Controversial Electroconvulsive Therapy has been in the news after the Sunday Mirror and Sky News revealed that it is used on teenagers with mental health issues.
The article states:
“Figures obtained under the Freedom of Information Act show that from 2016 to 2018, 5,165 patients were given shocks to the brain as high as 460 volts.
“The patients were aged 16 to 98. The total number of teens treated is not identified but a separate report seen by the Mirror shows one in six NHS Trusts administered ECT to under-18s.”
Actually, it is understood that these figures underestimate the reality as they are based on just 37 out of 50 mental health trusts, nearly all of which use ECT.
Professor of Psychology John Read told the Mirror:
“There can be no justification for giving ECT to teenagers. Their brains are still developing – and we know what it does to adults. In older adults it speeds up dementia.”
The Mirror also reported that:
- Over a third of cases had ECT given without patient consent
- 30% of trusts administer ECT without seeking a second opinion
- 70% of patients reported memory issues after treatment
However, supporters of the treatment argued that ECT can be a good option where other therapies had failed as an intervention which can be rapid, direct and relatively cheap for the NHS to administer to the most serious cases.
Further to the article in the Sunday Mirror, Barbara Keeley, shadow minister for mental health, said:
“The use of electroconvulsive therapy on children and young people with mental health conditions by NHS trusts is deeply concerning and warrants immediate investigation by the government and NHS England. Even in adults this treatment ought to be a last resort.”
The Royal College of Psychiatrists issued a statement defending ECT:
“Electroconvulsive therapy is a safe and effective treatment for many depressive illnesses, and it can act much faster than drugs. There is unmistakable evidence of this. Most people who receive ECT have much improved outcomes.
“ECT has been shown to be most effective to people at the more severe end of the spectrum.”
Yet Dr Joanna Moncrieff, of University College London, told Sky News that she had concerns about the use of ECT, especially on younger patients:
“If ECT works at all it jolts people out of a state of depression temporarily, but there’s no evidence that it has long-term benefit and there is evidence it causes long-term memory problems and lasting damage.
“I think it’s not worthwhile in the vast majority of cases, if at all. We just don’t have enough research on what ECT does to the brain and the developing brain in younger people.
“We know it can cause permanent memory loss, so it suggests it may do permanent damage. We know younger brains are more vulnerable to drugs, for example, so they are likely to be more damaged by ECT.
“Giving it to younger people is a worry.”
Professor John Read added:
“There’s been no research whatsoever into the efficacy or safety for children. The managers of the trusts need to rein in these psychiatrists immediately.”
ECT Therapy
Electroconvulsive therapy does have some undeniably negative connotations, whether it’s due to associations with One Flew Over the Cuckoo’s nest or historical use of the treatment without using anaesthetic or without full and informed consent.
Nowadays ECT in the UK is reserved for the most severe cases. Treatment is given under general anaesthetic with muscle relaxants to quiet the physicality of the seizures that the shocks induce. Side-effects remain quite common and can be serious and long-lasting. However, the treatment is given in cases of serious need, where the benefits are considered to outweigh the risks
ECT Compared to rTMS Treatment
Transcranial magnetic stimulation offers a new treatment route for severe and treatment-resistant depression. Rather than using electrodes to pass electricity through the brain, magnetic stimulation is used. This does not penetrate the brain as deeply or as aggressively. Yet over a course of treatment, the patient can find their symptoms start to lift in a process known as neuromodulation.
Transcranial Magnetic Stimulation (TMS) is a technological breakthrough in the treatment of depression without drugs and was approved by NICE for treatment of resistant depression in 2015. In addition, TMS can also treat a range of addiction problems and other mental health conditions including anxiety, DPD (Depersonalisation Disorder), OCD (obsessive compulsive disorder), PTSD (post traumatic stress disorder), BPD (borderline personality disorder).
Smart TMS Clinics
Smart TMS was established in 2015, providing TMS treatment at their original South Kensington/Brompton Cross centre in London. The company now has the UK’s biggest network of TMS treatment centres and is committed to further expansion in order to make the treatment available in more cities, reaching patients who need an alternative treatment option for their conditions.
Contact Us
For any other queries or for patients wishing to book an appointment at one of our UK clinics, please contact us:
- Tel: 0345 222 5678
- Email: info@smarttms.co.uk
Irish patients may contact Our Dublin Clinic direct on:
- Email: info@smarttms.ie
- Tel: 353 (01) 254 2514
- Website: www.smarttms.ie