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Govt responds to electroconvulsive therapy report

Government responds to electroconvulsive therapy report

The Ministry of Health today announced that the Government would partially or fully support majority of the Health Select Committee’s recommendations on electroconvulsive therapy (ECT).

Last November, after considering a petition requesting that ECT therapy is not administered to children, pregnant women and the elderly, the committee made eight recommendations to the Government.

Several of these recommendations focused on introducing regulatory controls on ECT use, particularly in relation to various patient groups, while others related to consent and monitoring issues. One recommendation called for ECT to be used only as a treatment of last resort once other options had been considered.

Dr David Chaplow, Director of Mental Health, said that in response to the committee report, the Government would partially or fully support seven of its eight recommendations.

``Generally, we are supportive of recommendations that can comfortably be accommodated without the risk of intervening in matters of clinical judgment,’’ he said.

``It is also important to remember that in practice, ECT is often a treatment of last resort in some groups, including children, adolescents, and pregnant women."

Dr Chaplow noted that the Ministry of Health has already started planning a review of the Mental Health (Compulsory Assessment and Treatment) Act 1992. The review would contribute to the Government’s response to a number of the committee’s recommendations, including issues concerning consent and the use of advance directives.

ECT has been used in the treatment of mental illness for more than 60 years. In 2003, the Health Select Committee recommended that a comprehensive, independent review be undertaken on the safety and efficacy of ECT and the adequacy of controls on its use in New Zealand. The review concluded that ECT continues to have a place as a treatment option for consumers of mental health services in New Zealand, and that banning its use would deprive some seriously ill patients of a potentially effective and sometimes life-saving treatment.

``Nevertheless, ECT can create anxiety among some patients and families, and the treatment still generates significant interest among some members of the public and various public interest groups,’’ Dr Chaplow said.

``While ECT remains a controversial treatment, partly because of a risk of cognitive impairment and, in particular, memory loss, I do not consider the evidence about risks and side effects to be conclusive, and note that new evidence is still emerging. We are concerned that if ECT is made only a treatment of last resort, increased suffering and illness-related morbidity, and even increased mortality, may result.”


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