Proble of Shock Treatments At Riverview Hospital

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New Health Authority To Probe Shock Treatments

Pamela Fayerman
Vancouver Sun

Tuesday, April 30, 2002

The newly created Provincial Health Services Authority is beginning its own probe of an elderly Riverview Hospital patient who has received more than 100 electric shock treatments against his will.

At the same time, the Public Guardian and Trustee's office of B.C. is "pursuing and making inquiries" about alternatives to the electroconvulsive treatments that 71-year-old Michael Matthews has received.

PHSA board chair Wynne Powell said in an interview that he and authority president Lynda Cranston want more information about Riverview's ECT program and the reasons why doctors have administered so many ECTs to Matthews over the past three years.

"Neither of us are medical doctors, but we want the very best standards for patients and obviously we need to rely on professionals. But we need to get to the bottom of this and we'll be drilling down to get the information," Powell said.

Matthews, who has been confined to Riverview for the last four decades, was interviewed recently by a Vancouver Sun reporter and photographer who were later ordered off the Riverview property by hospital security guards.

At the time, Mathews said of his treatments: "I'm braver now, but I don't like it. They hurt, I don't want it."

Matthews' situation was documented in The Vancouver Sun after records of ECT doctors' billings were obtained by Vancouver resident Julie Butler, director of an organization called the Citizens Commission on Human Rights, a Church of Scientology affiliate that exposes, and lobbies against, "psychiatric abuses."

Public guardian and trustee Jay Chalk said he wouldn't discuss his office's investigation, but case manager Linda Irwin advised Butler in a letter that alternatives to ECT are being investigated in the Matthews' case. The public trustee was given jurisdiction over Matthews' financial and legal affairs in July 1997.

Butler has been visiting Matthews for the past several months and was apparently his only visitor, but Riverview authorities banned her from the hospital last week. In a letter sent by hospital lawyers, Butler was told that she was no longer allowed contact with Matthews. The letter stated that "when shown your photograph, Mr. Matthews did not know who you were. . . . "

However, a more recent visitor, mental-health advocate Millie Strom, said that's hogwash.

Strom said when she went to visit Matthews for the first time last week, he did recognize Butler in a photograph and told Strom how much he liked Butler.

"On top of being forcibly shocked and over-medicated, having his only visitor denied is a travesty and another violation of his rights," Strom said.

Meanwhile, the chief executive officer of the hospital announced in an e-mail to employees Monday that today would be her last day as head of the mental institution.

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The reorganization of the health-care system by the provincial government is cited as the reason for the departure of Marion Suski as CEO of Riverview after less than two years.

Suski could not be reached for comment but Powell said that under reorganization plans, the hospital will now operate without its own CEO as the Forensic Institute and Riverview will have a merged corporate structure and will both come under the authority of an as-yet unnamed executive director for mental health programs.

Indeed, all of the hospitals and agencies that were autonomous before last week's reorganization will now answer to an executive director instead of a president/CEO, including the B.C. Cancer Agency, the B.C. Transplant Society and Children's and Women's Health Centre of B.C.

Powell said it is still too early to say how much money will be saved by "repositioning" health executives.

"The system doesn't need multiple presidents. We need to reorganize and rationalize the structure," he said in an interview.

Suski joined Riverview in the fall of 2000, just months before the provincial government of the day launched an external review of the increased number of ECTs performed on geriatric patients.

Some questioned if the increase was tied to a financial incentive on the part of doctors to do ECT. The final report never offered a conclusion on why the ECT treatments had increased since 1997, when doctors were allowed to charge the Medical Services Plan for each ECT performed.

Psychiatrists who do ECT get about $64 for each procedure and the anesthesiologist gets the same amount.

Dr. Jaime Paredes, the psychiatrist who alerted The Vancouver Sun to the ever-increasing volumes of ECT on geriatric patients, lost his job at Riverview over his whistleblowing role.

He had worked there for 15 years.

Cranston, who was only recently appointed to head the PHSA, said she was not familiar with the external review report, which recommended several changes to Riverview's ECT program, including improvement of its database.

In the years since Riverview's program was scrutinized, fewer ECT procedures have been done province-wide.

In 1999, there were 10,028; in 2000, there were 9,331 and in 2001, MSP paid for 8,540 ECT procedures. Riverview Hospital has declined to say how many procedures it has done recently.