Earlier this year, a bill was proposed in the U.S. state of Connecticut to end forced shock treatment. To put it mildly, the bill restored my hope.

Electroshock treatment, eventually re-branded as electroconvulsive therapy (or “ECT,” for short), was first used to treat a patient diagnosed with schizophrenia in 1938. The procedure, which involves applying a voltage to a person’s head to induce a seizure, was soon applied to people with diagnoses such as major depressive disorder and bipolar disorder.

To date, there is still no consensus on the mechanism of action of how the repeated induction of seizures could improve one’s mental health.

Still, the American Psychiatric Association currently promotes electroshock treatment as an effective treatment for major depressive disorder, stating “substantial improvement in approximately 80 percent of patients.”

Yet there have only been 11 randomized controlled trials of electroshock for depression; none were double-blind, all were conducted before 1985, and more than half of them found electroshock didn’t even outperform a  sham (placebo) treatment.

Electroshock treatment poses concerning risks of harm to both the brain and body, including permanent memory loss, cognitive deficits, and heart problems that can be fatal.

Worse, most patients are not informed about these potential harms, or the risk is dismissed as “minor.” As with psychiatric drugs, governments around the world have put in place laws intended to protect patients from psychiatrists at healthcare facilities who wish to perform electroshock treatment against patients’ will. Such laws are typically limited in their scope, allowing for forced electroshock when the decision is made by a psychiatrist that the patient’s mental state prevents them from being able to give informed consent. However, there are exceptions. Multiple U.S. states simply have no laws about electroshock on the books, and so allow it without any oversight. These states include Arizona, Georgia, Maryland, New Mexico, Rhode Island, and West Virginia.

Sadly, laws allowing forced electroshock to be performed on patients were only put in place after years of incessant patient abuse without regulation, rendering them better described as “laws preventing forced electroshock” so as to definitively describe the default condition in most states is to allow forced psychiatric treatments unless it is explicitly prohibited. Doing so would properly honor the accomplishment of activists passing the original 1971 law in Connecticut that abolished forced electroshock without the written consent of the patient.

Since 1971, protections have diminished, with Connecticut’s law now allowing for forced electroshock to be performed on an individual for a period of 45 days following the approval of a probate court judge (see C.G.S. § 17a-543(c)). The process is put in motion by the submission to the court of a form containing the signed approval of two physicians and the head of the requesting hospital.

Once the petition form is submitted, Connecticut law allows the hospital to begin performing the forced shock treatments. Though the patient may request a hearing to object, the patient’s request does not grant an automatic stay on the forced shock taking place… which means that they can forcibly shock a patient while the patient is waiting for their legal hearing.

The Clown, the Data, the Graph, and the Maps: How Forced Shock Treatment was Resurrected in Connecticut

Since my first encounter with involuntary psychiatric treatment in Hartford, Connecticut back in 2008, I dreamt of a world free from all forms of forced mental health services. My later introduction to the psychiatric survivor movement in 2017 brought awareness of an effort born in the early 1970s that, at least, delivered the legal changes to state laws around the U.S. that still give us the right to a legal hearing prior to being involuntarily drugged and/or electroshocked. To me, the existence of these hearings represented a tangible artifact of progress toward an ultimate end. The impossible was possible.

In comparison, my personal efforts to realize the fantasy have largely fallen flat, at times seeming only to further perpetuate the negative stereotypes of a labelled person. And, admittedly, the ambitious dream—of one day witnessing the finale to forced psychiatry without ever even imagining that the first act could be the conclusion to forced shock in the very state I was born—was a naïve one, which eventually seemed to have left me forever hopeless in the absence of any evidence of victorious progress.

Learning that my own home state of Connecticut was considering abolishing forced electroshock was a wake up from the child-like dream world turned nightmare, and into a reality where the first act was already underway.

Hope seemed to return.

Sadly, the deadline for the bill to be put out for public testimony uneventfully rolled by, quickly leaving me wondering whether the bill itself had been nothing more than a dream.

As one does, I reported to clown duty at Hartford’s Bushnell Park, where I spoke with many Connecticut residents about the state’s forced electroshock laws. After convincing people that it was, in fact, really legal to perform electroshock treatment on someone against their will, most responded with some version of “well, just because it’s legal doesn’t mean they actually do that to people.” Without having a law that I could point to (C.G.S. § 17a-543(c)) or being able to tell them I’m an electroshock survivor myself (I’m not), I didn’t really have the answer people deserved.

