125.    In contrast to Dr Leeks’ descriptions of a therapeutic community, the survivors who spoke to the inquiry overwhelmingly described their experience of Lake Alice as one of violence and terror. A key component of that experience was the use of electric shocks to punish or deter behaviour in the name of aversion therapy, sometimes wrongly described as “unmodified ECT”, in circumstances that departed from any recognised form of treatment.

Te patu hiko: wheako purapura ora - Electric shocks: Survivor experience

126.    All of the survivors who spoke to us about electric shocks being administered at the unit said they were used as punishment. Most survivors told us threats of receiving shocks were a part of daily life in the unit. Mr Alan Hendricks, who did not receive shock treatment himself, told us:

“ECT was regularly used as punishment. The ECT machine would be wheeled into the dining room to scare us into being good. As soon as we saw the machine, everybody stopped talking and we would be silent. The only reason for the presence of the ECT machine was as a threat of punishment.

… I am quite sure that it was punishment and not part of the treatment. I wasn’t stupid and could put two and two together. I saw people misbehave, saw them threatened with the punishment, saw them dragged away, heard their screams, and could see the heat marks left on their legs around the knee area when they returned. Those marks were described to me by the boys involved as being from the electrodes.”^[269]

127.    Survivors described Dr Leeks as “the main instigator” of the delivery of electric shocks.^[270] Other staff would “go through the motions”, “doing what they were told to do by Leeks”.^[271] This is consistent with Dr Leeks’ account. He told NZ Police staff were reluctant to get involved in aversion therapy, so he “expected to have to do it all myself anyway”.^[272]

128.    Survivors felt staff influenced Dr Leeks’ decisions about who got electric shocks by reporting to him who had been “naughty” that week. “Anything anyone did that was unacceptable to the staff was put in the Day Book and bought up weekly when the weekly ECT happened.”^[273] Kevin Banks said:

“Unmodified ECT was for punishment. You got it if your name was in Dr Leeks’ ‘blue diary’. The staff would put you down for this during the week and you could get it for very small transgressions such as talking back to staff, smoking cigarette butts, running down the road etc…”^[274]

129.    Some survivors described the sessions of shock treatment being worse if they had upset staff members. For example, Mr Charles Symes said that once he was grabbed from behind by someone to be taken for ECT, started fighting without realising it was Dr Leeks and broke his nose.^[275] He said, “I got a hammering from ECT after that. I got ECT for six days in a row and each time it was harder and harder. I was then put in security for three weeks”.^[276] Mr JJ said:

“I think the doctors and nurses got a kick out of giving it to us. It was like they wanted to really, really hurt us. One day there was an incident between me and a nurse. I broke a pot accidentally. He threw a hammer at my head. After that, he gave me ECT. I got it 12 times in the same day. I was in so much pain after.”^[277]

130.    Some survivors met Dr Leeks only when he was administering electric shocks.^[278] Some survivors felt Dr Leeks got enjoyment from delivering shocks. One survivor said, “I remember Leeks’ face when he would turn the knob; he smiled every time, and his smile would get broader and broader the more pain he caused”.^[279] Mr Marks said, “To me, it was clear the staff enjoyed giving it to us. When I would beg or cry for them to stop, they would just laugh.”^[280]

131.    Some survivors also remembered Fridays as “Black Friday” because Dr Leeks typically gave electric shocks on that day.^[281] Survivors vividly described the anxiety of waiting for Dr Leeks to arrive, not knowing who would be chosen to receive shock treatment.

132.    Most survivors told us they were afraid of being given electric shocks and many described the feeling of waiting to find out if they were on the list to receive shocks on a Friday. Bryon Nicol told us that children and young people who were to receive shocks would be locked in the dayroom so they couldn’t escape while they waited for their name to be called.^[282] Mr Banks told us, “I would wet my bed with fear on Thursday nights because I was so petrified of ECT”.^[283] He went on to say, “the whole room, even the big tough boys, were in terror and many would be crying in fear. Sometimes Dr Leeks would come into the day room himself and say ‘who’s for the zap’ or ‘who’s for the ride on the thunderbolt’ or ‘who’s for the national grid’?”^[284]

133.    Some survivors told us that children and young people would lose control of their bladders and bowels because they were so afraid to get shocks. For example, Mr Wickliffe said, “I knew lots of other kids who got ECT. They were always terrified of it; you could just see it in them. Some would urinate or defecate themselves in fear or others would be in the foetal position. Some kids would try to escape out of the windows”.^[285] Mr Wickliffe told us he and another survivor would often be on the list to receive shocks, “we would both lie in the foetal position in the dayroom, urinating and defecating with fear, clinging to each other, crying, waiting to see if we would be called for ECT. We only had each other”.^[286] Mr Malcolm Richards explains:

“We could see the children being physically dragged up for it; we could hear the terrible screaming. After their ECT the children were put on their bed in the upstairs dormitory near the ECT room. We could see them being brought down half-dead looking hours later, for dinner.”^[287]

134.    Mr JJ said when they were watching television in the lounge they knew when shock treatment was happening because “stripes would run across the TV screen”.^[288] Mr Banks told us that when Dr Leeks gave shock therapy the doors to the dayroom and the room where ECT was given were left open, “In the dayroom the boys could hear the screaming and cries of pain from those who were getting it”.^[289] He said they also saw the children and young people after they received shocks.

