Electroconvulsive Therapy Background Paper - ECT As a Treatment for Serious Mental Illness

Written by RESEARCH-ABLE, INC.

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Respondent indicated that research is needed on long term effects, positive as well as negative:

"Some people seem to respond only to ECT. Any treatments that are less daunting or undignified would be desirable ... ECT is a flash point for consumers. Health care professionals want to use what is readily available and take the easy way out, particularly in difficult situations. They have to be more sensitive to the issues of rights and choices ... They need to have better empathy with the feelings of families in this regard ... From a research standpoint, it is important to know how ECT is being used, how often and why, and to make sure it is not being abused."

National Alliance for the Mentally Ill (NAMI (Ron Honberg)

NAMI is a grassroots organization composed of families and friends of persons with mental illnesses and persons recovering from mental illnesses. Excerpts from a NAMI statement related to ECT follow:

"NAMI does not endorse any particular treatment or services. While not endorsing any particular form of treatment as a matter of policy, NAMI believes that access to treatments for individuals with mental illnesses that have been recognized as effective by the FDA and/or the NIMH should not be denied. NAMI therefore opposes measures that are intended to or actually do limit the availability and rights of individuals with mental illnesses to receive Clozaril (Clozopine), Fluoxetine (Prozac) and/or electroconvulsive therapy (ECT) from appropriately trained and licensed practitioners. These treatments are being singled out by NAMI because of ongoing efforts by various individuals and organizations to limit the rights of individuals with mental illnesses to receive them."

"In accordance with scientific evidence, we feel ECT is an effective, sometimes lifesaving treatment. I know many that feel ECT has saved their lives. That is not to say it has not been inappropriately used, especially in the 1940's and 1950's. But the treatment should be available to people who do not respond to other treatments. We are opposed to efforts to ban ECT. This would be an inappropriate and grave injustice to those who really need it ... Involuntary administration rarely happens. Given the controversial history and the dramatic nature of the treatment, most of those using it are extremely cautious ... People who need it most may not be in a position to accept the fact they need it. Involuntary administration should be the very last resort. There should always be a surrogate acting for the patient. Every step should be taken to minimize any consideration of involuntary ECT."

"We feel strongly that it should be among the treatment options. We are aware of side effects and short-term memory loss. We don't minimize these, nor downplay the fact that it is a powerful and dramatic treatment. On the balance, though, the benefits and detriments show evidence on the positive side. It may produce short-term memory loss, and may be permanent regarding the events surrounding the actual treatment. However, there is no evidence that the severe memory loss is permanent."

"The majority of our members feel it is important not to make this a political issue. As far as alternative treatments go, less invasive treatments should be tried for major depressions. ECT should be used only when people don't respond to traditional treatments. Persons should be fully apprised of the risks and benefits of the treatment. Significant family members in care giving roles should be fully informed regarding benefits and potential detriments."

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