I have long been concerned with the way society responds to people who come back from war. Veterans are routinely funneled into psychiatry’s grasp.[1] Over the decades, some people who fought in wars have shared with me their experiences of being psychiatrized upon return from war. Sometimes these experiences included veterans being stripped of their second amendment rights, and a host of other constitutional, civil, and human rights violations as they began to be forced into complying with psychiatric regimens, and on several occasions this included veterans being subjected to electroshock.[2]

When I would tell those in various forms of power what veterans had shared with me, the information of people’s lived experiences—people’s stories—simply dismissed as ‘anecdotal’ and therefore justified these accounts, in the master’s mind, as non-actionable intelligence that was of no consequence in a policy arena.

Underscored here, the whole psychiatrization of the experiences of active members of the military and of veterans is part of the problem. The work of people like Paula Joan Caplan[3] to discredit psychiatry and create opportunities for Veterans and people who work in the military to be listened to is essential.

However, if each individual’s story of forced psychiatric involvement and electroshock are considered “just” anecdotal by those in power, what would evidence of the routine practice of those encountering psychiatry through the Veterans Administration being electroshocked be? To see if I could answer this question, during the spring of 2015 I began a series of Freedom of Information Act (FOIA) exchanges with the Department of Veterans Affairs, Veterans Health Administration.[4] Perhaps you will accept what I found through these FOIA decisions as evidence of the use of electroshock on Veterans, and those receiving services through VAMCs in the US.

The FOIA Requests Produced Multiple Documents

One report was from Fiscal Year 2009 in the form of a 16-page “National and Regional Resource Report” in the “draft/pre-decisional” stage. The draft report described “programs not mandated by the Uniform Services Handbook” (p. 1), and included as “idiosyncratic mental health programs” in the draft/pre-decisional report were several types of programs – including programs for “Specialized Women’s PTSD Care”, “Military Sexual Trauma Programs”, and “ECT Services.” This entry addresses “ECT Services.”[5]

Here is What We Know

In the draft/pre-decisional report under the heading “ECT Use in the Veterans Health Administration” (p. 4), there is clear and convincing evidence of widespread use of electroshock throughout the VA system.

At least 5,009 electroshocks (electroconvulsive treatments) were used on at least 743 individuals through the VAMC network in 2009. The report only addressed electroshock that was delivered to someone two or more times. We have no information on how many times people were subjected to electroshock once. In 2008 there were at least 75 locations in the VAMC network across the United States that delivered electroshock. The report only addresses electroshock delivered through the VAMC network. The report confirms it does not include electroshock done in private or non-contracting VA institutions. In 2009, the VAMCs with the highest numbers of people electroshocked (30 or more people) were San Juan, Omaha, North Chicago, Kansas City, and San Antonio. Only 15 of the 21 Veterans Integrated Service Networks (VISNs) across the country responded to the request that the report I was given addressed. We can be sure that with any additional information, any amount of electroshock being conducted on those receiving services through a Veterans Administration Medical Centers (VAMC) reported would only increase the amount of people who were subjected to electroshock. Because of the lack of current information and perhaps misinformation, we have no idea of how many people have been or are currently are being electroshocked.

In addition to this information, multiple consent forms were sent to me, including a consent form for “maintenance” electroshock. I can say as a general statement that none of the consent forms sent adequately inform a reader of the known hazards of electroshock. A full analysis of these consent forms, compared with FDA guidelines, other known facts about electroshock, and informed consent process requirements in general, is underway.

The VHA Handbook 1160.01 (September 11, 2008) I received includes a campaign for the use of electroshock on veterans: a mandate for access to electroshock within every VISN; a mandate that electroshock be provided when a person is thought to meet the guidelines (discussed below); and a mandate for “maintenance” electroshock (pp. 31 – 32). The process for informed consent for electroshock is specified in Appendix A: “Treatments and Procedures Requiring Signature Consent” (pp. A1 – A2) and specifies, prior to “#9 Electroconvulsive therapy” (p. A2), this note:

“NOTE: It is not necessary to obtain a separate signature consent for sedation, anesthesia, or blood product transfusion if the combined consent form for the procedure already contains consent for sedation, anesthesia, or blood product transfusion . . .” (p. A2).

Waiving requirements for consent is a problematic in itself.

The VA/DoD Clinical Practice Guideline for Management of Major Depressive Disorder Version 2.0 (2008) makes it clear that “somatic treatment strategies” (p. 59) such as “electro-convulsive therapy (ECT)” – electroshock – should only be utilized with “specific training and expertise in the management of treatment-resistant depression and the use of these devices” (p. 59). Nonetheless, in official recommendations the VA/DOD illustrated support of electroshock:

“a. Electro-convulsive therapy (ECT) is a recommended treatment strategy for patients who have failed multiple other treatment strategies” (p. 59).