“Just seeing them was terrifying. Some had water drizzling down their temples; some had blood coming out of their mouths and all of them were dazed. Sometimes they had to be carried downstairs and sometimes they were unconscious. There were children aged 5 and 6 who received ECT, with and without anaesthetic. I recall seeing ECT administered when I was on cleaning duty to a boy who was 9. I saw the marks on his temples after he had it and heard his screams.”^[290]

135.    Some survivors described becoming familiar with the steps that were taken each week. For example, Ms Collis said,

“I knew that if Leeks came in with his trolley and tray, I was going to be put to sleep by injection and then get ECT. If he came in with just a trolley and no tray, I was going to [get] ECT but not put to sleep. I would hide under a table when they would come to drag us to give us shock treatment in the small side rooms. It was always Leeks that gave me ECT. The pain was like my head was exploding. Sometimes, I would wet myself, sometimes I would vomit, and I would get the shakes afterwards.”^[291]

Drawing of patients waiting to receive electric shocks.^[292]

136.    Once in the room, survivors were restrained while Dr Leeks gave the electric shocks. Mr Symes said, “Whenever they tried to strap me down like this on the table, I would always lash out and try to fight it. I would hear the ECT machine warming up, it would make this humming sound that I can still remember today. Once the humming stopped, it meant the machine was ready and the pain started.”^[293] Some survivors described being made to play an active role in the process. For example, Mr Marks said, “The ECT began with staff forcing me to prepare the electrodes myself. We had to wrap bandages around a pair of steel headphones. I then had to dip them in salt water so the shocks would not burn my skin”.^[294]

137.    Many survivors said Dr Leeks would turn the electricity dial up and down again and again so they repeatedly lost and regained consciousness. One survivor said Dr Leeks would start the machine on a low level, then turn it up and down again several times.^[295] He described a second button which, if pressed, would knock survivors out instantly.^[296] He said he was fully awake for all shock treatments.^[297]

138.    Mr Wickliffe said it was the most painful thing he had ever experienced in his life.^[298] He said he would scream his lungs out because, “the harder you screamed, the more bearable it was”,^[299] even though there was only a tiny hole in the mouthguard through which to scream.

“I remember, while being given the ECT, that Leeks would be asking me questions like: ‘How do you feel?’ It seemed that only the highest-pitched, screamed responses would satisfy Leeks. If you didn’t give an appropriate scream to his questions, he would move the electrodes from the top of my temples down to the side of my jaw. I think that Leeks liked to listen to the screams. I remember that when Leeks moved the electrodes down to a part of my cheek, I would give him a really hearty scream. Leeks would then be telling the other nurses around the table: ‘This must be the spot’.” ^[300] 

Drawing of patient receiving electric shocks.^[301]

139.    Survivors said they remembered the shocks playing with their vision and seeing black and white lines. Mr AA said the shocks caused “a quick intense pain with everything flashing”.^[302] Yet another said the pain was so agonising she thought she was going to die.^[303]

140.    Survivor accounts are consistent with Dr Garry Walter’s opinion to NZ Police in 2009 when he said severe pain was one consequence of unmodified ECT if the glissando technique was used improperly and the current was insufficient to bring about immediate loss of consciousness. He said other side effects were “flashes of light if the current was close to the optic nerve, aura, partial insight [sic], experience of the fear of death, perception of rhythmical movements, perception of respiration and choking”.^[304]

141.    Some survivors described very little aftercare following shock treatment. For example, Mr Symes said, “When he finished shocking us, we were wheeled back into our wards, they would unbuckle the straps that were holding us down, and roll us off on to our beds. We were just flicked off like we were rag dolls. It would take about five or six hours to come out of it”.^[305] Mr Richards described being carried out after receiving ECT and dropped into a cold-water bath.