In search of hard data, I began writing to the probate courts and found my answer surprisingly quickly from the State of Connecticut Office of the Probate Court Administrator, which provided the district-by-district data showing just how many petitions were filed by mental health facilities in Connecticut requesting permission from the probate courts to perform forced electroshock on people from 2012 to present.

Letter received from the State of Connecticut Office of the Probate Court Administrator containing data on forced electroshock requests received by district probate courts.

The heartbreak of seeing the unexpected increase found in the 2015 data for the first time was only made worse by the uncomforting realization that every district of the 24-row data table contained within it a story of a mental health facility and (at least) two physicians making the decision to bring back forced electroshock treatment.

Without further preface, the state-wide data graph showing the number of forced electroshock petitions filed to probate courts by mental health facilities throughout Connecticut from 2012 to 2024:

Forced electroshock requests filed to state probate courts by mental health facilities in Connecticut between 2012 and 2024.

The graph clearly shows an explosive state-wide increase beginning in 2015, but what caused it? To understand, one has to look at the data on a district-by-district basis and even on a geographical basis, hence the timelapse map of the data by probate district:

Forced electroshock requests filed to state courts by mental health facilities throughout Connecticut between 2012 and 2024 (by probate district).

What we see just before and after the 2015 increase, unfortunately, appears to be nothing more than the spread of Connecticut gossip; we’re watching the decision to use forced electroshock be born in Hartford, circle around to its neighbors in Manchester and Waterbury, hop on over to Middletown, and then head down to New Haven and as far as Stamford.

This is seen more clearly with a version of the map animation that highlights the earliest data from 2012-2016.

Forced electroshock requests filed to state courts by mental health facilities throughout Connecticut between 2012 and 2016 (by probate district).

 To put it bluntly: the return to forced shock is simply growing by word of mouth and what we are seeing here is not the result of a law being changed or under-reporting, but instead is just geographical.

And, to put it dreadfully: it appears that in almost any part of the state where one might now go to find a mental health facility in Connecticut, they may be at risk of forced electroshock treatment.

This was not the case in 2012 when only Hartford Probate District received forced electroshock requests.

And it sure was not the case in 1971 after the first law protecting individuals from forced electroshock was passed in Connecticut.

I’m sorry, it just doesn’t look good at all.

And I don’t think anything short of a Million Clown March is going to succeed in fighting this thing.

But I can at least address questions pertaining to this data and hopefully my (admittedly limited) knowledge of Connecticut can provide a worthwhile additional insight.

UNDERSTANDING CONNECTICUT’S FORCED SHOCK DATA
Why the huge increase in forced electroshock petitions in 2015 (and the continued growth since then)?

Identifying the cause of the increase is the most important (and upsetting) aspect of this analysis. I’ve been unable to explain away the increase through under-reporting, legal changes, or a mental health epidemic, which leaves us with a potentially lethal wound from Occam’s Razor: that the simplest explanation for the growth of forced electroshock throughout Connecticut is simply through the spread of the belief that it is worth the risk.

Do these probate requests represent actual forced shock?

A forced electroshock petition that is approved by a Connecticut probate judge grants the healthcare facility the right to perform forced electroshock on the patient for up to 45 days (see C.G.S. § 17a-543(c)). During this time, a patient can expect to receive two to three electroshock treatments per week.

Connecticut law also allows for forced electroshock to begin immediately after the filing of the probate court request—before the legal hearing where the probate judges allows or denies the forced electroshock procedure—which means that every single petition filed can represent an individual being electroshocked against their will (see C.G.S. § 45a-186(i)).

That being said, the petition grants a 45-day window to perform forced electroshock, after which the hospital can continuously file additional 45-day requests. This means that a single person could have up to eight forced electroshock petitions filed against them in a single year.  (This could go on for years, with one patient from Connecticut Valley Hospital in Middletown receiving over 500 forced shock treatments in a five-year period from 2015-2019).

Now would be a good time to show you the graph of the data for Middletown District, Connecticut’s number one forced shock offender:

Forced electroshock requests filed to state probate courts by mental health facilities in Middletown Probate District between 2012 and 2024.
Which specific mental health facilities filed the requests?

The State of Connecticut Office of the Probate Court Administrator wrote that the “…names of the hospitals that filed the petitions and the names of the facilities that were petitioned to administer the shock therapy is not information maintained by the probate courts.”

The data provided only states which probate districts the facilities requesting forced shock reside in—not the names of the facilities—however, Connecticut state law does not allow for forced outpatient electroshock treatment, only inpatient, which means we can extrapolate information from the data about the specific facilities in some cases.

