Throughout the course of 2024, judges in Connecticut’s probate court system approved nearly two hundred petitions from psychiatric hospitals to administer electroconvulsive therapy (ECT) to patients who had thus far refused the treatment, according to figures obtained under a Freedom of Information request and provided to Inside Investigator.
ECT, popularly known as electroshock therapy, involves administering anesthesia to a patient and then inducing a series of seizures by running electrical currents through the brain. ECT is generally used to treat major depression, bipolar disorder and sometimes individuals who experience hallucinations. Treatment generally consists of six to ten rounds of treatment, and, according to most literature, it is 60 to 80 percent effective in alleviating those symptoms when the patient has not responded to other pharmaceutical and therapeutic interventions. It is an attempt to jump start the brain.
Elisa voluntarily underwent ECT treatment at Silver Hills Hospital in New Canaan twice – once during a major bout with severe post-partum depression in 2003 that required her to be hospitalized, and again many years later in 2019 and 2020 following a hysterectomy that triggered another severe depressive episode.
“The medications made me feel worse and they take so long to kick in. I had never been on medication before and I was just going downhill,” Elisa said. “It’s not like it was pushed on me at all, it was presented to me as an option. I was just so desperate, I was looking for something because I was so far away from my baseline as how I normally am.”
Elisa, like many others, described some short-term memory loss associated with the treatment, in which the time surrounding the treatment is “fuzzy,” and describes waking up after one treatment not remembering where she was until the doctors reminded her. In 2020, following the ECT, she didn’t remember the hysterectomy until her husband reminded her. Nevertheless, she says she would have traded those side effects “in an instant,” for the relief she felt.
“I was so miserable with all the suicidal feelings, I was a mess,” Elisa said. The treatment worked for her almost instantly and, to this day, she credits it with helping save her life.
For most of the public, ECT likely sounds like a harsh, medieval treatment from a bygone era when psychiatric medicine and treatment were just starting out and has since been relegated to the dustbin of history alongside other treatments like lobotomy, but that is far from the case. In fact, ECT treatment has seen a rebound in usage following a campaign in the 1970s and 1980s to restrict the practice.
“There’s still big misconceptions about ECT,” Elisa said. “It’s scary as hell, but it was a lifesaver for me. It’s like a miracle to me.”
While the treatment worked well for Elisa, she voluntarily agreed to it. The information obtained from the Connecticut probate court system, on the other hand, shows the number of times psychiatric institutions and doctors have had to obtain a court order to administer the treatment against a patient’s will, and that number appears to be rising over the last ten years.
In 2015, there were 81 such petitions; by 2024, the last complete year for which information was provided, there were 193. The court petitions are concentrated in areas where there are major psychiatric hospitals like Hartford, Middletown, and New Haven.
Even though the information for 2025 was not for the whole year, there had still been 174 petitions to probate court for forced ECT, including 72 such petitions in Middletown, which houses Connecticut’s state-run psychiatric hospital, and 35 in New Haven, where Yale’s psychiatric hospital is located.
Involuntary ECT is really supposed to be a last resort, according to Kathy Flaherty, Executive Director of the Connecticut Legal Rights Project (CLRP), which offers legal services to psychiatric patients who believe their rights may have been violated.
Under state statute, a probate court can grant the authority to administer ECT to an unwilling patient if two things are true: the patient is incapable of giving informed consent due to their illness, and there are no other less intrusive, beneficial treatments available. The head of the hospital and two physicians must agree that the patient is incapable of making an informed decision and, if granted, the court order allows 45 days for treatment, after which the hospital must reapply for another court order.
Flaherty says her organization is also looking at the increased number of petitions and says that, according to past testimony, some psychiatric institutions may be obtaining petitions for ECT even when the patient has voluntarily consented to the treatment. While patients who are brought before probate court for a petition initially receive legal representation from a court-appointed attorney, CLRP gets involved when a patient files an appeal of the court’s decision.
Flaherty says that CLRP has several appeals pending and a judge recently decided in favor of the appellant in a probate hearing to mandate ECT, but she also says when an appeal is filed, the physicians often try something else even though they have the authority to administer the ECT.