“I felt a blow to my head and not sure if I hit the end of the bath as I was dropped in or if I had been given another belt with the ECT machine. I was pretty out to it and I could not stay afloat and sunk. I felt I was drowning until someone eventually pulled my head up. To this day I have problems with traumatic memories that come back with cold water – even a cold-water drink will bring on the flashbacks.”^[306] Drawing of patient after receiving electric shocks.^[307]

142.    Two survivors, Mr Symes and Mr Andrew Jane, were given ECT despite suffering from heart problems. When Mr Symes went to Lake Alice, his medical file said he had a heart problem.^[308] Mr Symes said once after receiving shock treatment he spent about a week and a half in hospital and was on a respirator because he was having heart and breathing difficulties.^[309] As an adult, a surgeon told him his heart condition meant he should never have been given ECT and that he was “lucky to be alive”.^[310] Mr Symes told us that his experiences with ECT had exacerbated his ongoing heart problems.^[311] Mr Jane had a heart operation as a young boy. He told us this would have been obvious to staff from the large scar on his back.^[312]

Ngā kōrero a ngā kaimahi mō te haumanu matakawa, te patu hiko me te Haumanu Hukihuki ā-Hiko āwhina kore - Staff accounts of aversion therapy, electric shocks and unmodified ECT

143.    Staff recollections of Dr Leeks and his practices were mixed. Nurse aide, Denis Hesseltine, said when he worked with Dr Leeks he honestly believed the psychiatrist had good intentions of helping young people to behave more positively.^[313] Former nurse, Brian Stabb, recalled Dr Leeks having “a genuine concern for his charges”.^[314] Yet, at other times, Dr Leeks was seen as “omnipotent and unreasonable” and a man who “put himself above being personally affected by administering [aversion therapy], and in so doing, failed to recognise the development of his own sadism and that of some of his staff”.^[315]

144.    Mr Stabb and Mr Al Scholes described helping Dr Leeks administer unmodified ECT, and both were disturbed by what they witnessed. Mr Stabb recalled witnessing about a dozen unmodified ECT sessions^[316] and the sheets being soiled after one session.^[317] He said unmodified ECT would last about five to 10 seconds and would stop once the patient had a seizure.^[318]

“Unmodified ECT is not an easy or pleasant business to view or assist with. The patient’s shoulders and knees had to be restrained to avoid injury as the convulsions were often quite violent. They would often yell and scream. Any claim that unmodified ECT was quick and painless is not true.”^[319]

145.    Mr Stabb felt Dr Leeks was occasionally attentive to patients in group and individual therapy. However, he described his use of unmodified ECT as sometimes “unsavoury to say the least”^[320]and “sometimes questionable, and on the fringes of acceptability, even for those times”.^[321] He vividly remembered one incident in 1975 involving a 15-year-old boy, Mr DW, whom he described as “active” and “quite sociable”.^[322] Dr Leeks saw the boy after he ran away. Following a 10-minute interview, Dr Leeks decided the boy should be given unmodified ECT. Mr Stabb described what happened next.

“[Mr DW] did not co-operate and had to be restrained. It was a prolonged episode in which he broke away from us at one point, and we had to chase him through the villa. During the chase I recall Dr Leeks running around the dormitory with the ECT machine under his arm. He was joking with us all in the process. It was bizarre. When we caught [Mr DW], he was taken upstairs fighting and screaming and given unmodified ECT. It was deeply distressing. The whole experience left me shaky, nervous, giggly, and close to incontinence.”^[323]

146.    Mr Stabb later expressed his discomfort to Dr Leeks about the way the boy had been treated. He recalled that Dr Leeks “reprimanded me and told me very clearly that it was not my place to question his clinical judgement, and that if I continued to do so, he would arrange to have me transferred to another villa. He also told me that I should consider my position in the hospital and my reliance upon hospital housing”.^[324] Mr Stabb said this threat had a profound effect on him, and his relationship with Dr Leeks was never the same. Asked about this incident at our hearing in 2021, Mr Stabb agreed he could see how the boy would have regarded the electric shocks as punishment.^[325]

147.    The incident was recorded in Mr DW’s notes by nurse Terry Fountain. He wrote that Mr DW left the hospital grounds at breakfast time on 11 August 1975 shortly before he was due to have ECT. He said this may have been the reason for absconding. He was returned shortly before midday by Marton police. The entry concluded, “Unmodified ECT Dr Leeks”.^[326]

148.    Mr DW’s nursing notes record he was given electric shocks at least seven times. In September 1976, after he had left Lake Alice, Mr DW was seen by Dr Frazer, a child psychiatrist at the Department of Social Welfare. Dr Frazer wrote that Mr DW had told him he received ECT 12 times. He described Mr DW’s account of events at Lake Alice as “very disturbing” and noted that his account was not an isolated one, “We have other reports from similar in-patients [about] the misuse of drugs, the use of ECT and the exposure to sexual deviation”.^[327]

149.    Mr Scholes, who worked at the unit from 1972 to 1974, views differed from those of Dr Leeks that patients were always unconscious when given ECT or that it was painless. He said what he witnessed was painful. “Sometimes the patients weren’t rendered unconscious and sometimes they would have felt the shock administered … on other occasions the patients would be conscious throughout.”^[328] Mr Scholes also accepted Dr Leeks gave unmodified ECT as punishment.

