SHOCK THERAPY FIRES NEW FURY
THE Hospital Authority is to draw up guidelines to regulate the use of electric shock therapy amid growing concern about misuse of the treatment, one of the most controversial issues in mental health and perhaps the whole of medicine.
Electric shock or electro-convulsive therapy (ECT) is standard treatment for severe depression, which involves attaching electrodes to a patient's temples and inducing a violent fit by passing electricity through the brain.
Alice, a once successful interior designer, describes ECT as a 'barbaric procedure'.
In 1982 she became severely depressed and tried to kill herself. 'I spent six months in a psychiatric hospital,' she said. 'I could not think, I could not even concentrate on the pictures in a magazine.' Alice, who is 41 and has two children, was put on a course of electric shock treatment. 'I felt as if I had been in a fight every time I came round from the general anaesthetic,' she said. 'When I left hospital, my past was a blur. I couldn't remember simple things like what my kids like best to eat. I can read the magazines again but my memory of the past has not returned. I am alive, but life no longer means so much to me.' Critics claim the treatment can be far more damaging to a patient's memory than most doctors admit. Opponents are fighting for stiffer warnings on consent forms so patients will be more aware of the risks.
The British mental health charity, Mind, recently called for ECT to be banned, except when conducted with the patient's clear consent. 'The popular perception is that ECT went out with the workhouses and Victorian asylums. But the fact is that thousands of people are still subjected to electric shock treatment with highly questionable results,' said Judi Clements, the national director of Mind.
As yet, there are no provisions in Hong Kong's Medical Ordinance governing the use of ECT. 'In the past we had very few psychiatrists and many were in private practice so it was difficult to regulate,' said Professor Chen Char-nie, chairman of the Mental Health Association of Hong Kong.
'ECT should not be considered controversial,' he said. 'Complaints about memory loss are very common. Usually after three months or so, they recover. But if someone is extremely depressed and they don't get ECT, they will die. It's as simple as that.' According to a psychiatrist with a practice in Central, 'the problem with ECT is its past abuses. It's a very effective treatment of depressed people who are at death's door. It's been shown in many cases to be more effective than drugs and to produce less harmful side-effects.' Most doctors agree the therapy suffers from a poor image problem. It has been widely misused since Italian doctors first treated a mute schizophrenic boy with a blast of electricity in 1938. In the 1940s and 1950s, it became highly fashionable: patients were strapped down and given electric shock treatment without anaesthetic. The convulsions were so violent they often fractured bones and shattered teeth, and occasionally proved fatal.