“If there was testimony in the underlying hearing that there hadn’t been other things tried, or the person was there and testifying themselves and there was an argument to be made that they were capable of giving that informed consent, we would likely appeal,” Flaherty said. “What has happened in a number of cases where we brought the appeal, the treating psychiatrists and the treating professionals in the unit decide they’re not going to proceed with the ECT even though they have the legal authority to do it and are going to try something else.”
Flaherty says the petition numbers provided by the Probate Court doesn’t necessarily mean those petitions were granted, but says that after reviewing dockets for Middletown going back to 2020, the “vast majority of them were.”
“I would say it is rare for a petition to be denied,” Flaherty said. “The vast majority of them are granted.”
“I never chose to have it,” said Chris Dubey, who was hospitalized in 2005 at the age of 22 following a series of suicide attempts. “They put me on a few other medications, and I had a few talks with a psychiatrist, and I met with a psychologist, but it wasn’t too long – maybe just like a month – that they started talking about how I had what they called ‘treatment resistant depression,’ and there really wasn’t much else to do for me, except give me ECT. My psychiatrist was really pushing it.”
“I was kind of shocked to realize they were still doing this treatment,” Dubey said. “I was skeptical about it because it seemed like an extreme treatment to be putting someone under anesthesia and then putting them into a seizure and despite all the good things they were saying about it, it just didn’t seem like a good idea. I didn’t want to do it, and I wanted to try other things.”
Dubey says that despite his suicide attempts, his family supported him in refusing the treatment, but the doctors applied for a court order, and it was granted after a short hearing. He was then forced to undergo sixteen treatments. Dubey says that while the treatment “tamped me down” mentally and emotionally, he also found it “emotionally traumatizing.”
“Everybody has their own individual experiences,” Dubey said. “In my experience, from what I had, it really was torture to be honest. I never consented to it; I never wanted it.”
ECT lingers in the public consciousness largely through popular Hollywood depictions that don’t necessarily reflect the reality of the treatment. Indeed, likely many people don’t even realize the practice is still being utilized.
However, according to the number of probate court petitions, it appears to be used more often against patients’ will over the last ten years. The causes for this – or whether there even is an increase in petitions for forced ECT – are varied and subject to debate, according to several experts and advocates.
Despite the treatment’s usage in psychiatric institutions, it remains a controversial subject, and recent legislative attempts to expand court permissions for forced ECT have highlighted a divide between the professional psychiatric industry and the patient advocacy movement; it is a divide that has persisted for fifty years, with much the same arguments and tactics being utilized over decades.
The effects of ECT, and the controversy surrounding it, are nothing new. ECT remains a last resort when all other treatment has failed. The question, however, is whether that last resort is worth the potentially traumatizing effects of forcing the procedure, and whether the probate court system is structured in a way that ensures the proper protections for patients.
One Flew Over the Cuckoo’s Nest
Perhaps no other image of ECT treatment exists in the general public’s mind more than the 1975 film starring Jack Nicholson, One Flew Over the Cuckoo’s Nest, based on the 1962 novel by Ken Kesey. Indeed, every individual interviewed for this story mentioned it. In the Academy Award winning film, Nicholson plays an anti-establishment rebel who is placed into a psychiatric institution and subsequently forced to undergo ECT when he becomes a disruptive presence and refuses to comply with hospital protocol and procedures.
The disturbing depiction of ECT in the film, however, was not reflective of ECT treatment at the time, but rather earlier forms of the treatment that did not involve anesthesia. For better or worse, the film cemented itself in the public consciousness and helped fuel a growing social movement in the 1970s that sought to push back on institutionalized mental healthcare and practices like forced electroshock therapy, according to authors Rael Jean Isaac and Virginia C. Armat in their 1990 book Madness in the Streets: How Psychiatry and the Law Abandoned the Mentally Ill.
The authors write that in the early days of ECT, the treatment was overused for everything “from alcoholism to zoophobia,” and the experience of patients could range from benign to frightening experiences and even bone fractures from the convulsions. Some patients received over one thousand treatments, or a dozen in a single day. However, by the 1960s, much of that had been eliminated by using anesthesia, changing the amount of electricity used, and changing the placement of the electrodes.
