Treatment Abuse, Behavior Modification, Thought Reform > Psych Hospitals

Re: Are We Really OK With Electroshocking Toddlers?

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xEnderx:
They do have pretty draconian bureaucracy, but if you know how to navigate things it makes sense. If you are "on the outside looking in" it can seem to be a pretty terrible system though. I think that is where most complaints I've heard originate from.

xEnderx:

--- Quote from: "Inculcated" ---My problem with this (a treatment I had at one point considered) is that this ”treatment” is administered with the logic that a trauma team might aptly use to justify extreme life saving measures in physical injuries. The flaws are that all too often the patients who receive ECT are not in an immediate endangered condition that requires an intervention of “last resort” rather they are despondent persons who are desperate to not feel the way they do at that time. Doctors who advocate this treatment are all too willing to accommodate their patient’s need for relief without considering or advising what of their patient will be lost to the treatment. Patients in severely depressed states may not consider the fact that follow up shocks are required to maintain the short term relief (This also perpetuates the side effects).

--- End quote ---


I do not disagree with any part of  your post, but I feel the issues you brought up have more to do with the doctors or treatment teams than they do with the efficacy (or lack there of) of the procedure.

Inculcated:

--- Quote from: "xEnderx" ---
--- Quote from: "Inculcated" ---My problem with this (a treatment I had at one point considered) is that this ”treatment” is administered with the logic that a trauma team might aptly use to justify extreme life saving measures in physical injuries. The flaws are that all too often the patients who receive ECT are not in an immediate endangered condition that requires an intervention of “last resort” rather they are despondent persons who are desperate to not feel the way they do at that time. Doctors who advocate this treatment are all too willing to accommodate their patient’s need for relief without considering or advising what of their patient will be lost to the treatment. Patients in severely depressed states may not consider the fact that follow up shocks are required to maintain the short term relief (This also perpetuates the side effects).

--- End quote ---


I do not disagree with any part of  your post, but I feel the issues you brought up have more to do with the doctors or treatment teams than they do with the efficacy (or lack there of) of the procedure.
--- End quote ---
Well, the quoted mid section of my post certainly does focus on the overuse and under inform aspect of the issues I have with ECT.
The rest …

--- Quote ---ECT, advising a cure in traumatic brain injury? The suffering of cognitive problems, including significant memory loss and learning impairment seems of little consequence to those who consider that they are applying this as a life saving measure to the severely depressed.

This quick fix is also strikingly similar to the philosophies of programming that are myopically fixated on the short term appearance of change without regard to the damage incurred by the individual


--- End quote ---
Less radical interventions are available, but as the use of ECT increases these options are being forgone.
I suspect the reasons for this have quite a bit to do with the treat and street pressures being applied to care providers.

 Maybe you could provide some insights into these conflicts, and how they've impacted mental health care.

If it came up in another thread’s discussion, I missed it. What kind of facility do you work in, and in what capacity?

xEnderx:
In my experience (which is a bit limited), ECT is very much a "last resort" treatment. I've only seen it used in adult patients that have been completely unresponsive (therapeutically) to less extreme measures. As previously mentioned, the vast majority of cases I've dealt with have been Major Depressive Disorder. From what I've seen, the treatments have been reasonably effective in helping to alleviate the most intense symptoms of the patients. The impact on memory and cognition have been entirely limited to a 5-6 hour window after the procedure. Most times the procedures take place between 7 and 8 AM, and then the patients return to our facility and spend the rest of the morning and early afternoon sleeping. By the time evening group starts at 8ish PM, they are back to "normal" in regards to memory and cognition. I've seen a lot more negative side effects from adjusting to psychiatric meds than I have from ECT.


"Treat and Street", or "Bed Flipping" as it is commonly referred to, happens constantly. Its not limited to any particular procedure. It is however, an inevitable result of managed care. I mean when health care is run as a corporation, do you really expect that corporation to use less monetarily efficient means to treat a disease or disorder? Not saying that its good, right, or that I support it, simply pointing out that managed care has changed health care into a system where patients literally are a medical record number. Some docs are less ethical than others, and the same is true for any profession.

Basically I'm just saying (in a long winded way) that in certain patients, ECT has quite a bit of therapeutic value. I also try to educate people that ECT and "Shock Treatment" are most assuredly NOT the same thing.

Inculcated:

--- Quote from: "xEnderx" ---In my experience (which is a bit limited), ECT is very much a "last resort" treatment. I've only seen it used in adult patients that have been completely unresponsive (therapeutically) to less extreme measures. As previously mentioned, the vast majority of cases I've dealt with have been Major Depressive Disorder. From what I've seen, the treatments have been reasonably effective in helping to alleviate the most intense symptoms of the patients. The impact on memory and cognition have been entirely limited to a 5-6 hour window after the procedure. Most times the procedures take place between 7 and 8 AM, and then the patients return to our facility and spend the rest of the morning and early afternoon sleeping. By the time evening group starts at 8ish PM, they are back to "normal" in regards to memory and cognition. I've seen a lot more negative side effects from adjusting to psychiatric meds than I have from ECT.
--- End quote ---
That’s an astonishing recovery. What assessments do you use to get a baseline and to then evaluate the patient’s experience of the effects and their individual ability to tolerate these?



--- Quote from: "xEnderx" ---"Treat and Street", or "Bed Flipping" as it is commonly referred to, happens constantly. Its not limited to any particular procedure. It is however, an inevitable result of managed care. I mean when health care is run as a corporation, do you really expect that corporation to use less monetarily efficient means to treat a disease or disorder?
--- End quote ---
No, and you have no reason to assume I have such an expectation
--- Quote from: "xEnderx" --- Not saying that its good, right, or that I support it, simply pointing out that managed care has changed health care into a system where patients literally are a medical record number. Some docs are less ethical than others, and the same is true for any profession.
--- End quote ---
Agreed.


--- Quote from: "xEnderx" ---Basically I'm just saying (in a long winded way) that in certain patients, ECT has quite a bit of therapeutic value.
--- End quote ---
Please elaborate on this

--- Quote from: "xEnderx" ---I also try to educate people that ECT and "Shock Treatment" are most assuredly NOT the same thing.
--- End quote ---
Please expand on this last part for me, specifically these differences. (I’m sure that it’s not like Ken Kesey’s representation of the procedure.)

Again:
If it came up in another thread’s discussion, I missed it. What kind of facility do you work in, and in what capacity?

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