Several psychiatrists have voiced objections to the proposed ban on direct electro convulsive therapy (ECT) or administration of shock to patients with serious mental illnesses -- a proposal made in the Mental Health Care Bill 2013, which would be taken up in the ongoing Winter Session of Parliament.
The Bill seeks to institute far-reaching measures to protect rights of persons with mental illnesses from decriminalising suicides, improving access to healthcare, health insurance and giving people the right to decide on advance course of treatment if they ever develop mental illness.
While the legislation stresses on elimination of cruel methods of treatment such as tonsuring and chaining of patients, it also includes a ban on ECT without anesthesia.
Modified ECT entails procedures in the presence of an anesthesiologist, while including a whole routine from anesthesia
administration, muscle relaxants, blood and electrolyte monitoring, intubation as well as drugs for recovery. This not only increases the cost of treatment, but also makes treatment inaccessible to a vast majority of people requiring the therapy as it restricts facilities to top health institutions.
Unmodified ECT is not what it appears to be. It is the safest and the most affordable treatment for conditions such as schizophrenia, manic depression and psychotic patients. It is available at sub-divisional hospitals and district mental health programme modules. The shock is given at very low voltages and for short durations, the psychiatrists claimed.
“As per global statistics, mortality in direct ECT is estimated to be one in a lakh. In modified ECT with anesthesia, the chances are one in hundred. In the last 30 years at SCB Medical College and Hospital here, at least 100 patients underwent ECT thrice a week. Not one has died or suffered broken limbs, spinal dislocations or other severe disabilities. On the contrary, most of them have been cured and are leading normal lives”, said Neelamadhab Rath, Odisha Mental Health Authority’s secretary.