If you’ve seen the film One Flew Over the Cuckoo’s Nest (1975), you might remember its representation of electroconvulsive therapy (ECT).
But did you know that Parkside Mental Hospital played a key role in ECT’s history? One of its leading psychiatrists, Dr. Hugh M. Birch, innovated ECT in Australia, making innovative developments in mental health treatment.
What is ECT and Who Invented it?
ECT uses controlled electrical currents to trigger a brief seizure, helping treat severe depression and schizophrenia on patients. Italian psychiatrists Ugo Cerletti and Lucio Bini invented ECT in 1938, after noticing that electric shocks calmed pigs down before slaughter.
Building Australia’s First ECT Machine
As a senior psychiatrist and later superintendent of Parkside Mental Hospital, Dr Hugh M Birch was determined to find better treatment options for patients at Parkside. At the time, the hospital was overcrowded and underfunded, relying on ineffective treatments such as insulin coma therapy and lobotomies. Birch was inspired by ECT’s success in Europe and was determined to bring it to Australia.
With no ECT machines available due to interrupted supplies in Europe during WII, Birch built his own ECT machine alongside Professor Kerr Grant at the University of Adelaide before performing, what is believed, Australia’s first recorded ECT treatment at Parkside Mental Hospital in 1941. This handmade device, using a telephone dial to time each shock became a successful treatment with higher recovery rates, setting a new standard for mental health care in Australia.
Challenges and Ethical Concerns
However, Birch faced significant challenges in implementing ECT at Parkside Mental Hospital, as his early procedures lacked anaesthesia and muscle relaxants, which resulted in memory loss and involuntary muscle contractions. Despite this, Birch believed ECT was a better alternative to lobotomies which could cause permanent brain damage and death. By the 1960s, anaesthesia was being used in ECT procedures to improve patient safety and comfort.
However, from the 1980’s, Cognitive Behavioural Therapy (CBT) and Art Therapy became more common, proving more effective than ECT for treating depression, anxiety and trauma through lasting, patient focused care.
Dr. Birch’s Legacy and Parkside Mental Hospital
In 1961, Dr Birch retired, leaving behind a legacy of innovation at Parkside Mental Hospital. His original ECT machine is now preserved at the CALHN Health Museum, Glenside site.
However the ethical debate around ECT still stands, as modern psychiatry favours less invasive treatments such as different types of therapies or medication to treat depression and schizophrenia. Many health professionals view ECT as a disciplinary measure rather than an intervention. Today, ECT can still be performed in Australia under strict regulations at hospitals such as The Queen Elizabeth Hospital, Royal Melbourne Hospital and St. Vincent’s Hospital Sydney, for treatment resistant depression or schizophrenia.
Written By Sahar Vahodi Far, CALHN Health Museum Volunteer