My experience of being subjected to ECT illegally without consent

I was 65 and had never been ill in my adult life apart from colds, but in the autumn of 2021, I was given a diagnosis of Stage IV prostate cancer with no support of any kind. Unexpectedly and suddenly I fell into a deep depression. This blog tells the story of what happened to me. This included being admitted to a general hospital in Shetland, being detailed under a Temporary Detention Order and flown unconscious to a psychiatric hospital in Aberdeen, being given two ‘antidepressants’ and an ‘antipsychotic’ simultaneously, and being given ECT without my prior knowledge or consent.

I am no longer depressed and am not taking any psychiatric drugs, but this is only because I instructed a solicitor and won an appeal against a Compulsory Treatment Order, and because I did not take the sertraline, olanzapine and mirtazapine tablets that were handed to me when I was discharged from hospital.

I have now obtained a copy of my medical notes. They show that I was ‘incontinent of urine’ during the first ECT session and had a brief cardiac arrest during the fourth. More shockingly, the record of consent filled in by the ECT doctors wrongly stated that I was subject to an extension to the Short Term Detention Order for the second session and to a Compulsory Treatment Order for the third and fourth, when in fact I had become an informal patient but had not been told about this. I would welcome any advice about whether this is a basis for legal action. There is more detail on my website.

Receiving a cancer diagnosis

I was single, self-employed and lived alone. I had been an only child and had no close living relatives. I registered with a medical practice in early 2021 in order to qualify for a COVID-19 jab. I had none of the classic symptoms of prostate cancer but I had stopped ejaculating fully. I decided that I ought to have it checked out, and in September made an appointment to see a GP. He rang me the next morning to tell me that my PSA level was over 70, which is extremely high. I knew then that it was very probable that I had prostate cancer. A series of appointment letters then arrived and I had to drive to Lancaster on my own for scans and to Kendal for a biopsy. Then an appointment with the urology department. I knew what the result would be when there was a Macmillan nurse in the room. She gave me her card and I had a short meeting with the consultant. When I asked about an operation he said no – it would be drug treatment because the cancer had spread to some lymph nodes. That was it. I drove home and waited for the next appointment letter that would reveal what the treatment was going to be. No one asked me about my circumstances or offered any support and I didn’t ring the number on the card that the Macmillan nurse had given me.

Deteriorating mental health

I had taken the news in a fairly detached way and had always believed that I was mentally and emotionally strong, but it was not a good time to get the news. It came after COVID isolation and reduced earnings, and online meetings around COP26 discussing the bleak prospects for the human species. My main home was in Orkney but I was still travelling down to Lancashire to work and was staying in an unofficial flat on the middle floor of a three-storey building that was an unfinished conversion project which looked derelict on the outside. Work had dried up and I had been living on savings that were running out. In fact, I had been spending more than I was earning for the last few years and as I owed more than I had in my bank account at the time, I became convinced that I would have to declare bankruptcy. It was also the beginning of winter. My mental health suddenly plummeted. I spent a lot of time in bed half-dressed, living on muesli and trying to spend as little money as possible. The skin on my right arm was wrinkling and I thought that I was getting dehydrated. There were some positive aspects, as I went over my life and had insights into my upbringing and relationships and psychological makeup that had a clarity that I hadn’t found before, so I wasn’t completely delusional. I can’t remember all the details of that time and don’t want to try too hard now to recall them.

Trying to get help

Friends were concerned to get texts and emails from me, and one couple came up from the Midlands to see if they could help, and were in touch with my cousin. I ended up being taken to A&E at the Royal Lancaster Infirmary by ambulance to be checked out. I lay sleepless on a trolley under bright lights all night. I remember a nurse sneering at me for wasting their time. I remember being visited at 4am by two mental health workers with a clipboard who started going through a questionnaire of irrelevant questions until I told them to fuck off. I remember the following morning being in a room and being questioned by another mental health worker. I remember telling him that I had just shat myself while standing at a urinal. I was discharged and told to ring for a taxi to take me home. I had just enough money with me to pay for the taxi, and hopefully, the COVID screen meant that he couldn’t smell me. I had no help of any kind for my mental health.

