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Minimise use of ECT

• The Irish Independent carried a report (April 1) stating that Electroconvulsive Therapy (ECT) "is recognised as an effective treatment for severe depression for many people who do not respond to other conventional therapies".

The effectiveness of ECT for severe depression is still subject to some debate.

It is important to bear in mind that ECT is a controversial treatment whose benefits are far from clear cut. There are differences of interpretation of the evidence regarding its efficacy. These differences may centre on whether short- or long-term effects are measured.

Some researchers claim that ECT has been shown to be effective in the short term in the treatment of severe depression. However, a 2005 study for the UK's National Health Service found that there was little evidence that ECT is effective in the long term, and that the short-term improvements are achieved only at the expense of an increase in cognitive impairment.

It is also important to note that these assessments of effectiveness are based on the doctor's report, and may not always tally with the patient's own experience.

ECT is an invasive treatment and should be one of last resort.

Although the Government has agreed that ECT should not be used against an individual's will, it is of serious concern that on three occasions in 2011 and once in 2012 individuals were given ECT against their will.

Legislation to prohibit the administration of ECT against an individual's capable will is needed as a matter of urgency.

Under its remit to promote high standards in the delivery of mental health services, the Mental Health Commission should do everything in its power to minimise the use of ECT in Ireland.

Orla Barry

Director, Mental Health Reform

Trinity Street, Dublin

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