“I do not really like to think of the ECT given in the Unit as having been punishment, but if I am being truly honest, it was punishment. With Dr Leeks, if a patient did something wrong, the response would be to give them ECT. I did not agree with how Dr Leeks administered unmodified ECT, and for the part I played in that I am sorry.”^[329]

150.    Gloria Barr, a nurse aide at the unit in 1976 and 1977, said it was common knowledge among staff and patients that Dr Leeks gave electric shocks as punishment (incorrectly described as ECT) and that patients were terrified of it. She said that “whenever a patient was taken upstairs, the rest knew what was going to happen. It was awful”.^[330]

151.    Ms Barr said Dr Leeks once told her to help him give “ECT”, which must have been unmodified, to a 12-year-old boy who had soiled his pants. She said the boy was “absolutely petrified” and the “expression on his face was one of sheer terror as he was marched upstairs”.^[331] She said Dr Leeks told her and another staff present to hold the boy’s limbs while he applied the electric current.^[332] She said the boy was immediately rendered unconscious, but it was “terrible to watch”.^[333] She told us she considered what happened to the boy to be torture. “I wish I had done something about it more then, but I really didn’t know who to go to.”^[334]

152.    Charge nurse Corkran told us he had no memory of being present when unmodified ECT was used.^[335]  However, On 27 January 1975, he recorded that Dr Leeks gave unmodified ECT to a patient.

“Admitted, along with another mis-guided youth, to have been responsible for several acts of vandalism directed at hospital property and fellow patients who have fallen out of favour with them. Placed in s/room [seclusion room] where he lost what critically balanced control he does have, was unresponsive to Largactil 50 mg by injection and was finally given unmodified ECT in an attempt to help him re-establish control. Dr Leeks officiating.”^[336]

153.    Mr Conlan, a nurse in the unit from 1972 to 1977, recalled “having words”^[337] with Dr Leeks over electric shocks he gave to Mr Paul Zentveld. Mr Conlan, who thought the treatment was aversion therapy, said Mr Zentveld began having muscle spasms, which he said was not meant to happen. Mr Conlan questioned Dr Leeks about this, and he replied to the effect that Mr Conlan was living in a hospital house. Mr Conlan interpreted this as a warning to not question Dr Leeks’ judgement again and to do as he was told.^[338] He said Mr Stabb had told him Dr Leeks had issued an identical warning to him by referring to the hospital house he was living in.^[339]

154.    In 2001, Crown Law asked Dr Leeks’ first wife, Ms Priscilla Leeks, what she considered Dr Leeks’ purpose was in giving electric shocks. She said they were intended as a “controlling device” to “modify children’s behaviour” and at times, in her opinion, there were “elements of punishment in the handing out of ECT”.^[.] 

155.    Dr Pugmire said Dr Leeks stopped using aversion therapy in 1974 after having experimented with “the use of electricity in negative reinforcement”.^[341] In 1977, Dr Leeks said he decided to give Mr Banks a series of three aversion therapy sessions for allegedly attacking another boy.^[342] Dr Leeks said this consisted of ‘faradic stimulation’ (a technical form of electrical therapy) while he thought and talked about his feelings of attacking the boy concerned. Mr Victor Soeterik, a psychologist who helped Dr Leeks at the unit, said he did not feel comfortable with the idea of faradic shock after Dr Leeks showed him a British journal on the subject, which described it as a type of aversion therapy to suppress behaviour temporarily.^[343] Having said that, Dr Pugmire recorded that when he removed the ECT machine Dr Leeks was using in December 1976, Mr Soeterik was part of a delegation brought by Dr Leeks to ‘put their case’ to have the machine returned.^[344]

Te patu hiko ki te paehema me ngā ū - Electric shocks applied to genitals and breasts

156.   Dr Leeks applied electric shocks to patients’ genitals and breasts, sometimes making other patients watch him do so. There is evidence that 15 individuals at the unit and at least one person in the adult wing were given electric shocks to the genitals, groin or breasts. In 11 cases, Dr Leeks was identified as responsible. Nurses were identified as responsible for the rest. Dr Leeks denied giving shocks to people’s genitals,^[345] but said he did put electrodes on boys’ thighs.^[346] Survivors and former staff described how Dr Leeks attached the electrodes to the upper thigh before sliding them up to their groin and on to the genitals.^[347]

157.    Survivors described the pain as excruciating. Mr Banks said it was, “like hot needles going into your testicles”.^[348] Survivors said the pain travelled through their whole body. Three survivors said the burn marks on their genitals remained to this day.^[349] One survivor said Dr Leeks put electrodes on her breasts, and she was aware of other girls who had experienced the same thing.