“b. Electro-convulsive therapy (ECT) may be a first line treatment for pregnant women, patients with psychotic depression, catatonic patients, or patients who have severe self-neglect issues.” (p. 59)

Yes. You read that correctly; “pregnant women.” And subsequently, the VA/DoD is supporting electroshock (and anesthesia, and a host of drugs) for fetuses.[6] The VA/DoD also instructs that:

“8. Patients who do not achieve remission after adequate trials of three different antidepressants should either receive augmentation with either medications or psychotherapy or receive combination antidepressant treatment or electro-convulsive therapy (ECT).” (p. 80)

In fact, electroshock as a modality to rid people of “major depressive disorder” is prominent in the guidelines and listed as the first ‘option’ under the title “Somatic Treatment Interventions” (pp. 130 – 132).[7] The “background” of electroshock offered by the VA/DOD is:

“Electroconvulsive therapy (ECT) has advanced in terms of its importance in treating severe MDD, especially in its psychotic and treatment-resistant forms. Refinements in anesthetic, physiologic monitoring, stimulus control, and neuromuscular blockade techniques are largely responsible for the advances and have contributed to ECT’s improved safety profile.” (p. 130)

This is fraud.

Whitaker and Cosgrove[8] (2015) point to the ways psychiatry dupes the general population when psychiatry is consented to “without genuine informed consent” (2015:158). This is something I have discussed[9] and know is relevant to electroshock. Certainly, full informed consent and informed choice is most relevant to someone who receives a prescription for a course of brain-damaging electroshock, which under some circumstances is seen as torture.[10] It is important that people have comprehensive and honest information about electroshock. Such authentic consent processes are not generally available. There is a pamphlet which I suggest people read called “Entering the Grey Zone”[11] to increase your knowledge about this brain-damaging procedure.

What these FOIA decisions show is that a) there was a 2008[12] dictate supporting the use of electroshock throughout the VA system and b) in 2009 there is evidence of nationwide usage of electroshock at VAMCs throughout the entire country.

One last thing: this is not a problem of 2008/2009 this is a problem of 2015 and beyond if some concrete actions to abolish the use of electroshock by VAMCs are not taken.

A document of the VA Western New York Health Care System Center, titled Memorandum 116A-9 (February 24, 2015) is evidence that, at minimum, in New York State the pro-shock campaign persists in 2015.

The purpose of Memorandum 116A-9 is “to establish guidelines and procedures for all staff in the application of electroconvulsive therapy at this Medical Center” (p. 1). The policy of the VA Western New York Healthcare System is that “ECT is an important therapeutic modality when utilized appropriately, and shall be the treatment of choice for certain clinical entities” (p. 1). The responsibility for carrying out ECT is “the Staff psychiatrist with designated ECT privileges” (p. 1). Procedures, Contraindications, Consultation, Pre-treatment Evaluation, Informed Consent, Required Credentials, ECT Procedures for Inpatients, and ECT Procedures for Outpatients are all addressed.

For the purposes of understanding the breadth with which the VA Western New York Health Care System (2015) promotes ECT:

“A. Indications for Use: There is currently no diagnosis that should automatically lead to treatment with ECT. Indications are based on a combination of factors, including the patient’s diagnosis, nature and severity of symptomatology, treatment history, consideration of anticipated risks and benefits of viable treatment option, and patient preference. Conditions for which ECT may be beneficial are:

1. Major depressive disorder

2. Bipolar disorder

3. Schizophrenia

4. Schizoaffective disorder.” (p. 1)

Memorandum 116A-9 is up for review on February 1, 2018 (p. 5). The VA Western New York Health Care System also sent me information including the “Equipment Record, Work Orders completed on the device, and the PM procedure that is performed on the device every 6 months” (August 19, 2015). These documents and forms are also under analysis.

Next Steps

Will you stand with me in holding the VA accountable for the misinformation campaign it is producing, and demand that the most recent data is made available for public scrutiny?

This current entry was to publicly document the information I have been sent by the Veterans Affairs Veterans Health Administration FOIA decisions.

I see this documentation as just the beginning of a more orchestrated exposure of psychiatry, and psychiatry in the military. I have plenty of information to continue going through — and more to seek out from future FOIA requests.

