Even as the Mental Health Care Bill 2013 is scheduled to be taken up in the Parliament during the ongoing Winter Session, psychiatrists have voiced objections to the proposed ban on direct electro convulsive therapy (ECT) or administration of shock to patients with serious mental illness.
The Bill seeks to institute far reaching measures to protect rights of persons with mental illness from decriminalising suicides, improving access to healthcare, health insurance and giving the 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 like tonsuring and chaining patients, it also includes ban on ECT without anaesthesia. This has raised the heckles among mental health experts as they deem it a step that would deprive a major chunk of patients from cheap and very effective treatment.
Modified ECT entails procedures in presence of anaesthesiologists while including a whole routine from anaesthesia 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 for 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 like schizophrenia, manic depression and psychotic patients that is available at sub-divisional hospitals and district mental health programme modules.
It is not cruel or barbaric as it is deemed to be. The shock is given at very low voltage and for short duration.
The shocks induce anaesthetic effect on the patient instantaneously and he does not feel any pain even if the convulsions appear to be so, the psychiatrists have argued.
“As per global statistics, mortality in direct ECT is estimated to be one in a lakh while in modified ECT with anaesthesia, chances are that one patient would die in a hundred due to anaesthesia-related complications. In the last 30 years at SCB medical College and Hospital here, at least 100 patients undergo 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 leading normal lives,” said Secretary of State Mental Health Authority and Director of Mental Health Institute Prof Neelamadhab Rath.
Rath, who is also the State nodal officer on National Mental Health Programme, has called upon the Parliamentarians to assess the scientific truths and benefits for the larger chunk of patients before moving to ban unmodified ECT or shock therapy without anaesthesia.