Ireland has enacted a ban on electroshock treatment, also known as electroconvulsive therapy (ECT), for minors under its new Mental Health Act, which took effect in May. The Citizens Commission on Human Rights (CCHR) International, a mental health industry watchdog, announced the development, calling it a major human rights advance. The law now safeguards individuals under 18 from a procedure that delivers up to 460 volts of electricity through the brain, which can cause severe memory loss and cognitive and brain damage.
In the United States, the Food and Drug Administration (FDA) has cleared ECT devices for those 13 and older for three limited conditions, but the procedure is broadly administered off-label, a practice CCHR wants to see stopped. CCHR helped obtain the first law banning ECT use on minors under 12 in California in 1976, and later in Texas on minors under 16 in 1993. In Western Australia, the group helped ban the practice on those aged 14 and younger in 2014, with the Mental Health Act enacting criminal penalties for anyone administering it to a child.
Jan Eastgate, President of CCHR International, praised Ireland's officials for recognizing the need to prohibit ECT's use on minors, increasing the age to 17. "However, like thousands who called for ECT to be banned in the U.S. under the FDA's Final Rule in 2018, the ban should be extended to all ages. CCHR is committed to achieving this," Eastgate said.
The Human Rights Institute in Ireland reported, "The adoption of the Mental Health Act in Ireland can be regarded as one of the country's significant developments in the advancement of human rights and in the reconsideration of the relationship between health, human dignity, and the public responsibilities of the state." The Irish Mental Health Commission noted, "The most significant right potentially affected by this legislation is the right to liberty and personal security."
The newly formed Stop ECT Coalition in the U.S., comprising a consortium of health and human rights organizations representing hundreds of thousands of individuals, is urging a review of how ECT devices remain on the market. According to the Coalition, ECT devices were "grandfathered" into FDA regulation in 1976 as a Class III high-risk device, bypassing modern standards requiring a Premarket Approval (PMA) with clinical trials proving safety and efficacy. In 2018, the FDA reduced the risk classification of ECT devices to moderate risk (Class II) without safety and efficacy trials. The Coalition emphasizes: "This incorrect classification allowed ECT devices to be used on children as young as five, pregnant women, seniors, veterans, and other vulnerable persons…Involuntary application—still occurring in some U.S. facilities—has been condemned by the United Nations and World Health Organization as a human-rights abuse." More information can be found at stopect.com/coalition.
Dr. John Read, Professor of Clinical Psychology at the University of East London, who has extensively reviewed ECT studies, said: "Several leading proponents [of ECT in earlier times] argued that ECT works because it reduces the intelligence or level of intellectual functioning of people. So they were arguing that some mental patients have too much intelligence, too much going on in their brains, and it needs to be reduced, and they believed that that was the therapeutic process." He added that the other type of brain damage they said was helpful was erasing traumatic memories. Read and colleagues have published a review of over a hundred studies demonstrating that the effects of ECT on the brain are similar to a closed-brain injury. For further details, see the CCHR article and related coverage.
Robert Rubinstein, a former psychiatry professor at the University of California in San Francisco, compared ECT to "kicking a Swiss watch… I can see very little if any reason to use it." Psychiatrist Dr. Niall McLaren stated unequivocally, "No psychiatrist needs to use ECT." A mental health strategy plan drafted by the World Health Organization's Department of Mental Health and Substance Use warned of ECT's health risks, including brain damage, cardiovascular complications, memory impairment, and even death, and stated that ECT should be banned for children and non-consenting use may constitute torture, as reported by Süddeutsche Zeitung.
Eastgate concluded, "Ireland's ban on electroshock treatment for minors marks a significant step forward in protecting vulnerable young people from a damaging procedure. While this decision advances human rights and personal liberty in the mental health industry, advocates like CCHR and the Stop ECT Coalition continue to call for a complete ban." CCHR, established in 1969 by the Church of Scientology and professor of psychiatry Dr. Thomas Szasz, has helped obtain hundreds of laws around the world that increase informed consent rights and prohibit deep sleep treatment, a combination of ECT and a psychotropic drug-induced coma.
