'Electric shock' therapy is on the rise in England
Electroconvulsive therapy (ECT), better known as getting a so-called electric shock, is on the rise in England to treat serious mental health conditions.
The controversial treatment was thought to have fallen out of favour, yet figures obtained via freedom of information acts demonstrate its popularity.
The treatment involves sending an electric current through the brain to trigger an epileptic seizure that helps to relieve certain mental health symptoms.
ECT's rise may be down to improved patient access, a lack of alternative treatments or simply the seemingly crude procedure's effectiveness at easing severe mental health problems.
Over 22,600 ECT treatments were carried out in 2015-16 across four-fifths of the NHS' mental health trusts - a rise of 11 per cent since four years earlier.
Electroconvulsive therapy in only recommended to relieve severe, manic depression
WHAT IS ELECTROCONVULSIVE THERAPY? Electroconvulsive therapy (ECT) is given under a general anaesthetic and using muscle relaxants. It causes the muscles to twitch slightly and not convulse. ECT's mechanism is unclear. It may involve changing blood flow patterns in the brain. Some users find it hugely beneficial, while others report feeling violated. Source: Mind
Almost two-thirds of NHS trusts reported an increase in the amount of ECTs conducted over the four-year duration, according to a Guardian analysis.
The typical number of treatments per patient also rose, from 9.6 in 2012-13 to 10.1 four years later.
Changes in ECT practices varied region-to-region, with Lincolnshire Partnership NHS foundation showing a massive 75 per cent increase, yet Mersey Care NHS trust's procedure number remained fairly constant.
Varying popularity around the country may come down to local medical preferences.
Richard Bentall, professor of clinical psychology, Liverpool University, said: 'The decision about whether ECT is to be used or not is based on the quirks of the local psychiatrist.'
Professor Bentall argues that a larger trial is needed to establish ECT's effectiveness, although other experts question the ethics of this.
Others have suggested the increase in ECT procedures could be down to a change in how it is given.
The electrodes are now applied to one side of the head, rather than at both temples as it was originally administered.
Andrew Molodynski, consultant psychiatrist, Oxford Health NHS foundation trust and national mental health lead, the British Medical Association's consultant committee, said: 'That has slightly fewer side effects and is less likely to cause memory impairment.'
The procedure should only be used as a last resort when antidepressants have failed
The rise in ECT use may also be due to an increase in the number of patients with treatment-resistant depression or doctors wrongly using the procedure as a first-line therapy as it is faster-acting than antidepressants.
Despite its supposed barbaric nature, patient acceptance of ECTs is also thought to have improved, which may be down to increasing evidence of its effectiveness.
A 2014-15 survey of 2,148 people, published by ECTAS and covering England, Wales, Northern Ireland and the Republic of Ireland, reported that 91.5 per cent of patients had improved after the treatment versus just 1.7 per cent who had worsened.
Yet, the mental health charity Mind, warns of its side effects, particularly significant, albeit short term, memory loss, which can cause anxiety in itself.
ECT use was relatively high during the 1950s to 1970s, when it was frequently performed without anaesthetic or consent, making it more of a punishment than a treatment.
The National Institute for Health and Care Excellence (Nice) advises ECT should only be used only as a last resort for those with prolonged or severe manic episodes, who are in a unresponsive state, or who have been unsuccessfully treated for severe or moderate depression previously.