158.    Perceived homosexuality was a common justification for giving boys electric shocks to their genitals. This justification was used in five of the 12 cases in which we found boys were given shocks to their testicles. One of the five told us Dr Leeks put electrodes on his temples, arms and hands for resisting ECT, on his legs for kicking a door, and on his genitals for masturbating and participating in homosexual activity. Dr Leeks would say, “[Let’s] cure your sexuality the hard way”.^[350] Other reasons for getting shocked on the genitals included refusing medications^[351] and bed-wetting.^[352]

159.    Dr Leeks and staff would make other patients watch them giving shocks to a patient’s genitals and made some patients give the shocks. One survivor said Dr Leeks punished him after a boy complained that he had abused him – an allegation the survivor denied. Dr Leeks made the boy give the survivor electric shocks to his genitals, saying it was his chance to exact punishment. “The boy then held the electrodes on either side of my penis.” He said this caused “unbelievable pain, it was agony”.^[353]

160.    Mr Wickliffe said he witnessed a survivor being given shocks on his penis. He heard the survivor screaming and sneaked upstairs to investigate. He poked his head around the door and was shocked to see that staff had “wrapped his penis in gauze and then attached electrodes to it [and] then proceeded to zap him”.^[354] On another occasion, Dr Leeks made a group of boys give this survivor electric shocks for abusing them. One of those in the group was Mr Banks.^[355]

161.    Another instance of a group of boys giving shocks was witnessed by staff and other boys in the unit. The survivor was Mr CC, who sexually assaulted five boys in the unit in 1974 and was later charged by NZ Police and convicted. Mr CC himself had been the victim of abuse. When the crimes were reported, Dr Leeks had Mr CC placed in solitary confinement in villa 8, the hospital’s medium-security villa. Mr CC said Dr Leeks entered his room in a rage about the sexual abuse. He was also upset that he would have to tell the boys’ parents what had happened to them.^[356]

“He punched me in the head several times and pulled my hair back and while I was on the floor he kicked me a couple of times as well. Dr Leeks seemed to have totally lost control, which was unusual, because he was usually so cool about everything, even when he was giving us ECT.”^[357]

162.    On his second day in solitary confinement, staff restrained Mr CC as Dr Leeks subjected him to a prolonged series of electric shocks to his “arms, legs and body, I was moving around trying to get away, I was yelling out in pain and terror … At one point I was cowering in the corner. He had turned the dial up and was pushing the prongs on parts of my body. I thought I was going to die”.^[358]

Mr CC said that on his third day in villa 8, Dr Leeks invited the boys Mr CC had abused into the room to give Mr CC electric shocks: “Leeks got them to turn the dial in turns. Some turned it longer than others. I was so traumatised. It felt like forever.”^[359] Mr Banks said Dr Leeks told him to give Mr CC shocks and “to turn the dial up as high as we wished”.^[360] Dr Leeks later confirmed Mr Banks’ account, saying he remembered Mr Banks turning up the dial to its top level. However, he said this was “still below the level of pain, but it was a fairly intensive stimulus”.^[361] Dr Leeks justified this to the Medical Association as being a therapeutic exercise.^[362]Drawing of Mr CC being given electric shocks.^[363]

163.    Mr Banks recalled “the horror on [Mr CC]’s face – he looked like he was screaming, but not a sound was coming out of his mouth”.^[364] A second boy, Mr EA, said all he could hear was, “Howard Lawrence [a nurse] in the background laughing and saying, ‘he’s getting what he deserves’”.^[365] Another survivor described the fear on Mr CC’s face while he was restrained.

164.    Nurse Conlan confirmed Dr Leeks invited the boys to give Mr CC electric shocks and put the electrodes on Mr CC’s thighs and then his genitals. He said he found the entire experience ‘strange’, ‘upsetting’ and ‘disturbing, particularly since it was “the first time I had seen this done” and it was outside the criteria the staff had seen for the use of electrical aversion.^[366]

165.    Ms Leeks, who also worked in the unit, remembered Dr Leeks becoming enraged after learning an adult patient had exposed himself to patients in the unit. She said Dr Leeks told her he wanted to give the man electric shocks and “would attach the nodes to his penis to stop that sort of behaviour”.^[367] It is possible she was referring to an incident that Mr Conlan also described involving an adult patient “labelled a sexual predator”.^[368] Mr Conlan said he came back from lunch one day to find Dr Leeks had the adult patient in a room, along with several of the unit’s patients. Mr Conlan said Dr Leeks asked him to be present, “while the kids shocked the patient on the legs and other places on his body. I was shocked and disgusted and got into a row with Dr Leeks as a result of what was taking place”.^[369] Mr Conlan said this incident and the one involving Mr CC were the only occasions he considered Dr Leeks had ‘exceeded’ the criteria for use of electric shocks.^[370]

166.    Other staff, including Mr Stabb, heard of patients being given electric shocks on their genitals. Mr Stabb told us, “I tried the ECT machine on my arm to see how it felt. It hurt. I could not imagine having that feeling on somebody’s genitals”.^[371] In a media interview in 2001, Mr Hunt said, “ECT was used on boys’ testicles to punish them for so-called sexual misconduct”. ^[372]