Orkney

My cousin and his wife came to my rescue and escorted me back to my home in Orkney, which is another unfinished building project with inadequate heating. The community psychiatric nurse came to see me and she did her best by arranging some practical help, but my mental condition did not improve and was made worse by starting treatment for prostate cancer. The results of my cancer tests were transferred from England and I had a phone call out of the blue from a consultant in Elgin. He was very direct and told me that I’d probably got another five years to live and would have injections every three months at the local GP surgery, but first I must take a course of pills to suppress the testosterone surge that would happen with the first injection. This is chemical castration and treatment is itself mood-altering. Additionally, the sudden loss of testosterone and loss of sexual function can cause depression. I remained very concerned about money as my savings had gone and I had no source of income.

Shetland

My cousin and his wife and son came to my rescue again and took me to their house in Shetland to look after me despite having busy crofting lives. This was the start of the Shetland winter and I was in the room within the roof that I usually stayed in, which now seemed over-warm. They took me to see their GP but she seemed nonplussed and didn’t offer any help. Days later I became concerned that I was having some kind of medical episode as my vision was disturbed. Much later I learned that this is a common side effect of the Triptorelin injection that I had been given to treat my prostate cancer. I asked to be taken to the hospital to be checked out, so my cousin contacted the GP who phoned the hospital to let them know that I would be coming.

The Gilbert Bain Hospital, Lerwick

My memory of my time in the Gilbert Bain Hospital is incomplete because I was heavily drugged. My notes from my stay in Aberdeen suggest that I was given the ‘anti-psychotic’ olanzapine and 150mg of sertraline. I had never been in a hospital before and until the cancer injection hadn’t taken any type of medication for over 30 years. I remember being fitted with a cannula that caught on the bed sheet and dug into my arm. I was in bed on my own in a featureless room, and solitary confinement in an alien environment in a heavily drugged state worsened my mental state. I remember that the staff weren’t particularly pleasant. I remember someone reading out some official language that must have been the temporary detention order. I remember a nurse with a heavily made-up face chatting to another nurse about having a shopping trip to Aberdeen. I remember a sadistic nurse who pushed some tablets into my mouth while laughing and wishing me a pleasant trip. They knocked me out to send me to Aberdeen.

The Royal Cornhill Hospital, Aberdeen – isolated in a side room

On 30th November 2021, I came to in a side room of what I later found out was Fyvie ward, which was for young people. They put me there because there was nowhere in a more appropriate ward. I was completely disoriented because no one explained where I was or how I got there, but I had a feeling that I didn’t belong there (which was not completely irrational) and fantasised about being a stowaway on a ship. Far from helping me, entering the hospital had made me a lot worse. I was beginning further psychiatric drug treatment that I now know included sertraline, mirtazapine, olanzapine and intermittent diazepam after whatever I had been given in the Gilbert Bain, whatever they had used to knock me out, and shortly after being given an injection to stop my body producing testosterone. It is difficult to distinguish between the underlying ‘mental illness’, the result of my body getting used to the drugs, and the despair of suddenly being confined in an alien environment far from home and any friends without the constant stimulations that I was used to. I was in a far worse mental and physical shape than I had been when I was admitted to hospital in Lerwick. I was unshaven, hadn’t had a haircut or a shower for a long time, and only had the work clothes that I had on when I was admitted in Shetland plus a few unsuitable things that my cousin had dropped off in Lerwick. I was extremely constipated and laxatives didn’t seem to be having much effect. I was already constipated in Shetland. If my appetite was not good when I was in Fyvie it is not surprising. I have since read that constipation is also a side effect of all three of the drugs that I was being given!

At one stage the nurses came to believe that I was suicidal. I was never going to do anything to kill myself – I had thought that my life was over because I had been diagnosed with advanced cancer. Nevertheless, they came into the room and took the laces out of my boots and took my belt and a phone charger cord. They then sat on chairs at the doorway in relays, watching me. They seemed to be pissed off about having to do this. I can’t remember how long this went on for, but they eventually stopped doing it. This certainly didn’t improve my mental state.

