INTRODUCTION

1. Electroconvulsive therapy: Closing the gap between myth and reality Ashley Frith-Pridham, Angela Kermack, and Annamaria Langellotti Department of Nursing, Mount Royal University, Calgary, Alberta References \ Acknowledgments We would like to thank Kevin Carver, RN, for his involvement and input of his expertise. We also express gratitude to Sonya Jakubec, Associate Professor, for her guidance and support throughout the development of our scholarly poster. INTRODUCTION ECT DEFINED The Department of Health (as cited in Bray, 2009) defines ECT as “a treatment involving the passage of an electric current across the brain. The treatment is only administered to an anaesthetized patient who has also been administered a muscle relaxant. The electric current induces seizure activity in the brain which is necessary for the therapeutic effect of treatment” (p. 561). Significant stigma exists surrounding the use of electroconvulsive therapy (ECT) in treating severe depression. When all other therapies have been exhausted, ECT can be an effective way to manage treatment-resistant depression; however, misconception, stigma and fear can dissuade individuals from accessing this treatment. This poster aims to bring some clarity to the misconceptions and stigma associated with ECT use, and illuminates the importance of empowering individuals to make evidence-informed decisions regarding their care and treatment plans. Current literature, research and expert interviews will be explored to provide a realistic analysis of the risks and benefits associated with the use of ECT. HISTORY OF ECT REPRESENTATION ECT, representing all that was brutal and inhumane in the past, began to acquire a massive stigma during present time. Kevin Carver, Registered Nurse, notes that, “there is a huge stigma surrounding ECT. Society portrays it as a barbaric procedure” (personal communication, March 5, 2012). Media depictions of ECT and anti-ECT coalitions play a role in the stigma surrounding this treatment. Distorted information is provided through the internet, movies, television, and press. Negative public reaction due to the history of ECT treatment is also a factor in stigmatization. Anti-ECT Legislation In the 1970’s, lobbying against ECT was initiated by ECT survivors, who had undergone unmodified ECT or who had suffered severe cognitive impairment after receiving ECT. Psychiatrist, Peter Breggin was an active voice in lobbying for anti-ECT legislation. Peter Breggin’s view on mental health focused around the negative iatrogenic effects of conventional psychiatry and treatments such as ECT. Media Portrayal of ECT Ken Kesey’s movie, One Flew Over The Cuckoo’s Nest, shows an unrealistic depiction of ECT as an inhumane treatment. In this movie, ECT was characterized with elements of electrodes, mouth guards, and thrashing limbs. Actor Jack Nicholson was shocked with a high dose of electricity and was administered without anesthesia. In 1971, Joan Didion wrote a review in the New York Times on Doris Lessing’s novel, Briefing for a Descent into Hell. The review noted that ECT had “obliterated the protagonists memory” (Shorter & Healy, 2007, p.156). In contrast to the barbaric portrayal of ECT in the past, recently the Dr. Oz Show featured a special episode on treating depression with Electroconvulsive therapy in January 2012. The show answered pressing questions that the public posed. Dr. Oz specifically spoke about how medical advances have dramatically modernized ECT, which improves its safety. These advances include general anesthesia and the switch to safer types of electrical stimulation. CONCLUSION Procedural modifications as well as the advancement of biomedical ethics have shaped ECT into a safe and effective treatment. Unfortunately, many patients may not access this potentially life-saving treatment due to stigma and negative portrayal of treatment. It is crucial for mental health care professionals to provide an evidence informed, accurate portrayal of ECT to patients as well as the general public. The use of ECT as well as other treatment options should continue to be explored to improve safety in the treatment of mental illness and ensure positive patient outcomes. One patient who received ECT for depression commented that “no one thinks twice when electricity is delivered to a heart that has stalled but when electricity is delivered to the brain, it is viewed as torturous rather than a miracle” (Payne & Prudic, 2009a as cited in ECT, Alberta Health Services, 2011) Kavanagh, A., & McLoughlin, D. (2009). Electroconvulsive therapy and nursing care. British Journal of Nursing (BJN), 18(22), 1370. Payne, N., & Prudic, J. (2009). Electroconvulsive therapy: Part II. A biopsychosocial perspective. Journal of Psychiatric Practice, 15(5), 369-390. doi:10.1097/01.pra.0000361278.73092.85 Shorter, E. & Healy, D. (2007). Shock therapy: A history of electroconvulsive treatment in mental illness. Toronto, Canada: University of Toronto Press. Van Daalen-Smith, C.L. & Gallagher, J. (2011). Electroshock: A discerning review of nursing literature. Journal in Mental Health Nursing, 32, 203-213. doi: 10.3109/01612840.2010.542879 Alberta Health Services (2011). ECT. Retrieved March 9, 2012, from http://insite.albertahealthservices.ca/amh/tms-amh-mod-ect.pdf Bray, J. (2009). The nurse’s role in the administration of electroconvulsive therapy. In P. Barker (Ed.), Psychiatric and mental health nursing (pp.560-570). London, England: Edward Arnold (Publishers) Ltd. Calgary Health Region. (2000). Electroconvulsive therapy (ECT) (E-1). Retrieved February 14, 2012, from http://iweb.calgaryhealthregion.ca Canadian Nurses Association. (2008). Code of ethics for registered nurses. Retrieved from http://www.cna- aiic.ca/CNA/documents/pdf/publications/Code_of_Ethics_2008_e.pdf College and Association of Registered Nurses. (2005). Nursing practice standards. Retrieved from http://www.nurses.ab.ca/pdf/Nursing%20Practice%20Standards.pdf Delva, N., Graf, P., Patry, S., Gosselin, C., Milev, R., Gilron, I., & ... Chan, P. P. (2011). Access to Electroconvulsive Therapy Services in Canada. Journal of ECT, 27(4), 300-309.