NAIROBI – A contentious psychiatric treatment, Electroconvulsive Therapy (ECT), is facing renewed international scrutiny following a UK-based study that highlights a wider range of severe adverse effects than previously acknowledged, including significant cardiovascular problems and emotional blunting. The findings, published on Wednesday, 20 November 2025, in the *International Journal of Mental Health*, are prompting urgent questions about patient safety and informed consent for a procedure currently administered in Kenyan health facilities.

The study, authored by Professor John Read of the University of East London, surveyed 747 ECT patients and 201 relatives. It reported that nearly a quarter of participants (22.9%) experienced heart problems like arrhythmia post-treatment. Furthermore, over half (53.9%) reported recurring headaches, and a staggering 76.4% experienced emotional blunting. Prof. Read has called for the immediate suspension of ECT, arguing that the research into its efficacy is “so flawed and inconclusive” it would not gain regulatory approval if introduced today.

ECT involves passing a controlled electric current through the brain under general anaesthesia to induce a brief seizure. It is typically recommended as a last resort for severe, treatment-resistant mental health conditions, including major depression, catatonia, and severe mania, when other treatments like medication and psychotherapy have failed.

ECT in the Kenyan Context

In Kenya, ECT is available in both public and private psychiatric units, including at the Mathari National Teaching and Referral Hospital (MNTRH) and several private facilities in Nairobi. The procedure is often positioned as a rapid and effective option for patients with severe conditions, with some local providers citing an 80-90% improvement rate for severe depression. A session in Nairobi can cost around KES 10,000, with a typical course requiring approximately six sessions.

However, research into the practice within Kenya has revealed significant challenges. A study published in *Frontiers in Psychiatry* noted that Kenya does not have its own national guidelines for the use and monitoring of ECT, with practitioners often relying on international standards, such as those from the UK's Royal College of Psychiatrists (RCP). The same study found that less than half of all psychiatric units in the country provide ECT services and highlighted a lack of a “specific guideline or policy structure” in the facilities that do. This raises concerns about standardised administration, patient monitoring, and the process of informed consent, especially in light of the new findings on adverse effects.

Recent local reports have also raised alarms about the potential for misuse, suggesting that ECT is sometimes recommended hastily without adequate exploration of alternatives or full disclosure of risks, driven by financial incentives. This aligns with global concerns voiced by the World Health Organization (WHO) and the UN High Commissioner for Human Rights, which have stated that administering ECT without free and fully informed consent can be a violation of human rights and may constitute ill-treatment.

A Divided Medical Opinion

The medical community remains divided on ECT. Proponents, including the American Psychiatric Association and the UK's Royal College of Psychiatrists, maintain that modern ECT is a safe and life-saving procedure when used appropriately for a narrow band of severe illnesses. Professor George Kirov from Cardiff University, responding to the new study, described ECT as “highly effective” and “life-changing” for many with severe depression. Similarly, Professor Tania Gergel of University College London stated there is “no evidence to substantiate claims that modern ECT carries any major risk to physical health.”

Conversely, Prof. Read’s research challenges the foundational evidence for ECT's effectiveness, noting that there have been no placebo-controlled studies on the treatment since 1985. His findings add to the well-documented side effect of memory loss, which can be persistent or permanent for a significant minority of patients.

Implications for Patient Care in Kenya

These latest findings place a significant responsibility on Kenyan healthcare providers and regulatory bodies, including the Ministry of Health and the Kenya Psychiatric Association (KPA). The Ministry's Kenya Mental Health Action Plan (2021-2025) aims to ensure access to “comprehensive, integrated and high-quality mental health care services.” The questions raised by Prof. Read’s study directly impact this goal, highlighting an urgent need for:

• Development of National Guidelines: Establishing clear, evidence-based national protocols for ECT administration, patient selection, and monitoring is critical.
• Enhanced Informed Consent: Patients and their families must be fully informed of all potential risks, including memory loss, cardiovascular complications, and emotional changes, alongside potential benefits and alternative treatments.
• Stricter Regulation and Oversight: Ensuring ECT is used strictly as a last-resort treatment and not as a premature or financially motivated intervention requires robust oversight.

As Kenya continues to implement its mental health policy, the global debate over ECT underscores the complexity of treating severe mental illness. The welfare of vulnerable patients depends on a rigorous, evidence-based, and transparent approach to controversial but potentially life-saving treatments. The position of the Kenya Psychiatric Association and the Ministry of Health on these new findings is eagerly awaited. FURTHER INVESTIGATION REQUIRED.