Losing the mind hurts, treatment to get it back hurts more

Reeking with the smell of medicines and worn-out bandages, the dimly-lit mental health ward of Jinnah Post Medical Center paints a gloomy picture for both the visitors and the patients. Amidst the melancholy, Amir Sardar, a twenty-year-old severely ill patient, manages to put a smile on everyone’s face with his jovial demeanor.

Sardar received several electric shocks in the last 10 years, as he is suffering from a prolonged mental disorder. Worse still, he has been chained to his bed for almost a month, a violation of the Sindh Mental Health Act 2013, which prohibits any form of ill-treatment including beating and chaining of patients.

“He [Sardar] is addicted to drugs and does not stay in control,” Shaheen said of her son who has visited the hospital many times in the last ten years. “He gets electric shocks and medicines, gets a little better, and then runs away again.”

Inhumane treatment of mental health patients is nothing new. This is in addition to the torture that mentally ill people go through at the hands of almost everyone they meet on the street, from stone-throwing children to sneering youths and dirty older men.

ELECTRIC SHOCK THERAPY:

Electric shock therapy or Electroconvulsive Therapy (ECT) is a hit-and-a-miss at best even though the procedure has been in use since 1940’s. It is a deeply controversial treatment. Many international healthcare organisations have been working for decades to ban this treatment.

But despite the controversial status of ECT, doctors at the Jinnah Post Medical Centre (JPMC) prescribe and carry out ECTs very frequently. Severely ill patients receive electric shock treatments at the psychiatry wing of the hospital.

The misery of the speech-impaired Sardar cannot necessarily be attributed to the side effects of electric shocks, but it cannot be completely ruled out either.

But while there is opposition to ECT, many specialists also hail it as a highly effective method of treating mentally ill patients.

A research paper by American Psychiatric Association says: “Numerous studies since the 1940s have demonstrated ECT’s effectiveness. Clinical evidence indicates that for complicated cases of severe major depression, ECT produces a substantial improvement in at least 80 per cent of patients.”

“Electric shocks are a part of treatment like any other medication,” JPMC Psychiatry Department’s Head Attendant Ruth Bhatti said, and added that ECT is given only when all other treatments have exhausted.

When asked about Sardar’s treatment with electric shocks, Bhatti said, “He has received electric shocks a few days ago. He has been given ECT in the past too.” Explaining, she said these shocks are painful but very crucial for the betterment of the patient. “He [Sardar] gets calmer for a few days after the therapy.”

INFORMED CONSENT:

While the legitimacy of ECT remains debatable, getting patients’ consent for the treatment has also been a contentious issue at local hospitals. According to the Sindh Metal Health Act, ECT can only be carried out with the informed consent of the patient or their guardian.

“Usually, the consent of the patient is not given much value at JPMC because of lack of awareness among patients and guardians,” an official said on conditions of confidentiality. “Doctors perform the shock therapy without worrying too much about consent.”

However, former head of the Department of Psychiatry Dr Musarrat Hussain said: “ECT is administered safely at Jinnah Hospital, where all the proper guidelines are followed including consent from the patient as well as proper dosages for anesthesia.”