167.    Mr Symes was the first survivor to complain of receiving electric shocks on the genitals from Dr Leeks. In a sworn statement to the Citizens Commission on Human Rights in 1978, he said Dr Leeks gave him ECT “below the belt” and on his “private parts”.^[373] Mr Symes said he took his statement to NZ Police in Whangarei and the Department of Health, but no investigation eventuated.^[374] 

168.    Sixteen individuals complained about receiving electric shocks on their arms, hands, shoulders, thighs, legs and feet while in the unit. Survivor, Pete Rose, said he witnessed Mr Steve Hunt give shocks to a 17th patient (now deceased) on his thigh for not eating his dinner. Mr Rose said the patient was unable to eat because he was in a drugged state.^[375] Mr Rose said Mr Hunt became enraged and brought the ECT machine to the dinner table and addressed everyone present, saying:

“’I want you all to see this – this is what happens if you don’t eat your dinner’ or words to that effect. He then placed the electrodes on [the patient’s] thigh and proceeded to give him several shocks. [The patient] shuddered as each of the shocks were delivered.”^[376]

169.    Survivors said other nurses, including Mr Conlan and Mr Lawrence, also gave patients shocks on their limbs as punishment for misbehaviour. Survivor, Alan Hendricks, recalled seeing boys come back from receiving electric shocks with ‘heat marks’ on their legs and knees.^[377] Mr Banks said Mr Hunt, Mr Lawrence, Mr Conlan and Mr John Blackmore were “the main ones who were into zapping us on our legs”. He said they would sometimes make patients, “put the electrodes on your knee, and you would be asked to turn the dial yourself. How could I possibly describe the pain? It was like a sledge hammer”.^[378]

170.    Mr Scholes told us he saw Mr Hunt give one boy shocks to the knee after he was seen kicking someone on the sports field. Mr Scholes told Mr Hunt he considered this “a bit over the top”, but Mr Hunt replied Dr Leeks had authorised such measures and he should take up the matter with him.^[379] Mr Hunt and Mr Conlan both admitted giving patients electric shocks but maintained it was done on Dr Leeks’ instructions.^[380] Mr Hunt accepted he gave a patient electric shocks on the legs for absconding.^[381]

171.    In a media interview, Dr Leeks also acknowledged he gave patients electric shocks on the legs. He said this was part of aversion therapy and, under this therapy, it “doesn’t matter whether you put it on their fingers or toes, or feet or legs, or arms”.^[382]

Aromatawaitanga mātanga, motuhake hoki o te patu hiko i te manga - Expert and independent assessment of electric shocks at the unit

172.   There is a marked difference between what experts said about Lake Alice and Dr Leeks in the 1970s and what experts have said since the mid-1990s. In the late 1970s, a series of psychiatrists spoke in favour of Dr Leeks and defended their understanding of the conduct in the unit. They included Dr Jim Methven and Dr John Werry, who attended the commission of inquiry into Mr Hake Halo’s case,^[383] Dr Dobson, who defended Dr Leeks publicly after an Ombudsman’s inquiry,^[384] and Dr David McLachlan, who provided an expert opinion to NZ Police in 1977, which we discuss further below.^[385] Dr McLachlan’s opinion contained the following testimonial in support of Dr Leeks:

“It would be appropriate … to comment on Dr Leeks personally as I know of him. He has been well regarded by psychiatric colleagues, and has been accepted as a psychiatrist with specialist training, interest, and ability in the management and treatment of young people. On many occasions he has been invited to address medical gatherings on aspects of his work, and this reflects his standing. Colleagues who know him much better than I do, accept him as a man who is compassionate, concerned for his patients and working diligently for their wellbeing. It would be entirely out of character for him to undertake the sort of ill-motivated practises [sic] that are alleged.”^[386]

173.    Many other psychiatrists spoke publicly in favour of Dr Leeks in the late 1970s. Some may have fallen into the error of thinking that the complaints about Lake Alice were about the legitimate use of ECT. At the time, the use of ECT was particularly controversial. Some opponents saw the therapy in any form as inappropriate or a form of torture, a view some maintain to this day. This may have led some in the psychiatric community to be overly quick to defend Lake Alice, assuming they were defending the use of therapeutic and properly administered ECT.

174.    Since the mid-1990s, medical, psychological and legal experts have been clear in their condemnation of what happened at Lake Alice. In 2001, Sir Rodney Gallen called Dr Leeks’ use of electric shocks to inflict pain and coerce behaviour “outrageous in the extreme”.^[387] At our hearing, an expert on aversion therapy and operant conditioning, Dr Barry Parsonson described Dr Leeks’ behaviour as a form of torture.^[388] Dr Alan Mawdsley said he had never heard of such conduct before and described it as “appalling”, “astounding” and “the behaviour of [a] thug”.^[389]

