Out on PubMed is this manuscript from 2 physicians at the University of North Carolina School of Medicine:
Resource Document for Electroconvulsive Therapy in Adult Correctional Settings.
Resource Document for Electroconvulsive Therapy in Adult Correctional Settings.
J ECT. 2020 Jun 12. doi: 10.1097/YCT.0000000000000694. Online ahead of print.PMID: 32558763
The abstract is available at the above link and copied here:
Electroconvulsive therapy (ECT) has been used for decades for the treatment of mental illness. Despite its proven efficacy, ECT is rarely offered to individuals with psychiatric disorders who are incarcerated in jails and prisons. There are currently 2.2 million people confined in US correctional facilities. Research has demonstrated that the prevalence of serious mental illness among the US incarcerated population is 4 to 5 times what is observed in the community, and there can be no doubt that individuals currently exist within jails and prisons who would benefit from this treatment modality. One issue identified as a barrier to ECT being offered to this patient population is a lack of professional guidance on the administration of ECT to individuals who are incarcerated in correctional facilities. Indeed, very little information has been published on this subject in the medical literature. We offer this article as a resource document for the utilization of ECT within adult corrections. This resource document includes a protocol to assist correctional providers and administrators in navigating the ECT referral process, a review of options for delivery of ECT to adult inmate patients, and a discussion of topics related to correctional ECT that warrant special attention, such as informed consent, the perception of ECT use within corrections, ECT-associated cognitive impairment, involuntary ECT, and ECT for competence restoration. It is vital that this important therapy be made accessible to individuals in correctional settings who are experiencing mental illness.
The abstract is available at the above link and copied here:
Electroconvulsive therapy (ECT) has been used for decades for the treatment of mental illness. Despite its proven efficacy, ECT is rarely offered to individuals with psychiatric disorders who are incarcerated in jails and prisons. There are currently 2.2 million people confined in US correctional facilities. Research has demonstrated that the prevalence of serious mental illness among the US incarcerated population is 4 to 5 times what is observed in the community, and there can be no doubt that individuals currently exist within jails and prisons who would benefit from this treatment modality. One issue identified as a barrier to ECT being offered to this patient population is a lack of professional guidance on the administration of ECT to individuals who are incarcerated in correctional facilities. Indeed, very little information has been published on this subject in the medical literature. We offer this article as a resource document for the utilization of ECT within adult corrections. This resource document includes a protocol to assist correctional providers and administrators in navigating the ECT referral process, a review of options for delivery of ECT to adult inmate patients, and a discussion of topics related to correctional ECT that warrant special attention, such as informed consent, the perception of ECT use within corrections, ECT-associated cognitive impairment, involuntary ECT, and ECT for competence restoration. It is vital that this important therapy be made accessible to individuals in correctional settings who are experiencing mental illness.
And from the text:
Considering that the prevalence of serious mental illness in jails and prisons is 4 to5 times what is observed in the general population (16%–20% vs4%), it is unreasonable to believe that a need for ECT does not exist within corrections.
This is a thoughtful review of the important, but highly sensitive, issue of providing ECT to seriously psychiatrically ill prisoners. I highly recommend it to all ECT practitioners as well as to all forensic psychiatrists or anyone interested in forensic psychiatry.
I am reminded of the time when our ECT service in New Jersey provided an acute course of ECT to an incarcerated convicted murderer diagnosed with schizophrenia who had developed catatonia.
Considering that the prevalence of serious mental illness in jails and prisons is 4 to5 times what is observed in the general population (16%–20% vs4%), it is unreasonable to believe that a need for ECT does not exist within corrections.
This is a thoughtful review of the important, but highly sensitive, issue of providing ECT to seriously psychiatrically ill prisoners. I highly recommend it to all ECT practitioners as well as to all forensic psychiatrists or anyone interested in forensic psychiatry.
I am reminded of the time when our ECT service in New Jersey provided an acute course of ECT to an incarcerated convicted murderer diagnosed with schizophrenia who had developed catatonia.
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