Inquiry from New York Times journalist

[RosyGlow19]

I'm a science editor at the New York Times, working on research for a story about ECT. Given the robust evidence base for the treatment, I'm trying to better understand why ECT use in the United States has been declining over the past couple of decades.

I'm hoping to speak with doctors who have started an ECT service relatively recently -- perhaps the last 5 years, give or take -- and could talk to me about how it's going. I'd like to talk to as many folks as possible, but am especially interested in clinics that serve smaller/rural/less wealthy communities, and those that are not affiliated with major medical centers.

On the flip side, I'm also interested in hearing about the experiences of doctors who have closed down their ECT service -- anywhere, including in larger institutions -- and the reasons for those closures.

If you're interested in speaking with me, my email is virginia.hughes@nytimes.com. Please feel free to pass this on to others who might be interested. (And if you have other suggestions of how I might find such people, I'm all ears!) Thanks very much!

---

Members don't see this ad.

 

[FlowRate]

Well, I'm hopeful that this is a good-faith effort that might result in some positive press for ECT. I don't do ECT but the biggest issue I run into is how many extreme negative preconceptions patients have of it.

It would be so helpful to be able to point to a recent article in a respected source to destigmatize it a bit. I think there are a lot of people who are "harmed" (more like an opportunity cost type of harm) by ECT reluctance/unavailability.

 

[Trismegistus4]

How does this help you dox people with naughty views?

 

[nexus73]

I'm a science editor at the New York Times, working on research for a story about ECT. Given the robust evidence base for the treatment, I'm trying to better understand why ECT use in the United States has been declining over the past couple of decades.

I'm hoping to speak with doctors who have started an ECT service relatively recently -- perhaps the last 5 years, give or take -- and could talk to me about how it's going. I'd like to talk to as many folks as possible, but am especially interested in clinics that serve smaller/rural/less wealthy communities, and those that are not affiliated with major medical centers.

On the flip side, I'm also interested in hearing about the experiences of doctors who have closed down their ECT service -- anywhere, including in larger institutions -- and the reasons for those closures.

If you're interested in speaking with me, my email is virginia.hughes@nytimes.com. Please feel free to pass this on to others who might be interested. (And if you have other suggestions of how I might find such people, I'm all ears!) Thanks very much!

What are your thoughts on these topics?

 

[calvnandhobbs68]

How does this help you dox people with naughty views?

How would you get doxxed if you just contacted her directly by email….

 

[Orgone]

 

[Trismegistus4]

How would you get doxxed if you just contacted her directly by email….

You happen to reveal details about yourself in the course of the exchange.

My operating assumption in this day and age is that the primary goal of any "reporter" is to get people fired from their jobs.

 

[VA Hopeful Dr]

You happen to reveal details about yourself in the course of the exchange.

My operating assumption in this day and age is that the primary goal of any "reporter" is to get people fired from their jobs.

That seems completely rational and not at all paranoid

 

[calvnandhobbs68]

You happen to reveal details about yourself in the course of the exchange.

My operating assumption in this day and age is that the primary goal of any "reporter" is to get people fired from their jobs.

I still don’t think you know what doxxed is….

I would expect if you email a journalist directly, you’re probably gonna want to go on the record about this. Who’s gonna want to hear from some anonymous “doctor” about ECT who may or may not actually be a doctor? However, your real life persona would in no way be linked to any SDN account, so there would be no way to know who you are on here (or even if you have an account on here).

 

[AD04]

That seems completely rational and not at all paranoid

Welcome to cancel culture where discussion about conflicting views are not allowed.

 

[WisNeuro]

Can y'all self prescribe for some of the paranoia and delusion in this thread? As part of the executive leadership of our state association, we field media/interview requests often. Out of the dozen or so times we've participated in the several years I've been involved, zero issues with either state or national publications. Get a grip, folks.

 

[VA Hopeful Dr]

Welcome to cancel culture where discussion about conflicting views are not allowed.

Do what now?

 

[nexus73]

I think proceeding with some caution with the media is fair. Especially in this era of click bait headlines and manufactured outrage. Clicks are necessary to stay in business and anti psychiatry sells. You’d hope to get a fair shake from the journalist not to take a quote out of context to push an agenda. But who knows. I think talking to the journalist to get their perspective on the topic, ECT, in this case, would be helpful in assuaging these concerns.