Recovery in Drum Ward

The transfer to Drum Ward on 7th December 2021 was a major turning point. This was a ward for older people and I was in a room with three other men to whom I could talk to. In Fyvie ward the nursing staff had not gone out of their way to reassure me or treat me as a human being, rather than as a suicide risk who was being looked after temporarily. In Drum ward the staff were more caring, and the rituals of serving meals three times a day and teas, coffees and snacks also three times a day meant that there was social interaction with them and with fellow patients, both men and women, throughout the day. The ward GP listened to my concerns about constipation, and after two sessions with suppositories, my bowels were moving properly again. I was still unkempt, partly because my cousin was too far away to visit and bring me fresh clothes, but my condition was slowly improving. Visits by the ward doctor seemed to follow no particular timetable that would have allowed me to prepare questions, but I do remember her telling me that she was pleased with my progress and that at one stage they were so worried about me that they had been considering ECT. The thought of this horrified me but I felt reassured that this was not going to happen.

The bombshell – being taken to the electroconvulsive therapy suite against my will for compulsory treatment with no prior warning

I remember being taken in a wheelchair by taxi to the Aberdeen Royal Infirmary for an X-ray. No one told me why this was being done. I thought that perhaps it was because of COVID, or because of my cancer. I have since read that this is a preliminary to administering ECT.

The first time that I realised what was going to be done to me was when I was told by a nurse one morning not to go through to the dining room with the other patients because I would be getting a general anaesthetic. I was helpless. I remember the feeling rising from my stomach as I realised what was going to happen. The ward doctor had not told me that I would be getting electroconvulsive therapy, let alone asked for my consent or told me what was involved and what the side effects could be, as she was obliged to do. I was taken to the ECT suite in a wheelchair by a nurse and I vividly remember the long journey through the hospital corridors and the feeling of the anaesthetic being injected into the back of my right hand. I still get angry and upset when I recall what happened, even though it is now several months ago. How could the bastards do that to me? How could they not even tell me what they were going to do to me? How could they assault me like that when I was already getting better?

This happened four times before I was able to stop them, on 24th, 28th and 31st December 2021 and 4th January 2022. I received a letter dated 11th January 2022 from the Mental Health Act Administrator telling me that I was made an informal patient on 26th December 2021. They didn’t tell me this before they administered 3 ECT treatments against my will, and they hadn’t applied for an extension to the Temporary Detention Order, so they had no legal basis for inflicting compulsory ECT on me. It makes me even angrier now that I know this.

The tribunal

The temporary detention order that had been granted in the Gilbert Bain Hospital under the Mental Health (Scotland) Act 2003 expired at midnight on 26th December 2021. An extension certificate was not put in place to extend the detention by five working days until a Tribunal was held on the the 6th January 2022. The consultant psychiatrist certified on 21st December that ‘due to the severity of his illness he would not be able to arrange representation on his behalf.’ She also stated, ‘he is reluctant to eat and drink expressing a wish to commit unconscious suicide as he states his bowels are blocked and he will fill with faeces and die as a result’.  This is a complete load of bollocks. Three days after the consultant psychiatrist certified that I was reluctant to eat and drink I was enjoying Christmas lunch and dinner with the other patients.

The husband of the ward doctor, who also worked at the hospital, also certified on 22nd December that ‘due to delusional beliefs – not able to instruct a solicitor.’ Seven days later I instructed a solicitor from Ormistons Mental Health Law Practice to represent me at the tribunal and received a copy of the Compulsory Treatment Order Pack that had been submitted to the Mental Health Tribunal for Scotland.

The tribunal was held remotely, with my solicitor speaking on my behalf. The Mental Health Officer making the application admitted that it was just over three weeks since she had visited me in the hospital and she did not know about my current condition, and at the time of her visit, it was not clear that a Compulsory Treatment Order would be required. The consultant psychiatrist was on annual leave and did not attend the tribunal or provide a substitute, so her views on my condition could not be challenged. Luckily, in her absence, the tribunal accepted evidence from a staff nurse who confirmed that I had made a huge improvement, that I was engaging well with staff and was able to give my views about treatment eloquently. He was my saviour and I am appalled to think what would have happened if the tribunal had believed the psychiatrists if the consultant psychiatrist had attended the tribunal, and if my confinement within the ward and involuntary treatment with ECT had continued. The tribunal ruled that the conditions set out in Section 64(5) of the 2003 Act had not been met and refused the application for a Compulsory Treatment Order. I agreed to stay in the hospital as a voluntary patient.

