http://exhibits.library.stonybrook.edu/mfp/files/original/67484e10678d88bad76ee093f97ee3e9.pdf fcd011f65a81218f02e653210f23ba7a PDF Text Text June 18, 1979 TD: Carl Letson, Program Aide Assembly Whys and Means Committee Capitol The ' Albany, N.Y. FROM: 122148 Fink, M.D. Professor of Psychiatry School of Medicine Max ‘ at Stony Brook Island, N.Y. llT9h S.U.N.Y. Long SUBJECT: Assembly Article Bill 3h. The proposed law 7237: proposed amendment to Mental Hygiene Law ignores present procedures which already provide that psychiatric treatments only be given after proper consent has been obtained. The law ignores the experience that when the restrictions on medical practice are increased, treatments are no longer given and patients are deprived of the best (most effective and safe) treatment for their care. The preposed amendment will serve to further deprive patients in state mental facilities of the type of care which may he most effective. As an example, we found that less than 1% of patients admitted in 1975-1976 to state facilities received ECT, while 5.2% of patients admitted to University hospitals received this treatment (Annie, Fink and Saferstein, 1978). This is particularly true for patien€;who have the following diagnoses: psychotic depression. involutionsl depression, depression in the elderly, endogenous depression, depression with delusions; as well as some patients with mania and catatonia. It is for such illnesses that ECT is particularly effective, with efficacy rates that are greater than other available therapies, including drugs (APA Task Force Report, Chapter 2, 8. Pp. 13-56. 1978; Fink, Chapter 3. pp. 21-h1). The proposed law restricts the sunber of ECT treatments to 15 in any-12 month period. Such a restriction ignores variability in response of subjects, relapse rates, and experience with different illnesses. While most patients respond with an average of 7-9 treatments, about 10% require more treatments. About 10% of depressed patients who are not given maintenance drug therapy may relapse within six months. �Letson C. 2. June 18, 1979 risk—benefit analysis of ECT finds it more effective and as safe (or safer) than antidepressant drug therapy for patients with A psychotic depression (Fink, 1978; Pink, Chapter 5, pp. 51-58, 1979). also believe that present guidelines for consent as described Task Force (Chapter 7. pp. 132-151, 1978) and Fink (pp. 219-222, 1979) are adequate safeguards. This is particularly true for experimental treatments. which already must meet peer review under existing by we APA IRB guidelines. This proposed law is heincus on many counts - deprives patients of an effective treatment, increases”the cost of care, increases risk of suicide and death, as well as impairs confidentiality, consent and freedom of choice in the doctorupatient relationship. Further. the history of such laws, as exemplified by the effects of a similar law in California, is to deprive lower class minority patients (those 'served principally'lthWate mental health services), of a useful treat;ment, while upper class patients, with the same illness ere able to obtain care in facilities in neighboring states. Such deprivation of fservicee of our minorities is not an acceptable position for the y'legislature of the Empire State. ra'References: American ikAsnis, Psychiatric Association, Task Force Report #1h, 6., Fink, end ‘h79-h82, 1978. M. Saferstein, 8. Am. J. Psychiat. 1978. 135: i a h Fihi; Fink, MF:be M. ”Convulsive Therapy: Theory and Practice. -‘Nsv_York, 1979. M. Campr. h Psychiat. 19: 1.18, 1978. Raven Press � Dublin Core The Dublin Core metadata element set is common to all Omeka records, including items, files, and collections. For more information see, http://dublincore.org/documents/dces/. 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Title A name given to the resource Correspondence to: Letson, Carl Type The nature or genre of the resource Text Identifier An unambiguous reference to the resource within a given context mfp-05-00-029-6-194 Date A point or period of time associated with an event in the lifecycle of the resource 1979 Creator An entity primarily responsible for making the resource <a title="Fink, Max, 1923-" href="http://id.loc.gov/authorities/names/n79039548" target="_blank">Fink, Max, 1923-</a> Subject The topic of the resource Correspondence -- Correspondence Relation A related resource The Max Fink Collection Description An account of the resource Rights Information about rights held in and over the resource <a title="IN COPYRIGHT - EDUCATIONAL USE PERMITTED" href="http://rightsstatements.org/vocab/InC-EDU/1.0/" target="_blank">IN COPYRIGHT - EDUCATIONAL USE PERMITTED</a> Source A related resource from which the described resource is derived Special Collections and University Archives, University Libraries. 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