Looking back at the journalists previous work and the organization they write for is probably a reasonable early step.

 

[Trismegistus4]

I still don’t think you know what doxxed is….

I would expect if you email a journalist directly, you’re probably gonna want to go on the record about this. Who’s gonna want to hear from some anonymous “doctor” about ECT who may or may not actually be a doctor? However, your real life persona would in no way be linked to any SDN account, so there would be no way to know who you are on here (or even if you have an account on here).

True, maybe "doxxed" wasn't the best choice of words, as I didn't mean "have the real-life identity of an SDN username revealed," and I didn't realize that by "how would you get doxxed if you just contacted her directly by email?" you meant that then she wouldn't know your SDN username. It's more that I think a "reporter" is always looking for clues as to whether a person holds Bad Guy views, even to the point of subtly probing for such, in the hopes of publishing an "expose" on a Bad Guy.

 

[Orgone]

Can y'all self prescribe for some of the paranoia and delusion in this thread? As part of the executive leadership of our state association, we field media/interview requests often. Out of the dozen or so times we've participated in the several years I've been involved, zero issues with either state or national publications. Get a grip, folks.

I'm glad that has been your experience while representing a state association.

My experience is seeing a known and respected colleague become unfairly and baselessly smeared by a "journalist", causing their practice and career to collapse along with their ability to provide for their family. To some people that may sound melodramatic, unthinkable and even "paranoia and delusion", but it is what I have seen.

And having witnessed that, I would urge all clinicians to exercise extreme caution when thinking about having any contact with journalists, do not assume they will be favorable or even fair to you no matter how friendly they seem, and ask yourself whether you have more to gain or more to lose.

 

[WisNeuro]

I'm glad that has been your experience while representing a state association.

My experience is seeing a known and respected colleague become unfairly and baselessly smeared by a "journalist", causing their practice and career to collapse along with their ability to provide for their family. To some people that may sound melodramatic, unthinkable and even "paranoia and delusion", but it is what I have seen.

And having witnessed that, I would urge all clinicians to exercise extreme caution when thinking about having any contact with journalists, do not assume they will be favorable or even fair to you no matter how friendly they seem, and ask yourself whether you have more to gain or more to lose.

Then he should make use of libel laws, otherwise, I remain skeptical until hearing both sides of the story.

 

[dl2dp2]

I'm a science editor at the New York Times, working on research for a story about ECT. Given the robust evidence base for the treatment, I'm trying to better understand why ECT use in the United States has been declining over the past couple of decades.

I'm hoping to speak with doctors who have started an ECT service relatively recently -- perhaps the last 5 years, give or take -- and could talk to me about how it's going. I'd like to talk to as many folks as possible, but am especially interested in clinics that serve smaller/rural/less wealthy communities, and those that are not affiliated with major medical centers.

On the flip side, I'm also interested in hearing about the experiences of doctors who have closed down their ECT service -- anywhere, including in larger institutions -- and the reasons for those closures.

If you're interested in speaking with me, my email is virginia.hughes@nytimes.com. Please feel free to pass this on to others who might be interested. (And if you have other suggestions of how I might find such people, I'm all ears!) Thanks very much!

NYTimes has a list of speakers on this topic. You might have luck in finding out about previous engagements, as generally, they need to be approved by the institutions' media offices. Anonymous online forums are not a great place to source this, as is demonstrated here.

Can y'all self prescribe for some of the paranoia and delusion in this thread? As part of the executive leadership of our state association, we field media/interview requests often. Out of the dozen or so times we've participated in the several years I've been involved, zero issues with either state or national publications. Get a grip, folks.

You are right. However, it's recommended that people receive media training prior to engaging in media work. Having done this type of activity, I know that even with a neutral point of view there are lots of pitfalls that are challenging for a typical community psychiatrist to navigate without formal training. Large national outlets are by definition not neutral.

 

[littlefred]

To be honest, I don't even know why the mods allow these kinds of requests here.

 

[WisNeuro]

You are right. However, it's recommended that people receive media training prior to engaging in media work. Having done this type of activity, I know that even with a neutral point of view there are lots of pitfalls that are challenging for a typical community psychiatrist to navigate without formal training. Large national outlets are by definition not neutral.

