ECT in Wales 2011

The Board of Community Health Councils in Wales has just published a report called Electro-convulsive therapy in Wales: a brief report on usage by Health Boards.

The Board of Community Health Councils (BCHCW) issued a Freedom of Information request to each Health Board Chief Executive in April 2012.

“This approach was necessitated by the lack of central data available on this topic. This short report will compare the responses received from each Health Board”.

I did something similar last year, and by and large came up with the same sort of figures. According to the BCHCW report 195 people (70 per cent of them women) in Wales underwent electroconvulsive therapy (ECT) in 2011, with Cardiff and Vale of Glamorgan University Health Board being the heaviest user. But the BCHCW report has diagrams and some detail that I didn’t have. And in the appendix it gives information from the different health boards.

In Abertawe Bro Morgannwg 22 of the 24 people undergoing ECT in 2011 were women. There were only 7 patients under the age of 60 (just one under the age of 40). All patients had bilateral treatment (Abertawe Bro Morgannwg was the only health board to give information about the type of ECT used).

In Betsi Cadwaladr almost half the ECT patients were over the age of 60.

In Cardiff and Vale, the highest user of ECT, there was a larger proportion of younger people with just under 40 per cent being over 60 and 10 per cent being under 30.

The figures from Cwm Taf are surprising, with 8 men and just 1 woman given ECT in 2011-12. Five were under 45, four were over 60.

Hywel Dda gave ECT to 30 women and 13 men. 28 were under the age of 65, with 2 being under the age of 25.

Interestingly, one health board, Aneurin Bevan, gave information about the number of treatments patients were given. (Often we are simply given an average.) In Aneurin Bevan the mean was about 9 treatments per course. Two people had fewer than 6 treatments, 9 people had 6-9 treatments, 7 people had 10-12 treatments, and 2 people had 13-16 treatments. Cardiff and Vale and Hywel Dda gave no information about the number of treatments and the other health boards only gave information on the length of time people were undergoing ECT, which can be misleading if maintenance ECT is being used. ECT is usually given twice a week, so for example, someone whose treatment lasted 42 days would have, at the rate of 2 per week, 12 treatments. But what about the person in Abertawe Bro Morgannwyg who underwent treatment for 172 days? Were they perhaps having maintenance treatment at fortnightly or monthly intervals?

The report concludes:

“What is most surprising is that this data is not collected on a national level. Bodies such as the Royal College of Psychiatrists and MIND determine that ECT is a controversial, severe treatment. As a result it is imperative that information on the usage of the therapy is collected centrally.”

Information on the use of ECT is collected centrally – and published. But the information is so inaccurate as to be useless, and, although the Departments of Health in England and Wales have been aware of this for a long time, they have not been sufficiently concerned to do anything about it. Perhaps this report from the Board of Community Health Councils in Wales will result in some action. As for England, Community Health Councils were abolished in 2003.

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