ECT in Wales: a fairly complete picture

Wales has the same problem as England when it comes to counting the number of people who undergo electroconvulsive therapy (ECT). Last year the Welsh Assembly Government came up with some improbably small figures; it would appear that the coding for ECT has caused similar confusion in the Patient Episode Data for Wales (PEDW) as it has in the Hospital Episode Statistics in England (HES).

Wales has a population of just under 3 million, with the south-east of the country being much more densely populated than the rest. It is divided into seven Local Health Boards (LHB) which are displayed on this map. All except for one of them have come up with at least some figures on their use of ECT, from which I have compiled the following table. The figures refer to the number of people who received ECT during the period from April 2010 to March 2011; the number of courses of ECT would be higher as some people receive more than one course in a year (this is one reason why the numbers of people being treated without their consent do not match those of the Health Inspectorate Wales which counts courses or rather requests for approval for courses of ECT). The figures do not include people treated in independent hospitals in Wales.

Going from roughly north to south, and west to east the LHBs in Wales are:

  • BCUHB – Betsi Cadwaladr University Health Board
  • HDHB – Hywel Dda Health Board
  • PTHB – Powys Teaching Health Board
  • ABMUHB – Abertawe Bro Morgannwg University Health Board
  • CTHB – Cwm Taf Health Board
  • ABHB – Aneurin Bevan Health Board
  • CVUHB – Cardiff and Vale University Health Board

Numbers of people receiving ECT 2010-2011 (the figures in italics are the number of people treated without their consent under s58A of the Mental Health Act)

  • BCUHB       36    8
  • HDHB         37    7
  • PTHB          ?
  • ABMUHB   21    5
  • CTHB          16    1
  • ABHB          25   9
  • CVUHB       65*  15*

* Estimates – CVUHB were only able to come up with figures for the 7 month period from September 2010 to March 2011 (38 people, with 9 treated under s58A)

In Wales about 210 people underwent ECT in 2010-2011. Five Health Boards were able to provide figures on the numbers of men and women who received ECT: women accounted for almost three-quarters (73 per cent) of patients. Cardiff and Vale UHB appears to be using a disproportionate amount of ECT, with Hywel Dda HB being another heavy user.

The number of people undergoing ECT in Wales has dropped by about two-thirds or more over the last fifteen years. A survey of ECT use in Wales by Richard Duffett, Drew Ridley Siegart and Paul Lelliott published in the Psychiatric Bulletin  in 1999 found an estimated 642 people, 71 per cent of them women, receiving ECT in 1996. The decrease is almost entirely accounted for by people treated with their consent, the numbers of people treated without their consent remaining much the same.

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