Yes, nothing wrong with some media training. probably a good idea. But, that's not the hesitancy here in this thread. The hesitancy/animosity here is some alternate universe MAGA/QAnon conspiracy junk. These are the same people that believe in some clandestine worldwide pedophilia ring pulled off by world leaders/lizard people.

 

[Orgone]

Then he should make use of libel laws, otherwise, I remain skeptical until hearing both sides of the story.

He/she did.

Yes, nothing wrong with some media training. probably a good idea. But, that's not the hesitancy here in this thread. The hesitancy/animosity here is some alternate universe MAGA/QAnon conspiracy junk. These are the same people that believe in some clandestine worldwide pedophilia ring pulled off by world leaders/lizard people.

This comment is needlessly insulting and laughably misplaced.

 

[WisNeuro]

This comment is needlessly insulting and laughably misplaced.

Knowing some past comments here, not all at all. Posters on this forum have openly espoused some of these literal views.

 

[deleted1100659]

I agree that im confused about the concern about being doxed for this, as the topic is ECT? What kind of controversial opinion would a psychiatrist really have about it? Probably most psychiatrists have the same views on it.

 

[WisNeuro]

I agree that im confused about the concern about being doxed for this, as the topic is ECT? What kind of controversial opinion would a psychiatrist really have about it? Probably most psychiatrists have the same views on it.

Yeah, we're not in the 30s and 40s anymore. There is really nothing controversial about the safety profile at this point.

 

[nexus73]

Yeah, we're not in the 30s and 40s anymore. There is really nothing controversial about the safety profile at this point.

Not controversial among psychiatrists and others specializing in mental health treatment.

Amongst the general population though, almost all patients are shocked when they hear that "SHOCK THERAPY" still happens. And it takes a fair amount of education to quell those fears. And still some patients refuse to do it despite suffering with refractory depression.

 

[WisNeuro]

Not controversial among psychiatrists and others specializing in mental health treatment.

Amongst the general population though, almost all patients are shocked when they hear that "SHOCK THERAPY" still happens. And it takes a fair amount of education to quell those fears. And still some patients refuse to do it despite suffering with refractory depression.

Hasn't been my experience in general and geriatric inpatient units where ECT was commonly done. We'd occasionally have a psychoed session with someone who wanted to talk about the research and recovery, but most people just shrugged and wanted to go through with it.

 

[Sushirolls]

1) I stopped at giving my experiences just here on SDN in the other thread for various reasons. I wanted to keep my anonymity.
2) I've found myself in interviews in the past with more regional news outlets, and thankfully were more benign topics, but even at that, those journalists made statements and summaries of 'facts' that were just wrong. It was cringe worthy, that most lay people wouldn't know, but clinical folks would be like what are they talking about? ECT can be rife for those same things to be erroneously declared.
3) To the MAGA comment above, the left leaning media, which NYT is, have gone so far off the deep end, I don't want to be a named in their material even for what should be a neutral topic. Supporting them in any fashion could further support their shameful biased reporting in other areas. I didn't look over the material Virginia has written in the past but I hope, and assume she has done well to be a credit to professional journalism with her past work. So despite Virginia being a presumed quality, unbiased journalist, her employer certainly isn't, and who knows the pressures her editor might place. So I last helped by pointing her to the formal sources where she is most likely to get the sources she hopes for.
4) I've had enough death threats in my life, I don't want to pop up on a national news article that gets the cult(ish) moving their cross hairs on me.
5) I've had negative interactions with specific people and Big Box shops in my ECT dealings of the past, and its a small enough world to either figure out who, if not mentioned in an article. I don't have the time to deal with any legal back draft. I loathe feeding lawyers money.

 

[Sushirolls]

Hasn't been my experience in general and geriatric inpatient units where ECT was commonly done. We'd occasionally have a psychoed session with someone who wanted to talk about the research and recovery, but most people just shrugged and wanted to go through with it.

A few areas of the country I've been, this is the case.
The most recent area I'm in, not the case. The patients are more averse, and the professionals are less accustomed. An interesting road block I had to face.
In summary, I'd say ECT, sadly, is still considered a contentious treatment, and addressing social stigma in consult is routine part of neurostim consults.

