Presentation to Leinster House 23rd February 2010 – Paddy Mc Gowan

Delete Section 59b 2001/06 Mental Health Act.

Good afternoon I would like to thank you for giving me the opportunity to speak to you today. My name is Paddy McGowan; I am a psychiatric survivor and activist. I have been an activist for nearly 25 years. I spent over ten years within psychiatry many of those years in the hospital and the community, I have had ECT carried out on me both voluntarily and forced. In my case, I was told that ECT was my last chance. They had tried all other medicines and treatments on me, but the only treatment I was offered was medicine and ECT. After the first treatment when I was taken back to the ward I lay on my bed, my head felt that it had been driven over by a steam roller, the pain was excruciating, I had problems with my memory, and I was confused. I was informed a few days later that I was going for another ECT treatment I immediately refused and was told that it would be easier for me to have the shock voluntarily, because if I was to refuse that my status could be changed to involuntarily. I was left to think over whether I would consent or not. I was advised by some of the staff and other patients that it would be better for me not to put up a fight. I received a number of other treatments over the years. I cannot honestly say that it did not help me but it has left me with long term memory problems. I would never allow myself to have it carried out on me ever again. If in the future I found myself in a posisition of being detained under the Mental Health Act I would honestly consider suicide. I have recovered from my time of severe distress, largely with the help of fellow survivors and friends, without the use of medication and ECT. I was told for years that I had a disease that I could not recover from; my family were left with absolutely no hope and almost given me up for dead.

I think we have to question what is wrong with our Mental Health Service provision, when we have to force people to use our services and have to use force to treat them. We don’t have to force people with mental health difficulties to use our general health services. We are often told that people who have to be forced with ECT treatment or indeed any other forced treatment within Psychiatry, have no insight, this argument is very often bandied about without any clear research being produced. The reality, is more likely that people have had bad experiences, subjected to these forms of treatments, the side effects are toxic to say the very least. My own experience of ECT is that I suffered from both long and short term memory loss. I have in the last 25 years advocated for people within psychiatric services, and my experience tells me that the majority of people who are deemed to be service users are very much opposed to forced treatments and more so around, ECT. The Irish Advocacy Network as a peer led organisation that provides advocacy to people in hospitals and the community are also opposed to forced ECT they are in favour of deleting section 59b, they are not opposed to ECT per say. People should have a choice around their treatment, and it is not the duty of the Network to make those choices for people. The Irish Advocacy Network is the longest service user group on the island of Ireland working with people for ten years in various states of distress.

The well known and respected Psychiatrist Peter Breggin has spoken in one of his books (Toxic Psychiatry) relating ECT to being the same as a (closed Brain Injury). Indeed other Psychiatrists of standing within the profession are of the same opinion. The Royal College of Psychiatry has also within their own code of practice declared   ECT is unlikely to help those with mild to moderate depression or most other psychiatric conditions. It has no role in the general treatment of schizophrenia. We know from the inspector of mental health services report for 2008 that 73% of people given ECT had a diagnosis of a Depressive Disorder, 27% had other conditions and 24 people given ECT had a diagnosis of Schizophrenia. The fear that most people have with the ECT is that there is no clear consensus from within Psychiatry around the efficacy and safety of the procedure. We are often told that ECT has saved people lives, yet we have never seen any research to prove or discount this statement, on the other hand, some people could claim that ECT has damaged people, and taken people lives. We know from some people that they claim they became suicidal after undergoing the procedure. How many people have died during the procedure? Some would say that deaths during the treatment were recorded as cardiac deaths or natural causes. We just simply don’t know, neither of the two groups either for ECT or against have any clear research or science to base an informed opinion. I would call on the Government to commission independent research on ECT preferably from outside the country. I think we as a country will find ourselves under investigation, similar to the last few reports that have been published we have questions as a country to answer. The institutional abuse scandals that have come to light have close linkages to our past Psychiatric Service Provision and practices.

There is another group that is not being taken into account here, they are a group I call the Service Refuser community. Over the years, I have come into contact with a large number of people who live and work in our communities who encounter mental health distress. When you speak with them, they clearly tell you that they have no faith in Psychiatry, because of fear and the treatments they could or have experienced at the hands of practitioners. People have found alternative ways of managing and living with their distress, they quite often tell me that they would love to be able to have contact with professionals, but don’t believe that they would find people who could understand their belief systems, I remember one individual I met, I asked him why he refused to use the services, his answer to me was I might be mad, but I am certainly not stupid. He believed that he would have no rights in Psychiatric Hospitals he had absolutely no faith in the Mental Health Act. His argument and that of others, coming from refuser community, also indeed from within the service user community was that the second opinion Psychiatrist provided for within the legislation is just a rubber stamping exercise. They would say that they come from the same professional group and in some instances, are friends or colleagues. The argument being that they are not fully independent, and do not provide a sense of security for the user. Fundamentally they come from a pro medical model view point which quite often is at variance with the user’s beliefs.

I would like to point out again that we are not saying that ECT should be abandoned; we are just simply saying that people should have choices. We as a society need to protect the human rights of all our citizens. We have come to a place now that we are starting to listen and respect service user points of view, can we afford to go back to the days of paternalism. I would like to thank Minister Maloney for arranging this meeting. However, I would like to point out that I find it difficult to understand why our meeting was held first and separate from the second meeting, in my opinion, both sides should have given their evidence on the same day to allow the senators and deputies the chance to ask questions of both sides, it begs the question why?. It seems that the opposing side has the opportunity of listening to our presentation, and we have no chance of contributing when they present. Both sides need to be able to contribute in the debate and challenge.  

We have also an online petition Delete Section 59b; the poll has just been alive for around a month or so. To date, we have received 522 signatures given that we had no resources nor did we publicise widely, and a short time span. I think it gives you a flavour of the feeling in society. When we close the poll, I think you will find that we will have obtained a large constituency from across the country who agrees with our position.

I urge you to protect the rights of people and value them as equal citizens in this land of ours, after all this country and ancestors fought for our independence and equality.

Thank You.