ECT is used mainly in the treatment of severe depressive episodes. It involves the passage of an electric current across the head of a person to produce a convulsion. The treatment is painless, as the individual is given general anaesthetic and muscle relaxant before and during ECT. It is used when antidepressant medication has not been effective, the severity of symptoms means it is not possible to wait for the effects of such medication to become apparent, or the side-effects to or risks associated with medication make ECT the most appropriate treatment option.
ECT by its very nature arouses anxiety in patients and families as well as a high degree of interest from the public despite numerous reviews of published studies showing ECT is a safe and important treatment option. Because of this high level of public interest the Government agreed to a Health Select Committee recommendation for a comprehensive review of New Zealand and overseas literature and of legislation to ascertain the effectiveness and safety of ECT and of the regulations surrounding the use of this treatment.
Independent review of ECT
The independent review of the medical evidence for ECT concluded that its use is appropriate for treating some serious mental disorders, and banning its use would deprive some seriously ill patients of a potentially effective and sometimes lifesaving means of treatment.
The review group considered the current regulatory controls for ECT needed to change. They recommend that where possible ECT use should only be administered with the patient’s consent, noting that patients should be able to refuse treatment in advance when regarded as competent to make this decision.
ECT delivery audit
In mid-2002 the Ministry of Health established baseline data on the quality of ECT delivery. The audit concluded that ECT is being delivered safely in New Zealand, while highlighting areas of service delivery that could be improved. Already changes have been implemented as a result of feedback provided from the audit to District Health Boards.