For example, Farmington Regional Probate District, which encompasses Farmington, Burlington, and Plainville, is a district within which only one inpatient psychiatric unit exists: the 3rd floor of the Connecticut Tower at UCONN Health Center.

Forced electroshock requests filed to state probate courts by mental health facilities in Farmington Probate District between 2012 and 2024.

A counter-example, where the specific facilities cannot be extrapolated, is New Haven Probate District, which contains two inpatient psychiatry facilities: Yale New Haven Psychiatric Hospital and Connecticut Mental Health Center.

Forced electroshock requests filed to state probate courts by mental health facilities in New Haven Probate District between 2012 and 2024.
Can the increase in forced shock petitions be explained by under-reporting?

The State of Connecticut Office of the Probate Court Administrator wrote that “…the probate courts do not have information relating to petitions for shock therapy prior to calendar year 2012…” indicating that an administrative change occurred to how forced electroshock petition records are kept. This suggests that the increase we see over time in the data is due to under-reporting as different probate districts adopted a change.

If under-reporting were the sole explanation, however, then we would not expect to see such a large increase in Hartford, where evidence shows they were reporting forced electroshock petition data to the state prior to 2015. I would be remiss not to mention that Hartford Hospital’s Institute of Living has a parking space with a sign reserving it for electroshock patients behind the Donnelly Building, though I doubt an involuntary patient has had the opportunity to use it.

Forced electroshock requests filed to state probate courts by mental health facilities in Hartford Probate District between 2012 and 2024.
Why does the data only go back to 2012?

I’ve been unable to identify any law or policy that states why the State of Connecticut Office of the Probate Court Administrator began aggregating district records in 2012. Connecticut state law has, however, required probate court approval for forced electroshock since 1978 (the original 1971 law stated that there could be no forced shock at all without the patient’s consent).

Were any children forcibly shocked?

We don’t know. We know there are youth and adolescent units in some of the districts that made forced electroshock requests (including Hartford Hospital’s Institute of Living). We also know that the state reported no requests from Probate Districts 55-60, which include the six regional children’s probate courts.

Is the data not just an indication that there is a growing mental health epidemic in Connecticut?

From 2012 to 2024, there was a 6,333% increase in forced electroshock petitions filed in Connecticut. While it is easy to suggest that this increase was caused by a likewise 6,333% increase in the number of patients critically affected by mental health issues, that assumption seems short-sighted.

To put this to rest, we can look at the steepest single-year change where we saw a 1250% increase in forced electroshock petitions for 2015. Did something happen in 2015 that caused a 1250% increase in mental health issues in Connecticut? I might be crazy, but not crazy enough to believe that something happened in Connecticut in 2015 that was worse than the Sandy Hook Massacre in 2012 or the COVID-19 pandemic in 2020, only the latter of which might even be represented in the data.

In your assessment, how bad is it?

Real bad. The way I see it, looking at the number of districts receiving requests rather than the number of requests is the scariest part of all this. The district count may not get headlines or attract attention because it’s focusing on lines people scribbled on a map long ago rather than the people suffering at the hands of this forced procedure; however, it can be viewed as a map of where it is safe and unsafe to seek mental health treatment without risk of being involuntarily electroshocked.

Connecticut probate districts which received forced electroshock requests between 2012 and 2024.

For non-Connecticutions, the Connecticut River Valley that travels down the middle of the state and the coastal cities by the New York border are the state’s areas of highest population density, making them the primary places one would find a mental healthcare facility in Connecticut.

A recent population density map from the State of Connecticut Census may help to illustrate the relationship:

Population density map of Connecticut per U.S. Census Bureau data.

The overlap between population density and the districts that have received petitions for forced electroshock illustrates what appears to be a nearly complete spread of the decision of mental health facilities to allow electroshock to be forced on patients.

Since this began spreading from Hartford over a decade ago, we’ve now had 24 out of 60 probate districts receive requests for forced electroshock. As the State of Connecticut Office of the Probate Administrator did not provide names of the specific facilities requesting forced electroshock, we cannot know at this time which facilities do or do not exercise their ability to forcibly electroshock patients without the heads of hospitals or inpatient psychiatric units openly stating that their policy is to never request forced shock treatment.

I can at least say, as someone who was born and raised here, that you’ll have an easier time finding an inpatient psychiatric facility that is willing to forcibly electroshock you than one that refuses to—and it wasn’t always that way.

Further graphs and other information are available here for public access.