Liberation

Becoming a voluntary patient transformed my life at Cornhill. I could see that there was the hope of resuming a normal life rather than being in continued confinement in an alien environment far from home. I refused any further ECT, got my wallet and bank card back, and was able to leave the ward between meal times and walk into Aberdeen. Money from an expensive motorbike that I had sold with my cousin’s help before going to Shetland was in my account, and payment of the state pension had started, so the balance was well into double figures. I walked to the local shopping centre and bought new clothes, I had a haircut, and I bought a radio and writing materials. I walked to Union Square and bought a MacBook and iPhone from the Apple Store. This meant that I had access to the internet from my bed in the ward, could start to sort out my debts, contact friends, have some of the mental stimuli that I had been missing, and order books online from Blackwells bookshop that were delivered to the hospital. I went out almost every day, sometimes twice. I visited the art gallery and the Aberdeen archives and sampled the coffee and cake in numerous cafes. I believe that this was the reason for my recovery – being relieved of the pressures of work and fending for myself, having people around me, having a routine, having the stimulus and exercise of exploring the city, and being fed and looked after by nursing staff who were caring.

I hadn’t been told any details by the ward doctor about the medication that I was being given morning and evening, despite now being a voluntary patient, so I asked a nurse and on 16th January wrote down what she told me – sertraline, olanzapine and mirtazapine. As I now had a MacBook I could look them up and confirm that these were two different ‘antidepressants’ and an ‘antipsychotic’. Each has a long list of recognised side effects, some very serious, and each takes some time to work and may cause mental disturbance before they do. I also discovered that some people have great difficulty withdrawing from them. There also seems to be controversy about whether ‘antidepressants’ are more effective than placebo, except in a minority of cases.

One day the ward doctor did come to see me in the dormitory and asked if we could have a word in a side room, and did I mind if there were some medical students present? It was an informal friendly chat rather than a consultation between doctor and patient, and I now know that this happened on 26th January. She asked me to tell my story. I suspect that she was hoping to show me off to the students as an example of successful treatment, as by then I was presentable and more articulate than any of the other patients on the ward. What she perhaps wasn’t expecting was for me to say, thank God the tribunal didn’t accept the statements from the psychiatrists who had only seen me for a few minutes each, believed the nurse, and allowed me to become a voluntary patient. I also said to the students that no one had told me that I was getting ECT until a nurse told me on the morning of the first treatment and thank God again that I was able to stop it when I became voluntary. The doctor told me semi-apologetically that she was away when the ECT started. I now know that she was responsible for arranging the ECT and must have chosen not to tell me what was going to be done to me. She asked me about a discharge date and I suggested after about another week, as I had just started on some new tablets for prostate cancer. I never saw her or any other doctor again – this is confirmed by my medical notes.

Discharge

No one told me about the tablets that I was taking, how to take them after I was discharged, their possible side effects (particularly when used in combination), and how and when to reduce the dose. I certainly didn’t give informed consent to continuing to take them after I became a voluntary patient, as I should have been asked to do.

On the day that I was discharged, I was handed a sealed paper bag from the pharmacy. I only opened it after I arrived home in Orkney that evening and read the labels on the boxes with the names of the drugs, the doses and when to take them. They were the same names that the nurse had given me – olanzapine, mirtazapine and sertraline, with the dose of sertraline being the maximum 200 grammes, which is four times the standard dose. I decided that I wasn’t going to take any of the drugs as no doctor had told me what they were and why I was to take them. Another ‘thank God’ moment as I dread to think what would have happened if I had followed the instructions on the labels and embarked on an extended course of powerful psychiatric drugs at the same time as having androgen deprivation therapy for cancer. I would probably still be living with the life-changing consequences now.