 

[WisNeuro]

A few areas of the country I've been, this is the case.
The most recent area I'm in, not the case. The patients are more averse, and the professionals are less accustomed. An interesting road block I had to face.
In summary, I'd say ECT, sadly, is still considered a contentious treatment, and addressing social stigma in consult is routine part of neurostim consults.

I don't doubt that there may be pockets of more averse attitudes to ECT, I just haven't encountered them in any of the places I have trained/worked at, all of which we have been involved in the units doing the work. And, in one instance doing pre/post testing for future publication. I'm just not sure that the controversy here is as widespread as some are making it out to be.

 

[Mad Jack]

Yeah, we're not in the 30s and 40s anymore. There is really nothing controversial about the safety profile at this point.

The issue comes if one asks the Brits how they feel about it and we compare and contrast. Between the two opinions you can paint ECT as whatever you like. And don't even get me started on scientology

 

[WisNeuro]

The issue comes if one asks the Brits how they feel about it and we compare and contrast. Between the two opinions you can paint ECT as whatever you like. And don't even get me started on scientology

Well, Scientiologists are right up there with the Flat Earthers and QAnoners. If anything, Scientology has a lower approval/belief rating than the latter two.

 

[Mad Jack]

Well, Scientiologists are right up there with the Flat Earthers and QAnoners. If anything, Scientology has a lower approval/belief rating than the latter two.

Oh yeah, but you know how the public is. If there's someone out there wild enough to make a claim, there are millions more willing to believe it regardless of its merits

 

[VA Hopeful Dr]

To be honest, I don't even know why the mods allow these kinds of requests here.

Because the person says exactly who they are, who they work for, and got verified through our usual procedures. No one is forced to reply, you could even place the journalist in question on ignore and then you wouldn't even see this thread.

 

[Trismegistus4]

I agree that im confused about the concern about being doxed for this, as the topic is ECT? What kind of controversial opinion would a psychiatrist really have about it?

The concern isn't having controversial opinions about ECT. It's that talking to "reporters" is like talking to the police--even if it has nothing to do with the subject at hand, they're listening for you to say anything that might provide them with a hint or clue that you did something illegal so they can charge you with a crime, even if you thought you were just being a helpful witness. It's that the reporter is going to be making these subtle little comments that serve as bait for you to say something revealing that you might be "racist" or "transphobic" or whatever, then they'll start "investigating" that and run a story about how a psychiatrist is a hating hater full of hateful hate.

 

[Stagg737]

I think proceeding with some caution with the media is fair. Especially in this era of click bait headlines and manufactured outrage. Clicks are necessary to stay in business and anti psychiatry sells. You’d hope to get a fair shake from the journalist not to take a quote out of context to push an agenda. But who knows. I think talking to the journalist to get their perspective on the topic, ECT, in this case, would be helpful in assuaging these concerns.

Looking back at the journalists previous work and the organization they write for is probably a reasonable early step.

Probably the best and easiest way to look into the risk, especially since OP's information is easily available with a simple google search including previous writing, positions, and multiple social media pages (LinkedIn, Twitter, personal page, etc).

Can y'all self prescribe for some of the paranoia and delusion in this thread? As part of the executive leadership of our state association, we field media/interview requests often. Out of the dozen or so times we've participated in the several years I've been involved, zero issues with either state or national publications. Get a grip, folks.

There's also a big difference between having an organization backing someone commenting in an article and/or a person representing an organization and making statements versus being an individual physician commenting. People's lives get destroyed for relatively benign things all the time. This doesn't seem like a topic that would lead to such an occurrence, but I've also encountered people who were persecuted when discussing much more benign topics.

 

[WisNeuro]

There's also a big difference between having an organization backing someone commenting in an article and/or a person representing an organization and making statements versus being an individual physician commenting. People's lives get destroyed for relatively benign things all the time. This doesn't seem like a topic that would lead to such an occurrence, but I've also encountered people who were persecuted when discussing much more benign topics.

Having made statements as an individual and on part of an organization within the MH sphere, some of the hyperbolic paranoia here is just a caricature of ultra right wing attitudes towards the media. There's no real there, there. I'm still unconvinced that there is a plethora of cases in which a MH practitioner, who had not engaged in illegal activity, or made completely egregious comments, has been "persecuted" discussing a general MH topic.

