Idaho bill allowing ECT advances

BOISE — Idaho is a step closer to allowing a new treatment for some severe mental illness cases to be provided to children 12 and older.

The House Health and Welfare Committee on Tuesday passed a bill to allow electroconvulsive therapy, known as ECT, to be provided to minors between the ages of 12 and 18 with the informed consent of their parents. The treatment, which a 2019 World Journal of Psychiatry article called one of psychiatry’s “oldest and most controversial treatments,” is only allowed to be provided to adults in Idaho.

Rep. Jordan Redman, R-Coeur d’Alene, presented SB 1354 and said that parents are traveling out of state to receive this kind of treatment for their children in cases where it might be deemed effective.

ECT sends a brief electrical pulse to a patient’s brain to induce a controlled seizure, and it’s used for patients with severe, major depression who have been resistant to other treatment, as well as severe psychosis, bipolar disorder, catatonia and schizophrenia. Those who testified in favor said it can be very effective for qualified patients.

Redman said he had a constituent in his district who traveled to Johns Hopkins Medicine in Baltimore, where the doctors have recommended ECT for their 16-year-old child.

“With our current law though, they’re going to have to go out of state for this treatment,” Redman said. “This bill will give them the opportunity to stay here in Idaho, and a path forward.”

He said Medicaid doesn’t cover ECT for children, so there’s no expected cost to the state.

A number of doctors and a lobbyist for the Meridian hospital Cottonwood Creek Behavioral Hospital spoke in favor of the legislation, as did a person who has received the care.

Two women spoke in opposition to the bill, arguing that its effectiveness was questionable and it may be dangerous for children.

Joan Derrick said she’s a retired nurse and said she’d witnessed harmful effects on patients who have undergone ECT.

“One thing is certain, it is quite lucrative, and in the parlance of our time, it has been rebranded with clever PR techniques to carry a positive image,” Derrick said.

She said claims that it is mild or comes with limited side effects “are deceitful at best.”

Meridian resident Dee Carter testified that ECT had helped him treat his severe depression that had been resistant to medication or any other treatments.

“I’m in favor of anything that anyone can do to help anybody that’s experiencing depression at the level that I have,” he said. “And I can tell you, you probably will never understand what it feels like to be as sick as I was and then to experience what it’s like to heal. It’s like a new beginning, and it’s indescribable.”

Dr. Roberto Negron, medical director at Cottonwood Creek, said that ECT has been refined over the last 30 years to make it safer for patients. He said the patients experience no pain during the procedure and there are limited long-term effects.

Asked about some opposition to providing it, he said there’s a lot of stigma around the treatment and mental health care.

Cottonwood Creek CEO Kevan Finley agreed with the issues around stigma for the treatment.

“Modern ECT has an image problem, not a safety problem,” Finley said. “It’s safer than most medical procedures.”

Committee Chairman Rep. John Vander Woude, R-Nampa, had concerns that the bill as written would allow the treatment to be provided without informed consent in emergency situations. David Lehman, lobbyist for Cottonwood Creek, said the language is because the treatment was added to existing code related to informed consent for treatment for children.

Lehman and the physicians present said there would be no emergency situations where ECT would be provided without informed consent.

Rep. Nate Roberts, D-Pocatello, said he shared Vander Woude’s concerns but thought there were potentially cases where having access to the treatment would be beneficial.

He said he’d vote to send it out of committee but may change his vote on the floor.

Rep. Brandon Mitchell, R-Moscow, said he had serious concerns and he struggled on the bill. He voted against sending it to the floor but also said if he received new information he may change his vote on the floor.

The committee passed the bill in a voice vote, in which it was unclear who else voted against it. The bill previously passed the Senate 23-12.

Guido covers Idaho politics for the Lewiston Tribune, Moscow-Pullman Daily News and Idaho Press of Nampa. She may be contacted at lguido@idahopress.com and can be found on X, formerly Twitter, @EyeOnBoiseGuido.