175.    For our hearing in 2021, Dr Parsonson reviewed Dr Leeks’ claimed use of these treatments. He told us he could find no evidence to suggest he “applied any established therapeutic procedure or followed any of the basic precepts of [aversion therapy]”.^[390] He also found Dr Leeks did not comply with accepted operant punishment practice.^[391] Psychiatric research has always regarded the use of punishment, the heart of this practice, as an intervention of last resort.^[392] Dr Parsonson told us he considered giving electric shocks to the limbs to be “closer to torture than it is to any known form of therapy”.^[393] Dr Walter said it was “never accepted practice” to give electric shocks to the parts of the body associated with “offending behaviour”.^[394]

176.    Dr Parsonson told us the training and research literature from the late 1940s onwards set out the proper application of aversion therapy.^[395] He said Dr Leeks’ use of electric shocks did not comply with properly conducted aversion therapy or operant punishment as Dr Leeks:

• did not seek patient consent beforehand,^[396] which was necessary and vital to the treatment’s effectiveness^[397] 
• administered shocks to inappropriate parts of the body, including the genitals, which was not a recognised feature of any aversion therapy^[398]
• routinely caused extreme discomfort and pain,^[399] whereas only a mild pain or degree of discomfort was required to establish a connection with the unwanted behaviour^[400]
• did not time the application of electric current to target, coincide and establish a conditioned response with the unwanted behaviour.^[401]

177.    Leoni McInroe received ECT from Dr Leeks as an adolescent at the unit. Her records were reviewed by psychiatrist Dr Peter McGeorge in 1993 and Dr Werry in 1995.^[402] Both found that Ms McInroe did not have any condition that could have legitimately been treated by ECT.^[403] Dr McGeorge described her ECT as “quite unjustified”,^[404] and Dr Werry said ECT had been “misused for behavioural control though I cannot say whether or not this was done wittingly”.^[405] Child and adolescent psychiatrist Dr Susan Perry gave a similar opinion in 1997 on Dr Leeks’ use of ECT on Mr DW, another unit survivor.^[406]

178.    Two psychiatrists examined Ms McInroe’s file notes for Crown Law in 2001. One of them, Dr Walter, described her ECT in December 1975 as a “dubious practice to say the least” because it was administered in response to “causing trouble” over boys.^[407] He said Dr Leeks gave her ECT as punishment, and a file note at the time supported this conclusion. The note read, “If any repetition of last week’s behaviour, to have ECT”.^[408] He also noted a one-off session of ECT did not constitute a course – either then or at any other time – and this added to the dubiousness of the treatment.^[409] He said it was unusual to give ECT so late in the day (5.30pm), suggesting the decision had been “rushed”, and the fact the patient had later vomited reinforced this impression because it raised the question of how adequately she had been fasted. There was also no evidence of Ms McInroe’s family being consulted or her consent obtained.^[410]

179.    Dr Philip Brinded, the other psychiatrist to review Ms McInroe’s records for Crown Law, said it was “difficult to see what [symptoms] she displayed that would have warranted [giving her] ECT”. He said her notes contained mostly comments about her boisterousness and excitability, and how she was “attention-seeking and manipulative”.followed by the note “ECT x 2”. He concluded that giving her ECT “certainly [fell] outside accepted medical practice”.^[411] In 2009, Dr Garry Walter advised NZ Police that “ECT was (and is) a treatment for a psychiatric disorder, not (isolated) psychiatric or other symptoms (like disobedience or absconding for example)”.^[412]

180.    In 2001, the Crown asked Dr Brinded, as well as three other psychiatrists (Dr Jeremy Skipworth, Dr Walter and Dr Rees Tapsell) to review the treatment of 20 other claimants. Their analysis was hindered by the lack of records from Dr Leeks showing why and how electric shocks or ECT were administered to the claimants. However, they identified many examples of ECT being given inappropriately.

181.    For example, when forensic psychiatrist Dr Skipworth reviewed the treatment given to one survivor, he concluded Dr Leeks “administered unmodified ECT, probably for punishment”. Dr Skipworth said this would have caused “significant pain”, and the survivor’s legal claim was “entirely justified”.^[413] Dr Skipworth looked at the notes of another survivor, who was admitted at age 14 and again at 17. He said the information confirmed the survivor had been given “ECT” numerous times as punishment for smoking and masturbating.^[414] Similarly, Dr Skipworth concluded a third survivor “was indeed given ECT as punishment for bad behaviour”. The notes did not reveal whether the ECT was modified or unmodified, but Dr Skipworth said it was clear to him from the survivor’s detailed description of his treatment that it was unmodified. “Either way”, he said, “this is grossly inappropriate treatment and would have been considered so even in 1973”.^[415]