 

[nexus73]

Having made statements as an individual and on part of an organization within the MH sphere, some of the hyperbolic paranoia here is just a caricature of ultra right wing attitudes towards the media. There's no real there, there. I'm still unconvinced that there is a plethora of cases in which a MH practitioner, who had not engaged in illegal activity, or made completely egregious comments, has been "persecuted" discussing a general MH topic.

I think it’s centrist paranoia personally.

But seriously, I think you lose all credibility when you say the paranoia is unreasonable and the paranoia is rooted in right wing politics. Why does politics come into play? People have varying levels of comfort and caution talking to media.

 

[WisNeuro]

I think it’s centrist paranoia personally.

But seriously, I think you lose all credibility when you say the paranoia is unreasonable and the paranoia is rooted in right wing politics. Why does politics come into play? People have varying levels of comfort and caution talking to media.

Because in the last several years, it has been an express political tool to paint the media as the "enemy of the state." I don't see how anyone can not conclude that the current anti-media vitriol is anything but related to politics. There have always been fringe political rags that should be suspect (OANN, Daily Kos, etc) but now you have people attacking neutral outlets like Reuters and the AP. To not see this is just willful ignorance.

 

[nexus73]

Because in the last several years, it has been an express political tool to paint the media as the "enemy of the state." I don't see how anyone can not conclude that the current anti-media vitriol is anything but related to politics. There have always been fringe political rags that should be suspect (OANN, Daily Kos, etc) but now you have people attacking neutral outlets like Reuters and the AP. To not see this is just willful ignorance.

You seem focused on right wing politics as the source of what you called paranoia. But the point is that a healthy caution about media in general is a good idea. Media outlets having political leanings is nothing new but is beside the point. The concern is more a journalist latching onto an errant comment or misstatement and spinning it into an article painting the source and topic in a negative light. If only because they don't fully understand the topic, or it makes the story more interesting.

An article about ECT being very effective and underutilized may not get the same clicks as an article about doctors in some backwoods state doing shock therapy even though they know it causes memory problems because it reimburses well.

You seem to be conflating a recommendation for caution with media as somehow yelling out "It's all fake news." Which is not really the case.

 

[randomdoc1]

Very interesting discussion. I’ll put in my personal experience but it’s just that and nothing more. Part of SEO optimization is getting high quality backlinks. But no personal experience with nyt. Agree, healthy caution is never a bad idea. Perhaps I should be more cautious, as I’ve regularly responded to reporter inquiries about basic questions in mental health. For example, how to find a therapist, self care tips for the summer, even some personality disorder questions. I do take great care with how things are phrased and cite sources like dsm v. So that helps. Been doing it for 2 years now and got great back links and seo. So fortunately no issues. But again, could be just lucky. Definitely doesn’t hurt to be aware of cautions to take.

 

[WisNeuro]

You seem focused on right wing politics as the source of what you called paranoia. But the point is that a healthy caution about media in general is a good idea. Media outlets having political leanings is nothing new but is beside the point. The concern is more a journalist latching onto an errant comment or misstatement and spinning it into an article painting the source and topic in a negative light. If only because they don't fully understand the topic, or it makes the story more interesting.

An article about ECT being very effective and underutilized may not get the same clicks as an article about doctors in some backwoods state doing shock therapy even though they know it causes memory problems because it reimburses well.

You seem to be conflating a recommendation for caution with media as somehow yelling out "It's all fake news." Which is not really the case.

Some people in the thread are advocating healthy caution. Some are....clearly not.

 

[Stagg737]

Having made statements as an individual and on part of an organization within the MH sphere, some of the hyperbolic paranoia here is just a caricature of ultra right wing attitudes towards the media. There's no real there, there. I'm still unconvinced that there is a plethora of cases in which a MH practitioner, who had not engaged in illegal activity, or made completely egregious comments, has been "persecuted" discussing a general MH topic.

Do you really only see distrust of the media in the right-wing individuals you talk to? Seems like a pretty narrow experience. Also, are you not aware of previous issues with The Last Psychiatrist or the guy who wrote the Slate Star Codex (who was actually doxxed by NYT)? Again, there is a big difference between flying solo and having a larger organization there to fall back on, even if you're making statements independently.

