[NYAPRS Enews] LG, TU: State Urged To Ban Electroshock On Minors

[Matt Canuteson]

NYAPRS Note: Thanks in large part to the longstanding efforts of
ex-patient and survivor advocates currently associated with We the
People and the Opal Project and with the full support of OMH
Commissioner Michal Hogan, the NYS Office of Mental Health released
stricter guidelines last week for the use of electroshock on children
under 16 (see http://www.nyaprs.org/Pages/View_ENews.cfm?ENewsID=7980).
Two corrections to the bottom Times Union piece: NYAPRS does support a
ban for ECT for children under 16 as it seeks strong state oversight and
informed choice patient protections for ECT use in adults, and the
article quotes John Allen rather than John Daniels. Tuesday's events
were attended by longtime advocate Linda Andre, who appeared at a book
signing for her new book 'Doctors of Deception' at the Book House
Wednesday night (for more details, see
http://rutgerspress.rutgers.edu/acatalog/Doctors_of_Deception.html).   

 

State Urged To Ban Electroshock On Minors

By Jamie Fuller Legislative Gazette  July 20, 2009

 

Human rights activists gathered on the East Lawn of the Capitol last
Tuesday to ask for legislative support for a ban on electroshock therapy
for minors - a ban put in effect in many other states already.

 

Electroshock therapy, or electroconvulsive therapy, involves running
electricity through the brain to cause a seizure, and has been used in
psychiatry to treat mental illnesses and severe depression for 70 years.

 

An estimated 100,000 people every year receive ECT, according to Mental
Health America, and the American Psychiatric Association, the American
Medical Association and the National Institute of Mental Health define
it as "a safe and effective medical treatment for certain psychiatric
disorders."

 

The protesters and mental health advocates are not calling for a
complete ban on ECT; they want the state to ban the treatment for people
under the age of 16 who cannot provide consent for the therapy.

 

Texas, California, Colorado and Louisiana are among the states that have
banned the use of ECT on people under age 16, and many other states have
laws that regulate the use of ECT. Lauren Tenney, organizer for The Opal
Project and We the People, the groups behind the 24-hour vigil and
demonstration at the Capitol, said a legislative ban on ECT for children
must be the next step for New York.

 

Assembly Felix Ortiz, D-Brooklyn, is proposing legislation that would
place many restrictions on electroshock treatment, including the ban for
children under age 16 the protesters seek (A.8779). We the People and
other organizations that provided support at the demonstration on July
14 hope the event will end their search for a senator to sponsor this
legislation, a hope that may be dim with the backlog of legislation the
Senate needs to pass due to the month of inaction and power struggles.

 

According to the state Office of Mental Health, 134 - 1.3 percent -
individuals out of the approximately 10,000 adult patients served in
OMH's inpatient service received ECT in 2000. The rate receiving ECT in
non-OMH facilities is 1.8 percent. The number of individuals receiving
ECT has risen 45 percent from 1990 to 2000-from 74 to 134 patients.

 

"I felt very depressed, in a case of hopelessness - I was in a very
vulnerable state," said Mariann Merlino, a demonstrator who received
four ECT treatments. My neighborhood psychologist said that ECT might
help, and I was reluctant at first. Eventually, I got so depressed, so
hopeless, that I agreed to it."

 

Merlino fits the description of the typical ECT patient today;
two-thirds of ECT patients are women, and half are over 65 in age. The
change in demographics from the young male patient of the mid-20th
century may be attributed to the aging of the baby boomers, and the fact
that Medicare covers some electroconvulsive treatments.

 

"When I went in for my first treatment, people were lined up outside the
door," said Merlino. "It was like ECT day."

 

Afterwards, Merlino said she regretted having the ECT treatments and was
relieved she only decided to have four.

 

"I pushed myself out of the downward spiral, but not with [the help of
my psychologist.]," said Merlino. "I ordinarily never would have done
this."

 

Instead of electroconvulsive therapy, the demonstrators advocate
alternative options such as support groups to help people who are
considering the controversial treatments.

 

"The best alternative for young people is setting up support networks,"
said Tenney. "Looking at the spirit of young people and treasuring it,
instead of locking them down and shooting them up with drugs."

 

Stephanie Orlando, director of Youth Power, a statewide group for young
people with disabilities or socio-emotional challenges, attended the
demonstration as a younger voice among many of the older organizers. She
also stressed the importance of support networks as the first treatment
for depression and other psychiatric disorders.

 

"For us, it is about the youth, and ensuring that they are given
services that help," said Orlando. "People should be told that ECT
should be a last resort, and alternatives like peer support need to be
given. Simple things like a person with a shared experience can be
helpful."

 

The state Office of Mental Health released a practice advisory on July
13, recommending the use of ECT on individuals under 18 only in "those
rare instances where other treatments have proven ineffective." However,
a complete ban on ECT for minors is unnecessary, according to OMH
because the treatment is hardly ever used on minors.

