Shock treatment stirs debate in state
Woman who 'lost years' works to ban procedure
By PAUL GRONDAHL, Staff writer
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First published: Saturday, July 18, 2009

They are lost years for Linda Andre.

Andre was a graduate student studying writing and photography at New York University when she was subjected to involuntary electroshock therapy in 1984 during a period of severe depression and commitment to a psychiatric hospital.

"Those years were taken away from me, just erased. I have no memory of several years after I was told shock treatment was harmless. I'll never get those years back," said Andre, author of a new book critical of the controversial treatment in which a jolt of electricity is sent though electrodes attached to a person's temples at a level that produces a grand mal seizure in the brain.

The 49-year-old New York City resident was in Albany this week to lobby legislators to pass a bill banning shock treatment on children and to take part in a protest in front of the state Office of Mental Health. She also planned to sign copies of her book, "Doctors of Deception: What They Don't Want You to Know About Shock Treatment," recently published by Rutgers University Press.

Andre has become a leading voice in a national debate over electroshock treatment, pitting patients who say they received relief from crushing depression by being shocked against people who say it did not work and left them with serious memory loss and other cognitive impairments.

Electroshock treatment, which is legal in New York and most states, is depicted in memorable and horrifying scenes in movies ranging from "One Flew Over the Cuckoo's Nest" to "The Changeling."

The American Psychiatric Association and other medical experts, however, as well as federal and state regulators, consider shock treatment done with a patient's consent and under accepted guidelines to be a relatively safe and effective means to combat severe and chronic depression among patients who have considered suicide and for whom other treatments have not worked.

More refined equipment and techniques have improved shock treatment to the point that it no longer resembles the barbaric, gruesome cinematic images or the way it was routinely administered as recently as two decades ago, its supporters say.

A leading proponent of shock treatment is Kitty Dukakis, the wife of former presidential candidate and Massachusetts Gov. Michael Dukakis, who in her 2006 book, "Shock," credited the "last resort" treatment with saving her life after a lifetime of depression, battles with drug and alcohol addiction and 25 years of taking antidepressants.

But a group of advocates, led by Andre, are seeking an outright ban of electroshock treatment, as a handful of states, including Texas, have adopted.

"There is no such thing as a safe amount of shock. That's a myth. Any current through your brain is too much current," Andre said.

On Monday, in advance of Tuesday's protest, state OMH officials released a policy advisory that requires tighter restrictions and additional limits on the use of shock treatment, also known as electroconvulsive therapy, on children under the age of 16.

Among the new policy requirements for patients under 16 are these:

A thorough psychiatric assessment by independent experts.

Written consent of the parents or legal guardians, along with written consent of the child when feasible.

A medical examination to screen for conditions that could increase risk of impairments.

A test of memory skills before, just after shock treatment and several months later as a follow-up.

In practice, shock treatment is rarely administered to children in New York.

In the past three years, no children were given shock treatment in a dozen state-operated psychiatric facilities that treat children. About four children on average were treated with shock by private psychologists, according to OMH records.

Among teens between 16 and 18, an average of about 35 youths were given shock treatment each of the past three years, all by private psychiatrists and none at state facilities.

Among adult psychiatric patients in the state, the use of shock treatment peaked at about 2,000 individuals in 1999 and has since declined to an average of about 1,600 adults each year currently.

"I know people on both sides of the fence on this issue and they're both right," said John Daniels, a special assistant to the commissioner of OMH who spearheaded the new policy for shock treatment on children.

"It's true that people like Linda were irreparably harmed years ago. It's also true that other people right now say nothing else helped and this saved their life," he said.

Harvey Rosenthal, executive director of the New York Association of Psychiatric Rehabilitation Services, an advocacy group, praised the efforts of Andre but stopped short of supporting an outright ban if strict regulations, oversight and informed consent are enforced.

"Linda and other advocates have battled courageously to bring about long-overdue regulations and protections," Rosenthal said.

The crux of the issue for Daniels is informed consent.

"Both sides have very strong opinions on this, but the last thing I'd want is a group of protesters banning a private decision based on free choice," he said.

Paul Grondahl can be reached at 454-5623 or by e-mail at pgrondahl@timesunion.com.