‘Unlocking the Asylum’- ECT in The North Wales Hospital

Last Sunday (9th September 2018) we held a very successful Open Doors event at Denbighshire Archives, which was attended by 300 visitors. The event focused on the ‘Unlocking the Asylum’ project, where mini talks were delivered relating to the foundation of the hospital and its first patients. An exhibition of original documents from the hospital collection were also on display, along with artefacts by the Denbighshire Museum Service collection, one of which was an ECT (Electroconvulsive therapy) machine used in the hospital itself. We also had a portrait exhibition by Same but Different called ‘The Beauty of Rare’.

Slide show photograph credits- Ceridwen Hughes, Same but Different

 

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So far, as a part of the project 12,600 post 1948 patient files have been listed and repackaged. Of these 12,600 patients 2,193 were treated with ECT for their illnesses. 2,072 of those patients recovered and were discharged, suggesting ECT treatment (used alongside other medication) had a high success rate.

So why, with such a high success rate, do so many people believe that the treatment was cruel and scary? Maybe because barbaric depictions in films such as ‘The Snake Pit’, ‘One flew over the Cuckoo’s nest’ and ‘A beautiful mind’ gave people a false impression. Maybe because the treatment was used so very frequently during the 1950s to the 1970s, sometimes without anaesthetic, made many people consider it more of a punishment than a treatment.

Despite this, it is evident from listing the patient files, that ECT was still used at the hospital up until its closure in 1995. ECT is in fact a therapy that is still used today, psychiatrists and patients still consider it to be a safe and effective treatment for severe depression and bipolar disorder. Current practice, known as modified ECT, uses muscle relaxants to avoid the physical dangers of a seizure and anaesthesia to avoid pain from the electricity.

 

Before the onset of ECT treatment, the main treatment for schizophrenia and depressive illnesses in the North Wales Hospital was Insulin shock treatment. This treatment was potentially dangerous and required skilled nursing care. In the 1930s, Professor Ugo Cerletti at Rome began investigating the application of electricity to give a shock to the brain directly through the skull. With Lucio Bini he devised a means of providing a non-lethal dose of electrical current that would induce a convulsion, using a machine capable of applying a controlled voltage for a fraction of a second. The technique was first successfully applied in 1938.

It was adopted in the NWH in July of 1941, when the committee of visitors authorized the purchase of an Ediswan electric convulsion therapy apparatus. Although ECT was initially used in cases of schizophrenia, within a year Denbigh’s medical superintendent was reporting that experience had quickly shown that ‘its chief field of usefulness is amongst the Depressions’. The treatment was administered on an increasingly regular basis during the war years- 47 patients received ECT in 1941, by 1943 the number had reached 158.

This trend continues in the patient files, as the use of ECT steadily rises during the 1950s up to the 1970s. Around the same time a revolution in the treatment of mental illness began with the introduction of antidepressants. The use of ‘Largactil’, an early form of antidepressant is widely prescribed within the patient files during the same period. Further development in antidepressants revolutionised patient management at the hospital, increasingly patients were admitted to the hospital, prescribed the medication, and once stabilised allowed home to continue their recovery. As a result the use of ECT by the late 1970s had become less frequent at the hospital.

Whatever our opinion may be about this treatment, it was a very important part of the development of mental health treatment during the 20th century.

Part of the NWH collection has already been catalogued and made available, however some records mentioned in this blog are as yet uncatalogued. The records will be available to view at the end of the ‘Unlocking the Asylum’ project in October 2019. In addition, please note that due to NHS regulations records of patients and staff which contain sensitive personal information are closed for between 75 to 100 years.

Rhian Evans
Project Support Officer
Unlocking the Asylum

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2 Responses to “‘Unlocking the Asylum’- ECT in The North Wales Hospital”

  1. Gwynne Morris Says:

    thank you very much for the info – involving much hardwork

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