I was so glad to be free that I wasn’t aware of any effects of going cold turkey and spent a few weeks travelling. In fact, I felt more alive and alert as the drugged state lifted. Why did they give them to me so carelessly when I didn’t need them and probably hadn’t needed them for some time before I left the hospital if I had ever needed such aggressive treatment? I read of patients complaining that their doctors did not warn them about side effects and withdrawal problems when they were prescribed the same drugs that I was given, and am incredulous that I could be treated, latterly as a voluntary patient, and then discharged from a psychiatric hospital without even being told by a doctor which drugs I was expected to continue to take and how to take them, let alone told about any adverse effects. Perhaps the clue is in the fact that the doctors specialised in the psychiatry of old age and expected their patients to be passive and incapable of recovering and challenging them.

I had two follow-up appointments with a locum psychiatrist in Orkney, done remotely because I was away from the island. The first was on 3rd March 2022 and the second on 7th April. Both times there wasn’t much to discuss, except to tell her that I was ok. There was no medication to adjust because I wasn’t taking any, and no depression to treat because I wasn’t depressed. At the end of the second meeting, she told me that she would discharge me from the mental health system.

Records of my ECT ‘treatment’

I now have access to my medical notes, which confirm that I did not consent to ECT, that I was distressed, that procedures to notify me were not followed, and that 3 of the 4 treatments were done after I had become an informal patient and so were done illegally. I have now received a response from the Mental Welfare Commission for Scotland to my Subject Access Request. The documents that they sent me confirm that the Royal Cornhill Hospital waited sixteen days before informing me and the Mental Welfare Commission that I had become an informal patient, and in the meantime gave me three ECT ‘treatments’ illegally. More shocking is the revelation that the second opinion doctor who signed the form authorising compulsory treatment never met me, as he should have done, and based his opinion on a video conference call with the doctor treating me in the hospital. He also falsely stated on the form that he had consulted with the patient.

The form recording my consent to ECT, filled in by the ECT doctors, contains very serious errors. The notes to ‘treatment’ number 2 say ‘STDC Ext’, which means an extension to the Short Term Detention Certificate. The letter that I received on 11th January 2022 confirms that no such certificate had been issued and I was an informal patient at the time and so could and would have refused treatment if I had known that. ‘Treatments’ 3 and 4 say ‘CTO’, which means Compulsory Treatment Order. No such order had been granted at the time of the treatments and the tribunal hearing on 6th January 2022 rejected an application for a CTO, so as an informal patient I could and would have refused these treatments as well had I been told about my rights. It seems that the hospital acted illegally by inflicting the ‘treatment’ on me against my strongly expressed wishes. The medical notes also confirm that the doctors responsible for my care deliberately didn’t tell me what they were going to do until I discovered what was about to happen on the morning of the first ‘treatment’, which was inhumane as well as against all guidance.

My drug treatment

I have advanced prostate cancer and have triptorelin injections every 3 months and take abilaterone and prednisolone (a steroid) daily. These all have serious side effects that I must tolerate in order to stay alive. I have a hospital appointment every 4 weeks for my condition to be monitored, including blood tests for liver function, PSA and numerous other things that could be affected by the androgen deprivation therapy. It seems to me, after reading about the potential side effects of the sertraline, mirtazapine and olanzapine that I was given, that they could have a serious adverse effect on my physical health if I continued to take them in combination with the cancer drugs. As the doctors at the Royal Cornhill Hospital told me nothing about the drugs that I was given, it seems that they never considered this issue, and certainly never discussed it with me, as they should have done. I didn’t take any of the pills that I was handed when I was discharged and I think that my improved mental state is proof that I didn’t need them and that they would probably have been harmful.

The legal basis for treatment

I do not have any legal training, but it seems that the doctors who gave me ECT did not comply with the requirements of the Mental Health (Care & Treatment) (Scotland) Act 2003, the Code of Practice for that Act, the NICE Guidelines on depression, or the hospital’s procedures set out in its leaflet for ECT patients.

Although I now want to get on with my life, I also want to come to terms with what happened and to call the doctors to account, by legal action if possible. I do not want them to get away with doing to anyone else what they so recklessly did to me.

As I get further information I will update my website: www.ectatroyalcornhill.co.uk