Over and under-reporting of ECT use

While I was looking for statistics about the use of electroconvulsive therapy (ECT) in the Republic of Ireland for a previous post, I came across this letter in the Irish Journal of Psychological Medicine.

“Electroconvulsive therapy: do the figures add up?” was the title, and I thought for a moment that I was not alone. But it turns out that the authors, two consultant psychiatrists and an assistant chief nursing officer from Waterford Regional Hospital, do not share my concern about the under-reporting of ECT use. Instead they are concerned about two incidences of over-reporting of ECT use from individual hospitals. In the Report of the Inspector of Mental Hospitals and Activities of Irish Psychiatric Services for the year 2002, the Waterford Hospital was apparently credited with giving ECT to 144 patients, not the 69 the psychiatrists said had received ECT. They suggested the error had been down to administrative staff. And another hospital appeared to have got confused between the number of people receiving ECT and the number of individual treatments. Such errors should be corrected, but I have never seen a letter from a psychiatrist complaining about under-reporting of ECT use. It seems that no-one wants to be identified with a higher than average ECT use, while no-one seems to object if their hospital is shown in official statistics using less ECT than it does use, or even none at all – no letters in professional journals for example from Welsh psychiatrists wondering why the Welsh Assembly Government statistics only show a fraction of the ECT being used in Welsh hospitals. Even though ECT is promoted by psychiatrists as a safe and effective treatment, no-one seems to want to be near top of the league table of ECT use.

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