However, a growing movement dubbed the “ex-patient movement,” led by former psychiatric patients who formed organizations like the Network Against Psychiatric Assault (NAPA) to lobby against the use of ECT, capitalized on the success of One Flew Over the Cuckoo’s Nest to push for states to place restrictions on ECT.
“The ex-patient movement’s effort to mobilize public opinion against ECT was given a major boost in 1975 when the filmed version of One Flew Over the Cuckoo’s Nest… won the Academy Award as best picture of the year and Jack Nicholson won an Oscar for his portrayal of Patrick McMurphy,” Isaac and Armat wrote. “ECT is portrayed as a form of torture, administered to the hero to subdue, not treat him.”
California was the first to pass a law restricting the use of ECT treatment in 1974, which was then revised in 1976 following a lawsuit brought by a psychiatrist who claimed the law impeded an individual’s right to voluntarily get the treatment. Under the terms of the California law, a patient who is too ill to give voluntary consent would be allowed a family member to either consent or reject a court petition for ECT treatment.
Following California, “twenty-five other states passed legislation singling out ECT for special restrictions.”
Consequently, ECT practically disappeared for nearly two decades, which is why many people may think it is no longer used. In the 1970s, state hospitals only administered the treatment to “one third of one percent of patients.” While ECT was used more frequently in private general hospitals, it was still exceedingly difficult for psychiatrists to wade through the red tape. The ex-patient movement went on to push for a total ban on ECT in several states and at the federal level through the U.S. Food and Drug Administration.
However, the push to restrict or outlaw ECT was met by pushback from psychiatrists who believed the treatment was effective. Patients who had benefitted from the treatment were less willing to share their stories for fear of social stigma, but beginning around the 1990s, ECT quietly began to work its way back into practice.
“Expert estimates of current usage range from 30,000 to 100,000 patients a year, indicating the high level of uncertainty as to the extent to which ECT is in fact given,” Isaac and Armat wrote. “In so far as the use of ECT has gone up, it is primarily in the private sector; public hospitals for the most part lack the capacity to give ECT, sending out patients for treatment to private hospitals in the rare cases they decide it is needed.”
Today, most available information places the number of individuals in the United States who receive ECT at 100,000 per year, according to a report by Irving M. Reti of Johns Hopkins Hospital, who writes that ECT “is hands down the most controversial treatment in modern psychiatry,” but that the practice “survived its critics because it is safe and it works.”
“Modern ECT is much safer and more controlled, with rigorous guidelines and patient consent protocols in place,” said Dr. Robert Ostroff, medical director of the Mood Disorders Unit and co-medical director of the Interventional Psychiatry Service at Yale Psychiatric Hospital, in a 2024 column posted to Yale Medicine’s website. “ECT is a treatment that is very burdened by bad publicity and public perception. Our best estimate is that half of the people who could benefit from having ECT are not getting it because of these factors.”
“I think a lot of people who don’t know much about ECT, or don’t know that it’s still available as a treatment, definitely have some preconceived notions about what it’s like, and some of those preconceived notions are formed more by cultural depictions of ECT rather than how it’s been delivered over the past several decades,” said Dr. Caleb Battersby, director of interventional psychiatry at UConn Health. “There are side effects, and the cognitive side effects can be pretty significant depending on the person and the modality of ECT being used.”
Battersby says that ECT tends to be a last resort treatment when medication has failed, but believes it shouldn’t necessarily be a last resort.
“It’s conceptualized as a last resort and it is used for people who have resistance to other treatment modalities, but I think in an ideal world it would be used more frequently because there’s probably people who it would save a lot of time and energy and months feeling depressed if they did ECT sooner rather than later,” Battersby said. “You have a lot of people who cycle through different medications and if medications aren’t working, you’re probably better off going with something like ECT rather than waiting for things to get to the point where you’re in the hospital and you’re doing really bad.”
Back to Normal Following COVID?
However, it is not voluntary ECT that concerns James Flannery of Glastonbury, who originally filed the FOI and received the data; rather, it is “forced” ECT that he believes should be eliminated. Flannery said he felt “overwhelmed” and “hopeless” when he saw that the number of ECT petitions was increasing.
