Yesterday’s Sunday Express, as part of its crusade for better mental health, has a brief article about electroconvulsive therapy (ECT) under the headline “Crusade for better mental health: 7,000 shock treatments on NHS condemned for brain damage”.
The article takes a critical look at ECT, quoting psychologist Richard Bentall as saying: “It is shocking that the NHS continues to use an unproven treatment with damaging side effects” and mentioning the critical review of ECT he co-authored with John Read. Psychiatrist Ian Reid is also given a brief quote: “This is not a last resort treatment but a very safe and effective potentially life-saving therapy for severe depression” which is then, at least in part, contradicted by a spokeswoman for the Department of Health who said: “Use of ECT is rare and usually a last resort.”
A woman who found ECT damaging is featured in a nice photograph with her dog (a welcome change from the usual photo of Jack Nicholson in One Flew over the Cuckoo’s Nest) and given a rather longer quote than a woman from Staffordshire who said: “If I had not received ECT I would be dead by now.”
The article, which is written by journalist Lucy Johnston, begins by saying: “Almost 7,000 electric shock treatments were carried out last year, a highly controversial therapy widely believed to have been consigned to the mental health history books”. It elaborates:
“The figures, from the NHS Information Centre, show many ECT patients are elderly and last year it was carried out 1,834 times on people aged 75 and over. There are currently no figures on the number of patients who undergo ECT but experts estimate up to 1,400 people in England and Scotland received a course of between four and eight ECT sessions last year and 470 of them were over 75.”
I don’t know who the experts are but the figures are wrong. Figures are available for the use of ECT in Scotland (here) show that over 400 people received over 500 courses of ECT in 2010, with people over the age of 70 making up over 30 per cent of them. It is England for which accurate figures are missing, and I am sceptical about the NHS Information Centre figures quoted by the Sunday Express. If they are based on the Hospital Episodes Statistics then they show only a fraction of the ECT used in NHS hospitals. The inaccuracy of their ECT statistics is a problem the Department of Health has long been aware of. It probably arises from confusion over the coding for ECT and from a general unwillingness to admit how extensively it is used. After all, if the Department of Health is saying, as they are quoted as doing in this article, that “use of ECT is rare and usually a last resort”, they are hardly going to see inaccurate statistics as a big problem, as long as the inaccuracy lies in the direction of under-reporting. However patently absurd the statistics in this article are (as well as the over 400 ECT patients in Scotland, over 1,000 people annually in England undergo ECT without their consent, so “up to 1,400 people in England and Scotland” leaves no room at all for any consenting patients in England), I doubt very much that anyone from the Department of Health or Royal College of Psychiatrists will feel tempted to query the figures quoted in the Sunday Express.