182.    Psychiatrists in the Ministry of Health also recognised that Dr Leeks had misused electric shocks. Psychiatrist Dr Janice Wilson was the ministry’s Director of Mental Health when Ms McInroe filed her claim in 1994. She told us Ms McInroe’s claims of inappropriate, unmodified ECT and the misuse of aversion therapy were “compelling and believable”.^[416] Dr Anthony Duncan, another psychiatrist, was the ministry’s Deputy Director of Mental Health in 2001, when the Crown settled with the first group of unit patients. He was eager to distinguish Dr Leeks’ use of electric shocks as aversion therapy from ECT, saying it was “totally indefensible to use electric currents to deliberately cause pain using any equipment, including ECT equipment”.^[417]

183.    In 2007, Mr Craig Patterson from the Royal Australian and New Zealand College of Psychiatrists was interviewed in a 20/20 television documentary. He commented on what happened at the unit, describing it as ‘torture’ and ‘terror’, and said “electric shocks for the purposes of getting children to modify behaviour is not medicine. It is not psychiatry … it is assault, it is grievous bodily harm”.^[418]

184.    Crown lawyers, too, recognised there was strength to survivors’ claims that Dr Leeks had used electric shocks inappropriately. In February 1999, Crown Law told the Ministry of Health that some of the claimants’ medical files seemed to corroborate their allegations they received unmodified ECT and that ECT was used as punishment.^[419] Dr Anthony Duncan, Deputy Director of Mental Health, wrote in August 2000:

“The Ministry accepts that there was “a culture of fear” in the adolescent unit and that ECT was used as punishment. As a consequence of the ‘culture of fear’, and the arbitrary use of ECT, it is inevitable that all claimants will have been psychologically damaged by their experience.”^[420]

185.    In 2009, Attorney-General Christopher Finlayson said Dr Leeks’ form of aversion therapy using an ECT machine was “indefensible even for its time”.^[421]

Te whakamahi i te patu hiko hei whiu - Use of electric shocks as a punishment

186.    Sir Rodney Gallen, reporting to the Government in 2001, was clear in his view that electric shocks were administered at Lake Alice “not as a therapy in the ordinary sense of that word, but as a punishment”.^[422] That conclusion was supported by a considerable body of evidence, which has since been augmented before this Abuse in Care Royal Commission of Inquiry, much of which we summarised in the previous section. The evidence that Dr Leeks and his staff gave electric shocks to punish is compelling. Survivor accounts of extreme pain inflicted punitively were credible, plausible, consistent and supported by the available evidence, including the accounts of some staff. As Sir Rodney concluded, there was “no doubt at all that the children saw the administration of [electric shocks] as being a punishment and intended to dissuade them from certain forms of conduct”.^[423]

187.    There is also no doubt that electric shocks were administered in the unit in ways that were not a legitimate form of ECT, even though an ECT machine was used to administer the shocks. Among other things, Dr Leeks:

• gave electric shocks when the dominant purpose was to change behaviour rather than properly conducted therapy
• used an Ectonus ECT machine to manually increase the electric current, which resulted in patients remaining conscious for much or all of the time and experiencing significant pain and discomfort
• seldom sought consent beforehand from patients or their legal guardians
• applied the electrodes to patients’ limbs, chests and genitals – not to the recognised area of the scalp
• sometimes gave electric shocks on a one-off basis, rather than as part of a normal course of treatment.

188.    Dr Leeks maintained he never used an ECT machine for punishment. Asked during a media interview in 1977 whether he had used electric shocks as a form of corporal punishment, he dismissed the suggestion as “arrant rubbish”.^[424] In an affidavit sworn in 1995, he said the unit was, “based on its being a therapeutic environment, not one based on punishment. Electro-convulsive therapy was not a punishment. When required to be given, it was a treatment”.^[425]

189.    However, the evidence we have heard clearly establishes that Dr Leeks intentionally used the ECT machine to deter children from actual or perceived bad behaviour by delivering electric shocks to other parts of the body. Indeed, for many, the experience of waiting for electric shocks was itself a form of punishment and inseparable from the experience of actually receiving the shocks.

I whakamahia te patu hiko hei whakamamae i ngā tamariki me ngā rangatahi - Electric shocks used to torture children and young people

190.    At our public hearing in 2021, the Solicitor-General accepted the allegations made by Lake Alice survivors had “all of the features of torture”.^[426] She said torture has three elements. First, the infliction of severe pain and suffering,^[427] “no doubt that has been met”.^[428] Secondly, by a person acting on behalf of the State,^[429] “also no question that has been met”.^[430] Thirdly, for the purpose of punishment. She was reluctant to express a view on that question, but said if a fact-finder, such as this inquiry, found that purpose to be the case, all three elements of torture would be met.^[431] She accepted that, as alleged, the conduct at Lake Alice “meets the three criteria for torture”.^[432]

191.    We agree with the Solicitor-General’s conclusions about the severe pain and suffering survivors experienced and Dr Leeks’ status as a public official. We have already concluded the evidence is compelling that electric shocks were sometimes administered at Lake Alice as punishment, outside the bounds of any proper therapeutic approach. It follows that in the view of the inquiry those acts meet the definition of torture as outlined by the Solicitor-General. 

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