Ireland has enacted a ban on electroshock treatment for minors under its Mental Health Law passed in May, according to the Citizens Commission on Human Rights International (CCHR). The law now prohibits the use of electroconvulsive therapy (ECT)—which delivers up to 460 volts of electricity through the brain—on individuals younger than 18. CCHR, a mental health industry watchdog, praised the move as a significant human rights advance.
In the United States, the Food and Drug Administration (FDA) has cleared ECT devices for those aged 13 and older for three limited conditions, but the practice is widely used off-label, a practice CCHR wants to see stopped. The group helped secure the first law banning ECT on minors under 12 in California in 1976, and later in Texas on minors under 16 in 1993. In Western Australia, CCHR supported a ban on those aged 14 and younger in 2014, with criminal penalties for violators.
Jan Eastgate, President of CCHR International, praised Irish officials for recognizing the need to prohibit ECT on minors, raising the age to 17. "However, like thousands who called for ECT to be banned in the U.S. under the FDA's Final Rule in 2018, the ban should be extended to all ages. CCHR is committed to achieving this," she said.
The Human Rights Institute in Ireland called the Mental Health Act "one of the country's significant developments in the advancement of human rights and in the reconsideration of the relationship between health, human dignity, and the public responsibilities of the state." The Irish Mental Health Commission noted that "the most significant right potentially affected by this legislation is the right to liberty and personal security."
The newly formed Stop ECT Coalition in the U.S., a consortium of health and human rights organizations, is urging a review of how ECT devices remain on the market. ECT devices were "grandfathered" into FDA regulation in 1976 as a Class III high-risk device, bypassing modern standards requiring Premarket Approval (PMA) with clinical trials proving safety and efficacy. In 2018, the FDA reduced the risk classification to moderate risk (Class II) without such trials. The Coalition emphasizes that this "incorrect classification allowed ECT devices to be used on children as young as five, pregnant women, seniors, veterans, and other vulnerable persons…Involuntary application—still occurring in some U.S. facilities—has been condemned by the United Nations and World Health Organization as a human-rights abuse." More information is available at stopect.com/coalition.
Dr. John Read, Professor of Clinical Psychology at the University of East London, who has extensively reviewed ECT studies, noted that proponents once argued ECT works by reducing intelligence or erasing traumatic memories, calling it "brain-damaging therapeutics." He and colleagues published a review of over a hundred studies demonstrating that ECT's effects on the brain are similar to a closed-brain injury. Robert Rubinstein, a former psychiatry professor at UC San Francisco, compared ECT to "kicking a Swiss watch," while psychiatrist Dr. Niall McLaren stated, "No psychiatrist needs to use ECT."
A World Health Organization mental health strategy plan warned of ECT's health risks, including brain damage, cardiovascular complications, memory impairment, and death, stating that ECT should be banned for children and non-consenting use may constitute torture. Eastgate concluded, "Ireland's ban on electroshock treatment for minors marks a significant step forward in protecting vulnerable young people from a damaging procedure."
