Over the past few weeks I have been witness to, and increasingly involved in trying to stop one of the most extreme examples of psychiatric brutality I have encountered in my 40 years in this field. And I have encountered quite a few.
I will describe these events in a series of installments, mostly using my correspondence with the various agencies of the state of Victoria involved in the case, or in some cases NOT involved despite our best efforts. These include the Department of Health and Human Services, the Office of the Chief Psychiatrist, the Mental Health Tribunal, the Mental Health Complaints Commission and the state government. I think the main message or motivation for writing these four or five pieces is not to show how fatally flawed and dangerous the profession of psychiatry can be (most MIA readers probably know that), but to remind us how complicit the rest of society can be. Some of the agencies that have behaved the worst in all of this are precisely the ones that are supposed to be protecting the human rights of people who use mental health services.
But I begin on a more positive note, with two invaluable contributions from the media. They will help readers who have not been following this series of calamities on social media get a sense of what has been going on. I suggest you sit down before watching and reading. This is not your usual, run-of-the-mill psychiatric abuse story.
On December 17th, 2015 a national TV station, ABC, broadcast a nine-minute segment on GD’s case in their current affairs ‘7.30’ programme. This was a powerful piece in which GD himself and his Dad had their say (not always the case in the mainstream media). The psychiatrist in charge of this whole sorry mess, Dr Paul Katz, did himself no favours by publicly expressing the view that being strapped to a bed for days on end is not so bad because these days they use velcro, not chains.
More recently, on February 14th, Melbourne’s quality newspaper The Age covered the story. I have pasted it in full below.
The discrepancy between ‘over 70’ in the article and the ‘over 50’ in the headline to this blog arises from the fact that the journalist — quite reasonably — included all the times that the electric shock failed to produce the convulsion that is required for the treatment to be deemed to have happened. This tends to happen increasingly over time because the brain’s threshold for a convulsion increases a little with each electric shock (presumably the brain’s attempt to protect itself from further trauma). This is one of the reasons why having so many shocks consecutively is particularly dangerous. The hospital records I have seen show that on one occasion they gave GD four in one day.
My next installment will focus on the role of the Office of the Chief Psychiatrist. This will show just how futile a gesture it was for the Minister to ask the Chief Psychiatrist for a report. (But apparently it is so ‘rare’ for a Minister to do anything at all that the journalist was very impressed.)
The Sunday Age, 14.2.2016 – Farrah Tomazin
The state government is investigating the treatment of a man who has had more than 70 hits of shock therapy without his consent, prompting his family and medical experts to fear for his life.
In a rare intervention, the government has asked Victoria’s Chief Psychiatrist for a report on Garth Daniels, a patient diagnosed with schizophrenia, whose case has reignited the debate surrounding the use of electro convulsive therapy (ECT) and the safeguards for people in psychiatric care.
Mr Daniels and his family say the 40-year-old, who is an involuntary patient at the Upton House psychiatric hospital in Box Hill, has been administered about 75 electric shocks in six months and spent almost 60 days last year tied to his bed with Velcro straps.
But while the hospital insists the treatment is “in accordance with the law and appropriate clinical guidelines”, Mr Daniels’ father Bernard believes that ECT – which involves inducing seizures by delivering an electric current through the brain – is making his son worse.
“His memory is clearly impaired and I fear that if this goes on, he could end up a vegetable,” he said.
The case has already sparked a number of legal battles: one from Mr Daniels, who is suing the hospital for assault and last week told The Sunday Age, “I don’t want to be in this hospital, I just want to go home as soon as possible”, and another from his father, who is attempting to gain an injunction in an attempt to stop Eastern Health from administering two types of drugs, Clexane and Zuclopenthixol.
But last week, Mental Health Minister Martin Foley was also asked to intervene, with Swinburne University clinical psychology professor John Read raising the issue with the government and lodging a series of formal complaints against the Mental Health Tribunal, which gave the hospital the go-ahead to increase the rate of Mr Daniels’ shock treatment.
Health department guidelines state that “a course of ECT can be up to 12 treatments performed over a period of time that cannot exceed six months”. And in order to administer ECT, a patient must also give informed consent, unless they are ruled incapable of doing so.
But Professor Read said this was precisely the problem: at the last tribunal hearing a few weeks ago, Mr Daniels was unable to have his say “because the hospital had him strapped to his bed, yet again”. The tribunal – having decided he was incapable of giving consent – then authorised a further round of ECT.
“There seems to be little or no protection of the human or legal rights of people using mental health services in the state of Victoria,” said Professor Read.
Psychiatrist Jock McLaren – who has independently assessed Mr Daniels and wrote a report telling the tribunal he believed the patient had the mental capacity to refuse consent – also raised concerns. “They need to realise that 20 years of conventional treatment has adjectively failed, and if they continue on the present course, this man could die,” he said.
Mr Daniels has been in and out of institutions for 20 years, following a drug-induced psychosis in 1996. His doctors say he can be “extremely aggressive” and “unpredictable” however he insists he is mentally capable of providing authority for ECT and doesn’t want it.
Asked about the case last week, Mr Foley told The Sunday Age: “Serious mental illness is devastating not just for the person who has it, but for those who love them. I can understand Mr Daniels’ family needing to seek assurances that their son is being well cared for. I am familiar with his story and have asked the Chief Psychiatrist to report back to me with an update on his treatment.”
Mr Daniels’ psychiatrist Dr Paul Katz did not respond to a request for comment, but a communications spokesman for Eastern Health supplied a statement saying: “Eastern Health provides treatment to all its mental health patients in accordance with the law and appropriate clinical guidelines.”
Although at the time of this writing the shock treatments have finally been stopped by the latest hearing of the Mental Health Tribunal (February 18), the psychiatrists may appeal this decision, and pressure needs to be maintained. Their first action after the hearing was to cancel GD’s leave privileges so that he could not attend the first class of a long-awaited photography course today.
More on the Mental Health Tribunal, and why its President is now under investigation, in a later instalment. The decision to finally prevent Katz and his colleagues from continuing the ‘treatments’ was made on the basis of ECT not being the ‘least restrictive treatment.’ Jock McLaren, a wonderful Australian psychiatrist, just said in an email to us all down here in Melbourne, “You need to demand an answer from the president of the tribunal as to why there is another less restrictive means of treatment now but there wasn’t last week?”
(Jock assessed GD as perfectly capable of accepting or refusing treatment, when the Upton House psychiatrists and the previous Tribunal hearings said he was incapable.)
We believe that the media publicity and the public outcry on social media may have helped the Tribunal get it right this time. At least they know they are being watched.
So… you may wish to sign the petition. Or attend a protest this Saturday (February 20) in Melbourne or London – or organise your own, however small?
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Melbourne protest details:
London protest details: