Shock doctrine

The latest iteration of the Mental Health Care Bill is expected to put strong checks on the use of electro-convulsive therapy ECT,which is used rampantly in India. Popularly known as shock therapy,it involves administering precise electric shocks to the brain to stimulate specific nerve cells,to kick-start severely depressed patients. It has been demonised in movies like One Flew Over the Cuckoos Nest the violent seizures,and the calm it creates later,put off observers. However,many in the medical community defend its use as a highly effective last-ditch treatment for depression.

After a couple of Italian doctors hit upon the method in 1938 and successfully treated a patient for hallucinations and confusion,albeit temporarily,ECT has been a standard line of mental treatment. Its use has waned as anti-depressant drugs took off after the 1970s and 1980s,but for the most recalcitrant cases,measured convulsions have been known to lift depression. As the Yale surgeon and bio-ethicist Sherwin Nuland has said,modern treatment looks nothing like the early ECT methods,before there was an effective way to paralyse the muscles,leading to the dangerous grand mal convulsions.

However,for all the refinement of the procedure now,there are ongoing studies that claim that ECTs benefits are short-term,and that it can impair memory and the ability to absorb new information. In India,of course,its only with these amendments to the Mental Health Care Bill that anaesthesia has been made compulsory,and necessary checks installed direct ECT will be avoided,and it will not be used on minors. However,the most important improvement could be to make sure the patients informed consent is available,wherever possible,and that the psychiatrist who recommends the treatment lays out the benefits and the possible side-effects.