What has not ended

There is no "UK" framework. There are three.

First, the most important thing: this page does not assess whether electroconvulsive therapy works. That is a matter of clinical data and we do not touch it. The question here is one thing only: consent.

England and Wales: under s.58A of the Mental Health Act 1983, ECT may not be given to a patient aged 18 or over who is capable of consenting and does not consent — except where s.62 applies, that is, treatment immediately necessary to save life or, not being irreversible, to prevent serious deterioration.

Scotland: a separate and stricter regime applies under the Mental Health (Care and Treatment) (Scotland) Act 2003, where a capacitous refusal is binding and cannot be overridden. Northern Ireland differs again.

Greece: we located no ECT-specific statute; the general provisions of Articles 95–99 of Law 2071/1992 on involuntary hospitalisation apply.

And the finding that is not a number: we searched for official statistics on how often ECT is administered without consent. We found none, in any of the three countries. That a practice of this weight is not systematically recorded is itself the finding.

[48] Mental Health Act 1983, ss. 58A and 62 · [49] Mental Health (Care and Treatment) (Scotland) Act 2003 · Greek Law 2071/1992, arts 95–99 · [50] Kaliora SC et al., J ECT 2013;29(3):219-224

Chemical restraint: drugs for behaviour, not for illness

In 2007 the US HHS Office of Inspector General reviewed six months of Medicare claims and found that 14% of elderly nursing home residents had a claim for an atypical antipsychotic — 304,983 people out of 2.1 million. That 51% of those claims were erroneous, amounting to $116 million. And that 22% of the drugs claimed were not administered in accordance with the standards on unnecessary drug use.

In November 2009 an independent report for the UK Department of Health estimated that around 180,000 people with dementia were receiving antipsychotics, that up to 36,000 might derive benefit, and that perhaps two-thirds of prescriptions would be unnecessary if appropriate support were available.

And the trend line, with equal weight: both reports preceded national reform programmes, and prescribing has since fallen substantially in both countries. 2007 is not 2026.

The distinction from the sister site: psydrugs.online covers the FDA's mortality warnings. Here the angle is restraint — a drug given to control behaviour rather than to treat illness.

[51] HHS Office of Inspector General, OEI-07-08-00150, May 2011 (review period 01.01–30.06.2007) · [52] Banerjee S, "The use of antipsychotic medication for people with dementia: Time for action", 2009

Residential programs for "troubled teens" — and why the title says non-medical

In October 2007 the Government Accountability Office testified to the House Committee on Education and Labor that it had found thousands of allegations of abuse, some involving death, at residential programs for troubled youth in the United States and at American-owned facilities abroad, between 1990 and 2007. It examined 10 closed civil or criminal cases from 1990 to 2004 in which a teenager died while enrolled in a private program.

GAO states itself that it did not verify the allegations, and that allegations should not be confused with proof of abuse. It also states that no federal agency collected comprehensive nationwide data.

The programs were wilderness therapy programs, boot camps and academies. Contributing factors GAO identified: the hiring of untrained staff and a lack of adequate oversight.

Why it appears here with an asterisk: these are largely residential settings, not psychiatric clinics, and it is a purely American matter. It is given as one exhibit, not as a pattern.

[53] US GAO, GAO-08-146T, "Residential Treatment Programs: Concerns Regarding Abuse and Death in Certain Programs for Troubled Youth", testimony 10.10.2007