AFTER Mikayla Campbell’s six sessions of electroconvulsive treatment, she achieved something she had been craving for years – a normal life.
For a few months, at least.
Mikayla has been medicated since the age of 14 for bipolar and borderline personality disorder, and was admitted to psychiatric facilities throughout her teenage years.
When she ran out of treatment options, she turned to “shock therapy” as a last resort.
The treatment took place at Bendigo’s Alexander Bayne Centre in January this year.
“I was scheduled to have between eight and 12 sessions, but at after six sessions with an amazing improvement and no side effects – other than muscle aches – I stopped, and lived a normal life,” Mikayla said.
“However, the effect was temporary and short-lived.”
Her crippling depression and suicidal thoughts soon returned. Mikayla chose to have shock therapy for a second time, six months later, at the new Bendigo hospital.
This time, her reaction to the treatment – and the side effects – were completely different.
“I have absolutely no recollection of my entire stay in hospital. Memory loss took over, I couldn’t remember conversations I had, things that had happened,” Mikayla said.
“I even forgot my PIN number and passwords for computers and social media.
“I could not remember names, faces, some people that I had met around the time of treatment I did not recognise. They were once again total strangers to me.
“I decided I would rather live with the depression than live a life I cannot recollect.”
Memory loss is one of the main side effects of electroconvulsive treatment, a practice described as “safe and effective” by the Victorian Health Department.
The treatment involves the person being put under general aneasthetic and muscle relaxant, with an electrical current sent through the brain to cause seizures.
Mikayla said some of her friends have also experienced shock therapy with more positive results.
“I have had friends that have received nothing but improvement from ECT,” she said.
“It has saved their life and allowed them to live normal happy lives.
“Each individual, with reliable information, has to make their own decision in regards to the treatment they will receive.”
The treatment is more common in Victoria than some would expect. At Bendigo Health in 2015-16, 63 people had ECT for a total of 868 treatments.
Like many people, it was Mikayla’s choice to undergo shock therapy.
But some do not consent. That’s when the Mental Health Tribunal determines whether the treatment will proceed.
In 2015-16, there were more than 700 applications to the tribunal for electroconvulsive treatment. Some people have multiple applications made about them.
That was the case for a Bendigo woman with schizophrenia, who appealed the tribunal’s decision in the Victorian Civil and Administrative Tribunal – and lost. She was ordered to undergo up to 12 courses of shock therapy.
She has now taken the matter to the Supreme Court – the first time an electroconvulsive treatment case will be heard by Victoria’s highest court.
Victoria Legal Aid is representing the woman in a case designed to test the state’s Mental Health Act when it comes to consent to treatment.
VLA executive director civil justice Dan Nicholson said they wanted to make sure safeguards in place in the act were being adhered to.
“I think a lot of people don’t realise that people are still given electroconvulsive therapy, or ECT, in Victoria,” he said.
“And probably a lot of people would be surprised to hear that it can be given to people without their consent.
“A lot of our clients find it very invasive and don’t consent to it.”
The law changed in 2014 to require the Mental Health Tribunal to rule on ECT matters. Up until then, doctors in Victoria could prescribe ECT to a patient without their consent.
Yet only 10 per cent of patients will have legal representation. And in 80 per cent of cases, the ECT decision will be upheld.
Mr Nicholson said that was a problem unique to Victoria.
“To give you some contrast, in New South Wales 77 per cent of people have a lawyer present for the equivalent hearing up there,” he said.
“It makes a really big difference.
“If someone is unwell, and is trying to argue against an application made by their treating doctor, it obviously makes a big difference to have a lawyer there to help them, and that’s what the stats tell us.”
Without a lawyer, there’s a 90 per cent chance the tribunal will grant the order for ECT.
In regional Victoria, it’s even more difficult for people to get legal representation.
“There are still some real challenges in getting access to legal representation in regional areas,” Mr Nicholson said.
“Especially when - as often happens in ECT hearings - they’re listed at very short notice. They might be heard the day an application is made, or the day after.
“That’s also a concern for us.”
The case in the Supreme Court stems from a decision by a Bendigo Health treatment team to apply for ECT against the woman with schizophrenia.
Bendigo Health executive director psychiatric services Dr Phil Tune said the majority of patients consent to the treatment.
“ECT is an extensively researched, very safe, very effective treatment used across Victoria and Australia for patients impacted by illness which is responsive to this type of treatment,” he said.
“Compulsory patients under the Mental Health Act who cannot give informed consent may still be treated with ECT, but this is authorised by the independent Mental Health Tribunal, with rights of appeal to higher bodies. We take great care to ensure every patient’s legal rights are protected.”