ECT without consent in Scotland 2012-2013

At the end of September the Mental Welfare Commission (MWC)  for Scotland published their annual report on monitoring the use of the Mental Health Act. This report covers the period April 2012 to March 2013.

According to the report 147 patients were treated without their consent and with the approval of the MWC and of these 88 “objected to or were resisting the treatment”. One of the non-consenting patients was aged under 18. In addition to the 147 non-consenting patients, a small number of detained patients consented to ECT (16 of the appropriate forms were submitted). The MWC is only interested in detained patients and therefore does not produce statistics on the overall use of ECT.

The report also briefly mentioned neurosurgery for mental disorder:

“In Scotland the Advanced Interventions Service in Dundee remains the only centre offering neurosurgical procedures. Four patients were seen for assessment during the reporting year all of whom were from Scotland. All of the patients had severe intractable depressive illness. For one patient the proposed treatment was the procedure known as Deep Brain Stimulation (DBS). In all four cases the treatment was considered to be in their best interests and form T1 certificate of consent to treatment was issued.”

Deep brain stimulation is regulated in Scotland, but not in the rest of the United Kingdom.

Once again Scotland has lapped Wales in the production of their annual report on the monitoring of the Mental Health Act. The Health Inspectorate Wales (HIW) has not yet published their report for 2011-2012 although it is now more than 18 months after the end of the reporting period.

Meanwhile they have published a report on the killing in 2010 of Karen Welsh by a fellow patient at Whitchurch Hospital, Cardiff. A BBC news item on the publication of the report on 13 September 2013 described the victim as a nurse who had “met the fellow hospital patient while being treated for depression and helped him when he was homeless”. The HIW report however goes into quite unnecessary detail about her treatment, including the fact that she had been given ECT, without suggesting in what way these details are relevant to the object of their report – the treatment received by the killer. The terms of reference of the report included a consideration “of the care Mrs A as far back as her first contact with Mr J whilst under the care of Health and Social Services to gain an understanding of the relationship between Mr J and Mrs A” but she appears to have had ECT many years before meeting Mr J (as the report calls her killer). ECT, the report explains in a footnote, “is a psychiatric treatment for depression in which seizures are electrically induced on an anesthetized patients for therapeutic effect” – a definition copied from the opening line of the Wikipedia article on ECT, something which doesn’t inspire confidence in the authors of the report.

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