in rates of use between regions; the over-representation of women in the statistics; and a significant minority of patients (deemed to lack capacity) treated without their consent. Psychiatrist Pamela Melding was quoted as saying some things in support of ECT; psychologist John Read was critical of ECT.
Next was an article (Deemed insane as a teen … for being gay by Georgina Stylianou) featuring a woman who had been given ECT in the Princess Margaret Hospital, Christchurch, in the Canterbury region in the 1970s and her attempts to obtain redress.
“In June 2010 the Crown was facing more than 250 claims from former psychiatric patients. Wellington-based law firm Johnston Lawrence led a class action against numerous psychiatric hospitals throughout the country. The firm represented Bellingham for six years. It collected medical records and prepared a detailed statement on her behalf before filing proceedings.
“Lawyers have promised me the world … I used to get excited thinking about it, but all that ever really happened was I got so stressed out by it all.
Former Wigram MP Jim Anderton has supported Bellingham in her fight for compensation. In a letter written to the former associate minister of health Jonathon Coleman, Anderton says: “Joan has expended the majority of an inheritance she received from her parents on legal fees.
“It is unnecessarily cruel to put them (former patients) through the further trauma of court cases and the burden of large legal costs when the matter can be resolved in a compassionate and prompt manner with a settlement payment from the Crown,”
For the past year Bellingham has been represented by Christchurch firm Grant Cameron Associates. She currently has a claim in with the Crown Health Financing Agency. Chief executive Graeme Bell last week told The Press there had been some “positive developments” with “potential settlements” for outstanding claims.
“All I can say is that Joan does have a claim in,” Bell said.
Cameron says from a legal standpoint Bellingham’s case, and many similar cases, “faced some major difficulties given the fact that these events happened so long ago”.
For Bellingham it was never about money or legal battles. “I would love an apology from the people who did what they did to me but I know that can’t happen. But more than anything I just want a life. I wanted to be a nurse, I wanted to be young and happy. I would have gone far as a nurse, I know I would.””
The third article spoke to a woman who had had ECT at Timaru Hospital in the 1960s and wasn’t taking legal action.
“She does not recall any great debate over whether or not she should have the treatment but assumes she must have consented to it.
“I think they went for what they thought you needed,” she said of the treatment options considered by the medical staff.
“I was not dragged screaming to have it. ECT was the thing a lot of people had in the 1960s.” ”
She later was treated experimentally with LSD at theDunedin private psychiatric hospital Ashburn Hall.”
The first of these articles discussed regional variation in the use of ECT in New Zealand. Pamela Melding, who was defending the use of ECT, acknowledged a “clinician factor” in the variation. John Read was more explicit:
“Read, an Auckland psychologist and researcher at Auckland University, says the geographic differentiations are important.
“They’ve been there for a long time and they’re huge. So that tells you that in any district health board it only takes one or two psychiatrists who are very keen on ECT.
“Your chances of getting this quite dangerous and ineffective procedure are quite arbitrary.” “
These “arbitrary chances” of getting ECT are deserving of further investigation, especially as the Ministry of Health defends ECT as a treatment for fairly specific circumstances. The only published survey I could find of ECT use in New Zealand dates from over a decade ago and found that only 60 per cent of the psychiatrists who responded to a questionnaire about ECT had prescribed it in their current post. (J. Strachan 2001 Electroconvulsive therapy – attitudes and practice in New Zealand, Psychiatric Bulletin, 25, 467-470). The author suggested that this “probably reflects the more transient nature of part of the New Zealand workforce”. But it would be interesting to know just how many psychiatrists in New Zealand actually use ECT today, now that it is used even less than in 1999. The Ministry of Health publish statistics on the use of ECT, but only at the regional level, and not at the level of individual hospitals and psychiatrists.
Psychiatrists in New Zealand use less ECT than those in many other countries, and they are even less likely to do any research or write anything about it. The Journal of the New Zealand Medical Association published an article in support of ECT by Pamela Melding (Electroconvulsive therapy in New Zealand: terrifying or electrifying?, 7 July 2006, vol 119, No. 1237) but apart from that New Zealand psychiatrists appear to have been silent on the subject, neither interested in publishing their views on the treatment or conducting any research into ECT.