 

[WisNeuro]

Do you really only see distrust of the media in the right-wing individuals you talk to? Seems like a pretty narrow experience. Also, are you not aware of previous issues with The Last Psychiatrist or the guy who wrote the Slate Star Codex (who was actually doxxed by NYT)? Again, there is a big difference between flying solo and having a larger organization there to fall back on, even if you're making statements independently.

Not at all, but that's a far cry from some of the paranoia seen here. And didn't TLP dox himself way back when? Either way, big difference between offering much larger commentary on a broad range of issues vs. commenting on a distinct non-controversial topic for the most part.

 

[clausewitz2]

Do you really only see distrust of the media in the right-wing individuals you talk to? Seems like a pretty narrow experience. Also, are you not aware of previous issues with The Last Psychiatrist or the guy who wrote the Slate Star Codex (who was actually doxxed by NYT)? Again, there is a big difference between flying solo and having a larger organization there to fall back on, even if you're making statements independently.

TLP just released a book (and still has his academic appointment as far as I know) and Scott Alexander is earning mid 6 figures from his Substack. I don't begrudge either of them their success but these folks were hardly destroyed by the experience.

 

[clausewitz2]

And didn't TLP dox himself way back when?

I don't think he meant to but he did give a conference presentation under his real name basically retreading content from his blog.

 

[MacDonaldTriad]

When the media asks about ECT, we stumble and are not as clear or as consistent as we should be. Let me be clear.

ECT works, and it works better than anything else we can offer. It works on a disease that is far from rare. Go stick that in your pipe and smoke it, and stop twisting the message. We are consistent in our approval because it's effect is impressive and essential in our efforts to alleviate suffering. If you feel differently, you need to do a ride a long with a psychiatrist and that will change your mind. If it doesn't, you have under validated your story and you should get out of the media because you are spreading misconceptions that hurt people and make it harder for us to help alleviate suffering.

This isn't just my opinion, this is clearly what the evidence shows. If you are at all being swayed by what the evidence says; you would not be asking this question. This is not controversial to anyone who doesn't have an alternative agenda and if you were not guilty of such, you wouldn't be asking these stupid questions.

There isn't a debate about this topic, there is only distortions that parallel pizza gate, the flat earth society, religious beliefs that think the world started with the garden of Eden only 5,000 years ago, and the moon landing was faked. Kind of hard to explain those dinosaurs don't you think?

You should talk to Olivia Dukakis about her feelings on this. Please stop presenting this effective treatment as a controversy that is in question to those who need it. If you publish anything that is less then positive about it, you are doing damage because it works and is relatively safe. It isn't without risk or side effects, but it has a rather appealing risk benefit analysis compared to other treatments and it has been underutilized when looked at with this lens. Only 8% of psychiatrists administer ECT because of this public perception and we are very far behind the need.

I'm not the end all of ECT knowledge, but I know those that are. Please don't interview Tom Cruise and introject his Scientology opinions about this, just to make it good reading. I would like to see Maverick, but I refuse to give Mr. Cruise my money so I will wait. What a mental health jerk he is. Just ask Brooke Shields. "Antidepressants are just a crutch and you shouldn't take them". Just like a one legged man shouldn't use a crutch because it only exposes one's one leggedness.

 

[smalltownpsych]

When the media asks about ECT, we stumble and are not as clear or as consistent as we should be. Let me be clear.

ECT works, and it works better than anything else we can offer. It works on a disease that is far from rare. Go stick that in your pipe and smoke it, and stop twisting the message. We are consistent in our approval because it's effect is impressive and essential in our efforts to alleviate suffering. If you feel differently, you need to do a ride a long with a psychiatrist and that will change your mind. If it doesn't, you have under validated your story and you should get out of the media because you are spreading misconceptions that hurt people and make it harder for us to help alleviate suffering.

This isn't just my opinion, this is clearly what the evidence shows. If you are at all being swayed by what the evidence says; you would not be asking this question. This is not controversial to anyone who doesn't have an alternative agenda and if you were not guilty of such, you wouldn't be asking these stupid questions.

There isn't a debate about this topic, there is only distortions that parallel pizza gate, the flat earth society, religious beliefs that think the world started with the garden of Eden only 5,000 years ago, and the moon landing was faked. Kind of hard to explain those dinosaurs don't you think?