“If somebody wants to go get zapped, I’m not going to stop them,” Flannery said. “My response to [the information] was kind of overwhelmed, because when you see it rising… I’m in the position here where I’m trying to get it to go away and if it’s rising, that’s a big wave to be pushing against. So, it sort of made me feel like we have no hope, because I had no idea how bad it was, and it’s getting worse.”
Over a ten-year window, the total number of ECT petitions that went before Connecticut probate courts went from 81 in 2015 to 174 in 2025. As indicated before, the majority of those petitions come from courts where there are large psychiatric institutions, including Middletown and Hartford, the location of Connecticut Valley Hospital (CVH) facilities. CVH has seventeen inpatient units, including a facility for youth, the Whiting Forensic unit, and three geriatric units, accounting for nearly 400 psychiatric beds. Generally, the patients who are admitted to CVH have not had success in treatment at other hospitals and will require more long-term care.
The number of petitions to Middletown Probate Court for ECT went from 54 in 2015 to 72 in 2025. However, that number has remained fairly steady – there were 78 petitions in 2016, and 64 petitions in both 2017 and 2022. CVH contracts ECT treatment out to Hartford Hospital’s Institute of Living and, to a lesser extent, Middlesex Hospital and occasionally Yale.
Dr. Vinneth Carvalho, deputy statewide medical director for the Department of Mental Health and Addiction Services (DMHAS), which runs CVH, says the impression that ECT petitions have increased, at least in Middletown, is likely because of COVID that resulted in the temporary shutdown of certain medical and mental health services and tipped Connecticut’s mental health system into crisis.
“What happened was that COVID happened. So, the numbers dipped during COVID,” Dr. Carvalho said in an interview. “During COVID, what happened was they [Institute of Living] paused operations. Some of our patients, we had to figure out how to manage them for a little while during the height of COVID. They weren’t admitting any new patients into the system, and they were trying to maintain the ones they had.”
“During COVID there was a disruption in ECT services,” Dr. Battersby said. “I wonder if that led to some decline and now, you’re seeing the numbers build up again.”
There were 125 petitions filed for ECT treatment in the state in 2020 and 189 in 2021. However, there were only 33 filed in Middletown Probate Court in 2020 and 49 in 2021, so there was a dip in petitions that likely came from CVH, before building back up toward its more normal numbers. Instead, it was other probate courts throughout the state that saw more petitions for ECT treatment between 2015 and 2025.
In 2015, ECT petitions were filed at ten different probate courts; by 2024, there were petitions filed at seventeen different probate courts, and thirteen courts in 2025. The increase in ECT petitions didn’t come from the Middletown Probate Court; it was other areas like Farmington, where UConn Health does its ECT treatment in-house, that saw increasing petitions.
Farmington went from three petitions in 2015 to 36 in 2025; New Haven, where Yale is located, went from nine to 35; and Hartford went from one to 12. In between, there were years where those numbers were even higher, particularly in 2024. Similarly, many probate courts that had previously seen very few ECT petitions over the years began to see more, particularly following the COVID pause.
For instance, West Haven’s probate court only saw seven years in which there were petitions for ECT treatment, but the number of petitions went from one in 2015 to a spike of 21 in 2022. Bridgeport probate court went from zero petitions in 2015 to a high of eight in 2022.
“What you’re seeing is a pickup back to the normal level numbers of what it was like back in 2016, 2017,” Carvalho said. “I would hesitate to say the numbers are increasing. We can’t read too much into the numbers, and we have to put context in the situation.”
Part of that “context” is that the Institute of Living and Middlesex Hospital, since 2024, has altered the way they interpret the statutes surrounding ECT treatment in Connecticut for persons who are conserved.
A conservator can be a family member or attorney appointed by a probate court judge to make medical and psychiatric decisions for a patient because they have been deemed incapable of making those decisions for themselves. The conservator can consent to administering medication to a patient against their will, but not necessarily ECT treatment; for ECT treatment, a psychiatric institution can seek a probate petition with or without the conservator’s approval.
However, since 2024, the Institute of Living and Middlesex Hospital have sought out court petitions for ECT treatment for conserved persons, even when the conservator consents to the treatment, believing that this is more in-line with state statute.