 

"It is a very rare procedure to begin with," said Jill Daniels, OMH
acting director of public affairs. "For ages 16 years and younger, we
can go back three years and find [ECT] in no state psychiatric
facilities. It is private practitioners who do this, and even then, it
is only about four children per year in the United States. It is not
something that is a wide practice."

 

Tenney has seen the advisory released by the OMH, and said it is not
enough. She said money is the reason she and other activists believe
nothing has been done to challenge the psychiatric industry in New York,
stating that ECT specialists make $400,000 - double that of other
psychiatrists.

 

http://www.legislativegazette.com/printable.php?id=4015 

----------

 

Shock Treatment Stirs Debate In State

Woman Who 'Lost Years' Works To Ban Procedure

By Paul Grondahl, Albany Times Union  July 18, 2009

 

They are lost years for Linda Andre.

 

Andre was a graduate student studying writing and photography at New
York University when she was subjected to involuntary electroshock
therapy in 1984 during a period of severe depression and commitment to a
psychiatric hospital.

 

"Those years were taken away from me, just erased. I have no memory of
several years after I was told shock treatment was harmless. I'll never
get those years back," said Andre, author of a new book critical of the
controversial treatment in which a jolt of electricity is sent though
electrodes attached to a person's temples at a level that produces a
grand mal seizure in the brain.

 

The 49-year-old New York City resident was in Albany this week to lobby
legislators to pass a bill banning shock treatment on children and to
take part in a protest in front of the state Office of Mental Health.
She also planned to sign copies of her book, "Doctors of Deception: What
They Don't Want You to Know About Shock Treatment," recently published
by Rutgers University Press.

 

Andre has become a leading voice in a national debate over electroshock
treatment, pitting patients who say they received relief from crushing
depression by being shocked against people who say it did not work and
left them with serious memory loss and other cognitive impairments.

 

Electroshock treatment, which is legal in New York and most states, is
depicted in memorable and horrifying scenes in movies ranging from "One
Flew Over the Cuckoo's Nest" to "The Changeling."

 

The American Psychiatric Association and other medical experts, however,
as well as federal and state regulators, consider shock treatment done
with a patient's consent and under accepted guidelines to be a
relatively safe and effective means to combat severe and chronic
depression among patients who have considered suicide and for whom other
treatments have not worked.

 

More refined equipment and techniques have improved shock treatment to
the point that it no longer resembles the barbaric, gruesome cinematic
images or the way it was routinely administered as recently as two
decades ago, its supporters say.

 

A leading proponent of shock treatment is Kitty Dukakis, the wife of
former presidential candidate and Massachusetts Gov. Michael Dukakis,
who in her 2006 book, "Shock," credited the "last resort" treatment with
saving her life after a lifetime of depression, battles with drug and
alcohol addiction and 25 years of taking antidepressants.

 

But a group of advocates, led by Andre, are seeking an outright ban of
electroshock treatment, as a handful of states, including Texas, have
adopted.

 

"There is no such thing as a safe amount of shock. That's a myth. Any
current through your brain is too much current," Andre said.

 

On Monday, in advance of Tuesday's protest, state OMH officials released
a policy advisory that requires tighter restrictions and additional
limits on the use of shock treatment, also known as electroconvulsive
therapy, on children under the age of 16.

 

Among the new policy requirements for patients under 16 are these:

*         A thorough psychiatric assessment by independent experts.

*         Written consent of the parents or legal guardians, along with
written consent of the child when feasible.

*         A medical examination to screen for conditions that could
increase risk of impairments.

*         A test of memory skills before, just after shock treatment and
several months later as a follow-up.

 

In practice, shock treatment is rarely administered to children in New
York.

 

In the past three years, no children were given shock treatment in a
dozen state-operated psychiatric facilities that treat children. About
four children on average were treated with shock by private
psychologists, according to OMH records.

 

Among teens between 16 and 18, an average of about 35 youths were given
shock treatment each of the past three years, all by private
psychiatrists and none at state facilities.

 

Among adult psychiatric patients in the state, the use of shock
treatment peaked at about 2,000 individuals in 1999 and has since
declined to an average of about 1,600 adults each year currently.

 

"I know people on both sides of the fence on this issue and they're both
right," said John Daniels (NYAPRS note: should be John Allen), a special
assistant to the commissioner of OMH who spearheaded the new policy for
shock treatment on children.

 

"It's true that people like Linda were irreparably harmed years ago.
It's also true that other people right now say nothing else helped and
this saved their life," he said.

 

Harvey Rosenthal, executive director of the New York Association of
Psychiatric Rehabilitation Services, an advocacy group, praised the
efforts of Andre but stopped short of supporting an outright ban (NYAPRS
note: should say 'for adults') if strict regulations, oversight and
informed consent are enforced.

 

"Linda and other advocates have battled courageously to bring about
long-overdue regulations and protections," Rosenthal said.

 

The crux of the issue for Daniels (Allen) is informed consent.

 

"Both sides have very strong opinions on this, but the last thing I'd
want is a group of protesters banning a private decision based on free
choice," he said.

 

http://www.timesunion.com/AspStories/storyprint.asp?StoryID=821203

 

 

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