You should talk to Olivia Dukakis about her feelings on this. Please stop presenting this effective treatment as a controversy that is in question to those who need it. If you publish anything that is less then positive about it, you are doing damage because it works and is relatively safe. It isn't without risk or side effects, but it has a rather appealing risk benefit analysis compared to other treatments and it has been underutilized when looked at with this lens. Only 8% of psychiatrists administer ECT because of this public perception and we are very far behind the need.

I'm not the end all of ECT knowledge, but I know those that are. Please don't interview Tom Cruise and introject his Scientology opinions about this, just to make it good reading. I would like to see Maverick, but I refuse to give Mr. Cruise my money so I will wait. What a mental health jerk he is. Just ask Brooke Shields. "Antidepressants are just a crutch and you shouldn't take them". Just like a one legged man shouldn't use a crutch because it only exposes one's one leggedness.

I agree with you except for the fact that I have personally seen ECT inappropriately used to try and manage problematic behaviors in a state hospital setting and this was not back in the days of Nurse Ratched and RP Mcmurphy. I don’t like negative press about our field because it can get In the way of us helping our patients, but without negative press some of us or the systems we work in will be harming our patients.

 

[WisNeuro]

I agree with you except for the fact that I have personally seen ECT inappropriately used to try and manage problematic behaviors in a state hospital setting and this was not back in the days of Nurse Ratched and RP Mcmurphy. I don’t like negative press about our field because it can get In the way of us helping our patients, but without negative press some of us or the systems we work in will be harming our patients.

While I agree with this sentiment, it's something of an aside. Almost any treatment can be neutral, or in some cases harmful, if applied inappropriately, or used in populations where it is not indicated. Like the Michigan doc who lied to patients and told them they had cancer to juice his reimbursements when those patients got chemo tx. It's not like we should discontinue chemo use because of this incident. And, ECT is exponentially less risky than chemo.

 

[smalltownpsych]

While I agree with this sentiment, it's something of an aside. Almost any treatment can be neutral, or in some cases harmful, if applied inappropriately, or used in populations where it is not indicated. Like the Michigan doc who lied to patients and told them they had cancer to juice his reimbursements when those patients got chemo tx. It's not like we should discontinue chemo use because of this incident. And, ECT is exponentially less risky than chemo.

Good point. I am probably really talking about a completely different subject such as working with a vulnerable and often challenging/unwilling population and how that can easily lead to abusive practices. Perhaps that is what the media is trying to address when they critique our field, but as they so often do they miss the nuance and focus in on something specific. I fell into the same trap in a way.

 

[ObsequiousAplomb]

I agree with you except for the fact that I have personally seen ECT inappropriately used to try and manage problematic behaviors in a state hospital setting and this was not back in the days of Nurse Ratched and RP Mcmurphy. I don’t like negative press about our field because it can get In the way of us helping our patients, but without negative press some of us or the systems we work in will be harming our patients.

Is this any worse than the triple antipsychotic megadose polypharmacy routinely used in this population based on the demands of nursing staff and threats of reporting physicians for "under treating" the patients if they stop at Zyprexa 20 TID and Seroquel 600 TID?

 

[MacDonaldTriad]

"Harming our patients?", Really? ECT is proven effective and is under used based upon evidenced based medicine. I'm not a fan of evidence based medicine, but this one example is non-controversially and is very convincing. If you are against it because you just don't agree with putting voltage between someone's temples, why is it OK to put an order of magnitude of more joules of energy to someone's heart to stop A-fib? ECT is a reasonable treatment alternative and we need to stop telling people to avoid it. It works and can help people that don't benefit from anything else we can offer.

I'm strong on this , but this isn't the end of story and try to tell me I'm wrong and you will be hit with full force of both patients and doctors who have experience with this. Anyone who chimes in differently (and there may be some) have not been working with the most severely mentally ill and are on a different plane than what I'm talking about.

Being an effectual psychiatrist and being anti-ECT is hypocritical, anachronistic? or oxymoronic?, or I'm not sure what the right word is but it isn't good. It just means you are damaging useful options that are well needed in a field that has a great need for useful tools. ECT works and of all the other suggestion haven't been better. TMS, DBS, or other alternates, have not worked and nothing is more effective. It doesn't surprise me that an Italian guy in the 30s was right about ECT's usefulness.