“What they’re saying is that any patient who is conserved should get authorization from the probate court if we want ECT. They’re not saying it is the conservator who should decide, they’re just saying there may be an element of doubt if somebody is conserved so we want to make sure the probate court is the one authorizing that,” Carvalho said. “We had always operated, we had it in our policy, that if someone is conserved that we should go to probate court for authorization for ECT, but I don’t know that the institutions that were doing the ECT were enforcing it.”
Another area of context has to do with Connecticut’s aging population and the groups for whom ECT is most successfully used – elderly patients. According to Dr. Battersby, geriatric patients affected with depression tend to respond well to ECT. CVH has three units for elderly psychiatric patients.
“What we use it for is primarily depression that is very difficult to treat,” Battersby said. “There are certain types of depression that tend to respond really well to it, so folks who have late-onset depression, so geriatric depression, they tend to respond very well, so maybe there are more referrals or more petitions to the probate court because of the aging population and ECT have a better response rate among them.”
“A number of these older folks, their kidneys may not be functioning well, their livers may not be functioning well, they can’t tolerate medications,” Dr. Carvalho said. “If you have severe depression where you’re going to take your life, you’re not eating, you’re medically compromised and there is no medication that can treat that depression, then you have to look for something that’s not medication and ECT has to be a consideration.”
Dr. Carvalho says they are focused on getting patients to the point where they can be discharged back to the community to continue their lives, and when every other medication has failed, they eventually turn to ECT. She says that in 2025, the hospital was able to successfully discharge six patients following ECT.
Despite new treatments for depression that are beginning to be used by psychiatric institutions, like Ketamine and transcranial magnetic stimulation, which uses magnetic waves to stimulate nerves in the brain, Carvalho says that ECT remains the most studied and effective treatment so far when all else has failed.
“We are focusing on discharging people from the hospital. We have people who have been here for years, ten years, eleven years. I know that we’ve had a focus on making sure that patients who have chronic refractory illness, we look at other options for them so they can get transitioned from the hospital and live a meaningful life in a less restrictive setting,” Carvalho said. “ECT is still a really safe, effective treatment for chronic refractory mental illness,” Carvalho said.
Shocked 500 Times and the Push for 90 Day Petitions
In 2019, Carol Levesque, a 70-year-old patient at CVH, appealed a probate court decision to administer ECT to her against her will.
According to the court complaint filed by attorney Virginia Teixeira, formerly an attorney with CLRP, Levesque had received involuntary shock treatment “approximately 500 times” since 2015, was forced to attend “serial probate hearings” every forty-five days, and endured “a constant fear of shock while being deprived of her constitutional right to due process.” Indeed, the court exhibits showed thirty probate decisions between 2015 and 2019.
“Ms. Levesque is aggrieved because she would have been discharged if the forced shock were ‘beneficial’ as required by statute,” Teixeira wrote. “However, Ms. Levesque remains on a locked unit despite 500 shocks, with the hospital pursuing more shock rather than pursuing beneficial treatments that could lead to discharge… she believes a reasonable decision maker would conclude that shock is not beneficial if 500 shock treatments did not lead to her discharge.”
Although the Attorney General’s Office made multiple motions to dismiss the case, six years later, in December of 2025, a judge ruled in favor of Levesque’s appeal. During the court process, Levesque was granted a stay, meaning the hospital could not administer ECT to her while the appeal was pending.
According to Judge Edward S. Domnarski’s decision, two doctors testified that Levesque was unable to give informed consent because there were times when she was “psychotic” and “down,” and said she had “been on everything.” However, neither offered evidence they had discussed other options with Levesque, nor did they provide factual evidence that she lacked “decisional capacity.”
“After a careful review of the record, the court concludes there is a lack of substantial evidence to establish that the appellant was incapable of giving informed consent to ECT,” Domnarski wrote in his December 2025 ruling. “She was present at the hearing, heard the testimony of the doctors, and then expressed a desire not to receive ECT. This is not a case where a patient’s physical or mental condition, at the time of the hearing, renders them incapable of giving informed consent.”
