Ireland has enacted a ban on electroshock treatment, also known as electroconvulsive therapy (ECT), for individuals under 18 under its Mental Health Law enacted in May. The Citizens Commission on Human Rights (CCHR) International, a mental health industry watchdog, hailed the move as a major human rights advance.
The ban safeguards minors from a procedure that delivers up to 460 volts of electricity through the brain, which can cause severe memory loss, cognitive impairment, and brain damage. In the United States, the Food and Drug Administration (FDA) has cleared ECT devices for those 13 and older for three limited conditions, but the practice is often administered off-label, a practice CCHR wants to see stopped.
Jan Eastgate, President of CCHR International, praised Irish officials for recognizing the need to prohibit ECT use on minors. "However, like thousands who called for ECT to be banned in the U.S. under the FDA's Final Rule in 2018, the ban should be extended to all ages. CCHR is committed to achieving this," she said.
The Human Rights Institute in Ireland reported that the adoption of the Mental Health Act is "one of the country's significant developments in the advancement of human rights and in the reconsideration of the relationship between health, human dignity, and the public responsibilities of the state." The Irish Mental Health Commission noted that "the most significant right potentially affected by this legislation is the right to liberty and personal security."
CCHR helped obtain the first law banning ECT use on minors under 12 in California in 1976, and later in Texas on minors under 16 in 1993. In Western Australia, the practice was banned on those aged 14 and younger in 2014, with the Mental Health Act enacting criminal penalties for anyone administering it to a child.
The newly formed Stop ECT Coalition in the U.S., comprising a consortium of health and human rights organizations, is urging a review of how ECT devices remain on the market. ECT devices were "grandfathered" into FDA regulation in 1976 as a Class III high-risk device, bypassing modern standards requiring Premarket Approval (PMA) with clinical trials proving safety and efficacy. In 2018, the FDA reduced the risk classification to moderate risk (Class II) without such trials. The Coalition emphasizes: "This incorrect classification allowed ECT devices to be used on children as young as five, pregnant women, seniors, veterans, and other vulnerable persons… Involuntary application—still occurring in some U.S. facilities—has been condemned by the United Nations and World Health Organization as a human-rights abuse." More information is available at stopect.com/coalition.
Dr. John Read, Professor of Clinical Psychology at the University of East London, has extensively reviewed ECT studies and notes that some early proponents argued that ECT works by reducing intelligence or erasing traumatic memories, a theory known as "brain-damaging therapeutics." He and colleagues have published a review demonstrating that ECT's effects on the brain are very similar to closed-brain injury. Robert Rubinstein, a former psychiatry professor at the University of California, San Francisco, compared ECT to "kicking a Swiss watch… I can see very little if any reason to use it." Psychiatrist Dr. Niall McLaren stated unequivocally: "No psychiatrist needs to use ECT."
A mental health strategy plan drafted by the World Health Organization's Department of Mental Health and Substance Use warned of ECT's health risks, including brain damage, cardiovascular complications, memory impairment, and even death. The plan states that ECT should be banned for children and non-consenting use may constitute torture.
CCHR, established in 1969 by the Church of Scientology and professor of psychiatry Dr. Thomas Szasz, has helped obtain hundreds of laws worldwide that increase informed consent rights and prohibit deep sleep treatment, a combination of ECT and a psychotropic drug-induced coma.
