Patient information leaflets about electroconvulsive therapy are misleading patients

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An independent audit of Electroconvulsive Therapy patient information leaflets in Northern Ireland, Scotland and Wales’ (attached) has found that ‘Patients and families across the UK are systematically being misled about the risks they are taking and the limited nature of ECT’s benefits.’

The study, to be published this month in the scientific journal Psychology and Psychotherapy: Theory, Research and Practice, used the Freedom of Information Act to obtain patient information leaflets from 23 hospitals administering ECT in the three devolved nations, and evaluated them against the same 40-item accuracy scale previously used to assess ECT clinics in England.*

The number of accurate statements (out of a possible 29) ranged from seven to 20. The most frequently omitted statements included: cardiovascular risks (mentioned by only 5 leaflets), that it is not known how ECT works (3), risk of mortality (2), risks from multiple general anaesthetic procedures (2), how to access a legal advocate (2), and that that there is no evidence of long-term benefits (1).

The leaflets made between six and nine inaccurate statements (out of 11). Nineteen minimised memory loss, blamed the memory loss on depression, claimed that ECT is the ‘most effective treatment’, and asserted it has very high response rates without mentioning similar placebo response rates. All 23 leaflets wrongly told patients that ECT saves lives.

The researchers concluded:

‘ECT information leaflets in these three nations are barely more accurate than those in England, and do not comply with the ethical principle of informed consent’.

They recommended that:

  • ‘Psychologists and other mental health professionals have a shared responsibility to implement the ethical principle of informed consent
  • All mental health professionals need to inform themselves of the research evidence for the efficacy and safety of all treatments offered to their patients
  • Managers of mental health services, and government agencies, need to actively oversee ECT clinics, including the information given to patients’

Lead researcher, Dr John Read (Professor of Clinical Psychology at UEL) commented

‘Following our audit of England ECT clinics the Royal College of Psychiatrists amended its own information leaflet, but our study found that their new one, used by numerous ECT clinics, has seven inaccurate statements and nine omissions. This is irresponsible.’

 

Co-author Lisa Morrison, who received 96 ECT treatments, primarily in Northern Ireland, most recently in 2016, added:

‘Consent to a medical procedure is a human rights issue. Without accurate information, informed consent cannot be given. These leaflets are negligent. Many of us live with the devastating consequences which we were never told could happen. Why and how has this been allowed?’

Dr Christopher Harrop, Clinical Psychologist, stated:

‘It is an absolute disgrace that patients are told such an inaccurate and non-evidenced version of the pros and cons of ECT.’