Writing for the Connecticut Bar Association in 2020, Teixeira argued the legal standard between forcibly administering medication is stricter than that of forced ECT. If a patient is incapable of giving informed consent to medication, the court appoints a conservator to make the informed decision for them. There is no such requirement for ECT and “the hospital can proceed with the shock procedure without being legally required to have a discussion with anyone about the benefits, risks, and alternatives to shock.”
Secondly, she argues there is no real right to appeal because filing an appeal to forced ECT does not result in a stay of execution – the hospital can still administer the treatment while the appeal is pending. “The hospital can schedule shock on the day the petition is granted, and may have administered dozens of treatments before an appeal is heard.”
“In Connecticut today, a person has no real legal recourse even when a probate court order is made on unlawful procedure, and even when basic due process protections that already exist were ignored,” Teixeira wrote. “By the time any appeal could get in front of a superior court judge, the forced shock is over. An automatic stay of the probate court order and an informed consent requirement are fundamental aspects of a safe and fair process. It is unconscionable for people to receive forced shock pursuant to probate court orders that are found to be legally invalid on appeal.”
Furthermore, the attorney for the patient, who is appointed by the probate judge, has little incentive to advocate for a patient to appeal because the attorney is only compensated to represent the patient during the initial petition; they are not compensated for an appeal. This is why the appeals largely fall on CLRP.
However, during the 2025 legislative session, there was a push by the Public Health Committee to double the authorization for ECT treatment from 45 days to 90 days. The proposed bill was supported by numerous doctors and psychiatrists and opposed by mental health advocacy groups, and several individuals – including Chris Dubey – who described themselves as part of the “psychiatric survivors movement,” in a debate that echoed that of the national debate in the 1970s and 1980s.
The Connecticut Hospital Association argued the extension is necessary because “experience shows that the current 45-day limit for this process may impede patient care and result in significant patient decomposition before a probate court can hear a matter.” Dr. Eric Gambardella, a psychiatrist with Middlesex Hospital and assistant professor of psychiatry at UConn, similarly testified that extending the time limit would make administering the treatment easier and more consistent for everyone involved.
“More and more, patients are requiring this treatment on a prolonged maintenance schedule to reduce the severity of symptoms, improve functioning and prevent any decompensation,” Gambardella wrote. “With this change, we will be able to continue maintenance treatments when clinically indicated and avoid abruptly discontinuing care, which risks decompensation and increased morbidity and mortality. In patients that lack capacity to consent, have benefit from treatment and require maintenance, this can help ensure better outcomes.”
Middletown Probate Court Judge Joseph D. Marino also offered testimony in support of the extension. Having “presided over thousands of shock therapy hearings,” Marino said the current 45-day authorization is too short and does not allow enough time “for a true indication of the effectiveness of the treatment upon the patient.”
“Extending the time period to 90 days would provide a clearer indication to the treating physicians and the court as to whether shock is beneficial and should be renewed,” Marino wrote. “Moreover, the extension of time from 45 days to 90 days does not diminish the procedural and due process safeguards contained in the statute.”
Opponents to the bill questioned the overall effectiveness of ECT, listed off the side effects, and warned of a further stripping away of a patient’s right to self-determination. There was even opposition testimony from doctors and professors from outside the state and outside the country, warning of potential side effects.
Tom Burr of the National Alliance on Mental Illness (NAMI) warned that someone who may have consented to the initial treatment may change their mind after receiving the first series of treatments, but the proposed extension “would seemingly allow for multiple rounds of shock therapy to be administered pursuant to the initial consent.”
“We should not diminish this safeguard for the sake of convenience,” Burr wrote. “These time limits have been in place for decades and work. There are ways to ensure that, in the case of maintenance shock therapy, that hearings are timely requested and scheduled so that treatment does not get meaningfully disrupted. But for the vast majority of people subject to shock therapy, the existing time limits are an important protection and should be continued.”
Kathy Flaherty of CLRP argued that prior to 2003 there was no limitation on Probate Court orders for ECT, that the 45-day window was reached through conversations with stakeholders, and that with courts approving roughly 200 ECT petitions each year, she was unaware of any problems with the current law.