We do not have current data for how many people are being electroshocked through the VA/VHA — but we know at least 743 people were shocked at 75 different VAMCs a total of 5007 times in 2009 (Office of Mental Health Services, 2010). It is essential to keep in mind that these data only reflect people who were electroshocked two or more times, and 6 VISNs did not respond at all to the original query that was being reported on by the VA.

There are untold numbers of people who were subjected to electroshock one time, who are being electroshocked right now. Burstow’s (2015) Psychiatry and the Business of Madness[if !supportFootnotes][13][endif] debunks the myth that electroshock stops suicide, and – unfortunately – sheds light on the reality of its life-ending consequences. An important question we will ask is whether electroshock is contributing to the suicide rate amongst veterans.

I am proposing here a concentrated effort to obtain accurate and current data concerning the use of electroshock and other psychiatric procedures and products delivered through the VA/VHA/VAMCs.

If you would like to be involved with this unfunded effort as an advisor, or to assist with conducting a literature review and designing a study, or being a study coordinator and implementing what research design we may come to — if given an Institutional Review Board’s approval to conduct the study — please contact me.

Please leave comments and make suggestions for analysis and other information I ought to put in follow-up FOIA requests to the Veterans Health Administration, such as whether electroshock is still supported as a “first-line treatment for pregnant women” by the VA/DoD (2008, p. 59).

It is important to remember that it is not just that we are still in search of comprehensive data on the use of electroshock in the VA system. This issue of not having full and accurate data on electroshock is not specific to the VA. It is consistent with the horrendous reality that in the US, we do not have accurate numbers of how many fetuses, children, adults, and seniors are subject to electroshock. Yes, fetuses, I will remind you, because electroshock is supported as a “first line treatment for pregnant women” (VA/DOD, 2008. p. 59)

Please encourage people who are involved with the military, or who are concerned about the ways psychiatry conducts itself within the military, to speak out — and seek out — supportive alternatives to psychiatry. Please be prepared to listen when people start talking.

Electroshock has infiltrated the front lines. People who receive services through VAMCs are — at untold rates — subject to electroshock with a fraudulent consent process in the name of ‘help.’ We all ought to be concerned about the relationship between psychiatry and the military.

* * * * *

References:

VA Western New York Health Care System (February 24, 2015). Center Memorandum

No. 116A-9. Electroconvulsive Therapy (ECT). FOIA Request: VHA-15-06889-F

Office of Mental Health Services (May 28, 2010). National and Regional Resource

Report. Draft/Pre-decisional. FOIA Request: VHA-15-04065-F

The Management of MDD Working Group. (2008). VA/DoD Clinical Practice

Guidelines for Management of Major Depressive Disorder. Version 2. 0. FOIA Request 15-06677-F

* * * * *

Footnotes:

[1] It would be foolish for society to continue to ignore Erving Goffman’s (1961) Asylums.

[2] Despite the fact that many ‘doctors’ promote electroshock, electroshock (electroconvulsive treatment, ECT), is a brain-damaging procedure where varying volts of electrical current is shot into your brain to cause a grand mal seizure. As classified by the FDA, electroshock devices remain Class III experimental devices. Any supposed ‘informed consent’ which has been given for the procedure is consent via fraud, and therefore, worse than forced (discussed elsewhere).

[3] http://www.paulajcaplan.net/

[4] As a note, the Information Officers were always incredibly responsive, respectful, and helpful.

[5] A future entry will address “Military Sexual Trauma Programs” and “Specialized Women’s PTSD Care”.

[6] Please know that a follow up blog entry, “Electroshocking Fetuses” is forthcoming.

[7] followed by the ‘option’ of Vagus Nerve Stimulation (pp. 132 – 133). The larger manual ought to be dissected because it is full of potential hazards.

[8] Whitaker, R. and Cosgrove, L. (2015). Psychiatry Under the Influence: Institutional Corruption, Social Injury, and P{rescriptions for Reform. Palgrave Macmillan.

[9] https://www.madinamerica.com/2015/06/with-a-public-defrauded-illegitimacy-of-forced-psychiatry-crystalizes/

[10] Please see Tina Minkowitz’s blog https://www.madinamerica.com/author/tminkowitz/

[11] http://endofshock.com/ECTPamphlet.pdf This group was spearheaded by Loretta Wilson and others including John Breeding, Don Weitz, Dorothy Dundas and Evelyn Scogin.

[12] http://www.va.gov/vhapublications/ViewPublication.asp?pub_ID=1762

[13] Burstow, B. (2015). Psychiatry and the business of madness: An ethical and epistemological accounting. Palgrave Macmillan.