Forced treatment is not a new topic here on World of Psychology, nor is this the first time we’ve discussed the unusual case of Ray Sandford. What did Mr. Sandford do wrong?

Nothing. He’s simply mentally ill, the medications and prior treatments over his lifetime have failed him, and his legal guardian is a social service agency in Minnesota. The convergence of those three characteristics means he was a prime candidate — in the court’s eyes — for ECT treatment.

The only problem? He opposes his electroconvulsive therapy (ECT). And despite experts’ insistence that Mr. Sandford is not competent to make such decisions for himself, his case has galvanized the “mad pride” movement and those who opposed any type of forced treatment.

Last week, Minneapolis’ City Pages wrote a nice in-depth piece about Mr. Sandford’s case. They describe the bizarre reason court-ordered ECT treatments are on the rise in Minnesota:

In 1976, just as ECT was at the nadir of its popularity, a 14-year-old Minnesota boy was shocked against his and his mother’s objections. The mother filed suit and went before the Minnesota Supreme Court. The resulting decision held that legally competent patients were immune from being shocked against their stated objections. Moreover, the case made clear that even incompetent patients were entitled to a court proceeding before being administered electroconvulsive therapy.

On its face, the Price-Sheppard decision appeared to bolster patients’ self-determination—after all, the requirement for guardians to get court-approval before administering the volts is one that didn’t exist before.

But in practice, court-ordered ECT has been on the rise since the ruling, for a number of reasons. The ruling assumed that a committed person is—by very virtue of being committed—incompetent. Second, attaining the court order is more of a bureaucratic formality than a serious deliberation.

The good news is that this abusive treatment may be joining the dinosaurs in a few years. The FDA is requiring the manufacturers of ECT machines to, after 70 years, conduct clinical trials research to show the treatment is both safe and effective. What, you say, there’s no such clinical trials on record? Nope. Lots of case studies and small-scale studies, but since the FDA grandfathered the machines in, they never required the same kind of rigorous scientific data psychiatric drugs do. Until now.

New research into ECT may have trouble meeting the FDA requirements, since the positive effects of ECT are short-lived (“maintenance treatments” are often required for the rest of your life), while the long-term adverse effects — unpredictable memory loss — are non-reversible.

Which is good news for folks like Mr. Sandford, although it’ll still be years in coming.

In the meantime, we hope Mr. Sandford finds a way to stop the treatments he doesn’t want. Because if Mr. Sandford were my brother, I’d do everything within my power to find him more appropriate and least restrictive care.

Read the full article: Minnesota mental health patient Ray Sandford forced into electro-shock therapy

Dr. John Grohol is the CEO and founder of Psych Central. He is an author, researcher and expert in mental health online, and has been writing about online behavior, mental health and psychology issues -- as well as the intersection of technology and human behavior -- since 1992. Dr. Grohol sits on the editorial board of the journal Cyberpsychology, Behavior and Social Networking and is a founding board member and treasurer of the Society for Participatory Medicine.

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What if Ray Sandford Were Your Brother? | World of Psychology (5/24/2009)

    Last reviewed: By John M. Grohol, Psy.D. on 24 May 2009
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