Lisa Morrison cannot recall her wedding day. She has no memory of significant moments in her children’s early lives – gaps she says were left by electroconvulsive therapy (ECT), a treatment she received six times on the NHS between 2009 and 2016 for severe depression. The 52-year-old from Northern Ireland now describes the procedure as something that “took from me” and caused only more harm to her and her family.
Ms Morrison, a mother of two, was taking antipsychotics, antidepressants, three tranquillisers, and sleeping tablets before being offered ECT. “I was back in the emergency department, self-harming and suicidal, so it clearly wasn’t working, but they kept giving it to me,” she said. It was only years later, after she moved back in with her husband in 2018, that she began to realise the extent of her memory loss. “He would talk about things I didn’t remember; our wedding day, significant events in my children’s lives,” she said. “Sometimes I find it very distressing, especially when I think about my children and their early years. It’s something else that was taken from me, from people who were meant to help me.”
Since 2020, Ms Morrison has been diagnosed with complex post-traumatic stress disorder and a dissociative disorder. Her husband, Gary Morrison, recalled how after treatment “she seemed to regress to a childlike state; her extreme fragility and vulnerability meant she had to be carefully nurtured. I was desperate for something to help her.”
Research findings raise questions about ECT
ECT, which involves sending electric currents through the brain to trigger a brief seizure, is administered to about 2,500 people in the UK each year, according to mental health charity Mind. The aim is to relieve severe symptoms of conditions such as severe depression, catatonia, or prolonged manic episodes. But a growing body of evidence from patients and their relatives challenges the treatment’s effectiveness and safety.
Ms Morrison co-authored a study with clinical psychologists at the University of East London that surveyed 286 relatives and friends of ECT recipients. Published in the journal Psychology and Psychotherapy: Theory, Research and Practice, it found that while 45% of respondents reported an improvement, 42% thought the treatment had made the problem worse. Two-thirds said it diminished the patient’s quality of life, and 34% believed it caused brain damage.
A larger international survey led by Professor John Read of the same university, involving 1,144 participants across 44 countries, produced similarly stark findings: only 45% of recipients said ECT helped the initial problem, and just 29% felt it improved their quality of life. Professor Read, a co-author of the study with Ms Morrison, believes the treatment should be “immediately suspended”. He notes that no placebo-controlled trials of ECT have been conducted since 1985 and argues that without stronger evidence of effectiveness, its role in mental health care needs re-evaluation.
The side effects extend beyond memory loss. Memory loss itself is a well-documented risk – some research suggests around 7% of patients receiving unilateral ECT report persistent memory loss 12 months after treatment. A study in the International Journal of Mental Health identified 25 other concerning side effects, including cardiovascular problems, fatigue, emotional blunting, headaches, muscle aches, confusion, nausea, and disorientation. While some experts state there is no scientific evidence that modern ECT causes long-term brain damage or permanent cognitive deterioration, patients and relatives frequently report otherwise. The risk of death from the general anaesthetic used during ECT is rare, estimated at about one in 100,000, with cardiovascular complications cited as a cause in around 30% of those deaths.
Proponents of ECT point to its efficacy: the Royal College of Psychiatrists reported that 68% of patients were “much improved” or “very much improved” at the end of treatment in 2018–2019, and some studies claim response rates of 80% or higher for severe depression. But critics argue that these figures do not account for long-term outcomes or the experiences of those who feel harmed.
Official responses and calls for review
The treatment has faced growing political scrutiny. In March 2023, multiple MPs called for an urgent and comprehensive review of ECT, with some advocating for a ban or suspension due to concerns over irreversible brain damage and its disproportionate use on women. In 2019, women made up around two-thirds of all ECT patients – a figure that has remained stable over the past decade and is attributed to higher rates of depression in women. The average age of acute ECT recipients is around 62, and older individuals have shown greater responsiveness.
Mental health charity Mind has said the evidence base for ECT is “not fit for purpose”. Rosie Weatherley, its information content manager, said: “This latest study further substantiates the need for a rethink about whether and when this treatment is offered to patients.” Mind also claims some patients are offered ECT before other treatments, such as talking therapies, which it says is against the guidelines from the National Institute for Health and Care Excellence (NICE).
A NICE spokesperson said: “ECT is recommended only in restricted circumstances when other treatments have not worked, or when a condition is potentially life-threatening. It is not a routine or first-line treatment. Before ECT is considered and offered, clinicians must weigh up the individual risks and benefits, including the potential for cognitive impairment. Where patients have capacity, consent must be given freely and without coercion, and they must be made aware of their right to withdraw it at any time. In cases where a patient lacks capacity, any decision to proceed with treatment is made within a strict legal framework and must comply with relevant legislation. We keep our guidance under review as new evidence emerges.”
An audit of patient information leaflets in Northern Ireland, Scotland, and Wales – co-authored by Ms Morrison – found that they did not comply with the ethical principle of informed consent, raising further concerns about the adequacy of what patients and families are told before treatment. The Department of Health and Social Care said: “Our thoughts are with anyone who has experienced harm or distressing side effects following ECT. Patient safety is paramount to us and we take all accounts of this kind incredibly seriously. It is NICE who is responsible for issuing national guidance and advice and ensuring that this reflects the best available evidence. Clinical guidance from NICE is clear that patients must be fully informed of the risks and side effects before any decision is made, and that appropriate precautions must be taken throughout.”
Ms Morrison, now a lived experience consultant and mental health campaigner, has called the “severely disabling effects” of ECT a human rights failing and wants more research into the treatment. Professor Read has suggested alternative approaches such as cognitive behaviour therapy could help people if they are seen early enough. “These findings highlight the necessity to be fully transparent about the efficacy and risks of ECT to both patients and relatives,” he said. “Without this level of detail, the consent provided by patients and their loved ones may not meet the requirements of informed consent.”
