In my last post I discussed the disappearance of statistics electroconvulsive therapy (ECT) without consent from the Care Quality Commission’s annual report on monitoring the Mental Health Act. The Care Quality Commission should know how many times people have been treated under section 58a of the Mental Health Act (that is, without their consent) because every time a psychiatrist wants to use ECT under s58a they have to request a visit from a member of the Care Quality Commission’s panel of psychiatrists to authorise the treatment. And so, under the Freedom of Information Act, I asked the Care Quality Commission for the statistics for 2010-11.
Since the Mental Health Act Commission (the predecessor of the Care Quality Commission) first published statistics on the use of ECT without consent they have consistently shown women and the elderly as much more likely to be given ECT without their consent than men and younger people. (They are also of course more likely to be given ECT with their consent, but the Care Quality Commission does not collect statistics on ECT when it doesn’t involve the Mental Health Act). In the final report of the Mental Health Act Commission, covering the period 1 April 2007 to 31 January 2009, women made up 68 per cent of those being given ECT without their consent and more than half of all the patients were over the age of 65. In the Care Quality Commission’s first annual report women made up 67 per cent of the ECT patients and people over the age of 65 again made up over half the patients.
When I asked for last year’s statistics I was given some very bizarre figures which showed a complete reversal of the usual picture. Men outnumbered women and younger people outnumbered older people. When I queried them they came back with a minor adjustment but substantially the same. Here, for what they are worth, they are (with 2009-10 figures in brackets). The figures refer to the number of visits by Care Quality Commission psychiatrists; the actual numbers of people being given ECT are very slightly lower, as the Care Quality Commission psychiatrists can refuse to authorise ECT although they almost always do authorise it. And there may be more than one request for the same person in a year.
Under 25 74 (13) 50 (22)
25-34 177 (31) 55 (27)
35-44 147 (40) 82 (62)
45-54 137 (78) 73 (86)
55-64 75 (100) 62 (158)
65-74 61 (97) 49 (241)
75-84 29 (69) 67 (222)
over 85 18 (10) 50 (80)
For 22 people in 2010-11 age was not specified, giving a total of 731 men and 497 women with 1 person whose sex wasn’t specified (making 1229 altogether).
I find it hard to believe that psychiatrists have suddenly turned their attention from giving ECT to women and older people, to giving it to men and younger people. At first sight an explanation might be that columns have been mis-labelled, men and women being switched and the age bands being switched, with the under 25s for over 85s, 25-34s for 65-74s, etc. But this would still leave young men considerably outnumbering young women which would in itself be unexpected, although in previous years it is in this age group (the under 35s) that men have come closest to women.
The Care Quality Commission figures show 10 requests to use ECT on young people under the age of 18 in 2010-11.