Shock therapy’s still being used in Wales

Electroconvulsive therapy – ECT – has a chequered past and remains one of the most controversial elements of modern psychiatry. Contrary to public opinion, it is still in widespread use today in Wales, as Health Editor Madeleine Brindley reports

THERE is a short scene in the seminal film One Flew Over The Cuckoo’s Nest, in which Jack Nicholson is restrained and subjected to electroconvulsive therapy, known as ECT.

It is an intensely brutal scene – from the moment a bit is placed into Nicholson’s mouth to the point where what appears to be large headphones are placed on the side of his temples and a jolt of electricity passes through his brain.

The tight close-up of the camera, focusing solely on his face, only serves to amplify the apparent brutality of ECT – Nicholson’s body bucks against the restraining hands of the numerous, white-clad health staff gathered over him as the electricity triggers a seizure.

In the context of the 1975 film, which won five Oscars, this extreme form of therapy was administered to curb Nicholson’s character’s rebellious behaviour, and speaks volumes of psychiatric treatment of the time – to the layman at least the ethos appeared to be one of quietening difficult patients rather than seeking to understand, address and treat their actual symptoms.

This short, one-minute clip from the film continues to shape our perception of ECT, indeed it has done much to vilify this most controversial form of therapy.

Even watching this piece of fiction, it is hard to associate what appears to be a cruel and almost barbaric treatment with the sterile, evidence-based world of mental health medicine.

The comments which accompany a clip of Nicholson’s One Flew Over the Cuckoo’s Nest ECT on YouTube are typical of the dominant public attitude. One person wrote: “… like electrocuting an animal to make it seem more humane when they are eventually slaughtered”.

The prevailing stereotype of ECT is of a “dangerous and inhumane practice,” which belongs to dark days of mental health when experimentation was the norm.

And yet, according to figures released under the Freedom of Information Act to the Citizen’s Commission on Human Rights – an international psychiatric watchdog, which was co-founded by the Church of Scientology – ECT was administered to patients 579 times last year in Cardiff and Vale NHS Trust alone.