“If ECT is not resulting in improvement in the individual’s condition, why is it continuing to be performed? Does it meet the requirements of “beneficial” treatment? Arguably, it does not,” Flaherty wrote in testimony. “Shock therapy is what is done after psychiatry has otherwise failed the patient. The legislature has a special duty to ensure full protective due process to these most vulnerable patients.”
“Praying For a Miracle”
Rita Ricciardi says she was hopeful that ECT would help alleviate her son’s severe depression that had, till that point, not responded to medication. While initially it seemed as if the treatment was making headway with his depression, by his third treatment, the side effects had become so overwhelming for him that he couldn’t continue.
“Nothing had worked, including Ketamine injections. He was getting so tired of things not working and constantly changing the medication,” Rita said in a phone interview. “We tried the treatment, being hopeful, praying for a miracle.”
Severe headaches, nausea, pain in his jaw and uncontrollable physical twitches and spasms resulted in him being placed on more medication to counter the side effects of ECT, thus compounding his existing symptoms of depression, anxiety and obsessive-compulsive disorder, along with side effects from medication he was already prescribed.
“I begged him – his father and I did – for him to try it just a couple more times, and he did,” Rita continued. “My son was desperate, he wants to heal, he wants to get help but now he’s suffering from the physical ailments from the ECT. We had to end that treatment and continue with the medication. He took his own life about nine months after.”
Rita believes the ECT was helping her son, and she hopes that in the future the treatment can be modified to lessen or eliminate the side effects. However, not everyone reacts the same way; some have only minor side effects while others experience something much different. Like many psychiatric medications, how exactly ECT works – when it works — remains unknown.
“We don’t necessarily know how it works. There’s lots of different explanations,” Dr. Battersby said. “The mystery of its effectiveness is not unique in psychiatry; a lot of medications, a lot of treatments we use, we have some idea why they work, but certainly not the full picture.”
But the question remains whether and under what circumstances should such a treatment be administered to an individual against their will. While current state statute appears to offer guardrails requiring two doctors and the head of the hospital to assert the patient is incapable of giving informed consent, based on some of the cases that have been adjudicated through the appeals process, it appears that doesn’t always happen; if a patient can manage to file an appeal, are they really incapable of giving consent?
According to Dr. Carvalho, depending on a patient’s condition, they may be capable of speech and argument to advocate for themselves, but they may be doing so through a delusional, paranoid, or incoherent logic created by their illness.
“It could be that the patient is lucid or it could be that the patient is not lucid but just says I don’t want it, it’s not good for me, or the patient says it in a way that’s psychotic,” Carvalho said. “If the patient is working with Connecticut Legal Rights Project or an advocate, to say they don’t want it, then they have the option to appeal it.”
Secondly, the safeguards around administering medication against a patient’s will are more robust than those of ECT, requiring a conservator who can give informed consent to medication treatment, but not requiring a conservator for ECT – a more invasive procedure.
“I was in the position and still am that I don’t want to live in a state where I have to worry about being forcibly electroshocked,” Flannery said.
The effects of the treatment obviously differ by individual; for Elisa, who received the treatment voluntarily, it was a lifesaver; for Chris Dubey, who received the treatment against his will, it remains a source of trauma that he feels he has yet to get over; for Rita’s son, the treatment may have been effective but his reactions to it made continuing impossible for him.
“I felt better. I didn’t need the medications, and I was back to myself,” Elisa said. “I was suicidal, I was so sick, and then that just disappeared overnight. I know two people who committed suicide recently, and if it [ECT] was more readily available or if it was offered more routinely, I think it could possibly save people’s lives.”
“I’m still struggling. Not in the same ways,” Dubey said. He remains on disability benefits and has had some additional health issues, including a neurological disorder. However, he says he still has difficulty concentrating and reading due to the ECT. “That never went away.”
Chris said this past year he re-enrolled in community college, is taking online courses, and is trying to recapture the joy he had during his initial college years, but did not re-enroll for the spring semester due to his ongoing concentration issues. He remains an advocate for mental health patients and their rights, using his own story to either push for or against legislation.
“I still deal with emotional issues, just like all those events that happened to me back in 2005 and 2006, I became permanently disabled,” Chis said. “It was all quite devastating.”
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