The office of the Director of Mental Health in New Zealand has just published their annual report for 2011. According to the report the use of electroconvulsive therapy (ECT) has increased by nearly 18 per cent since the last annual statistics, although use is still low compared to Australia. The actual number of people receiving ECT is given as 286 (compared to 235 for the last one-year reporting period). However, in both years, there were District Health Boards (DHBs) adding people after the statistics had been analysed so those numbers are lower than the real numbers of people receiving ECT. I am not convinced, either, that they are accurate. There are a number of misprints (for example 490 divided by 75 is not 9.21) and there are some statistics that look improbable. Is it really the case that Canterbury DHB did not use ECT on any non-consenting patients, while in Capital and Coast DHB 43 per cent of ECT administrations were give to people “not able to consent”? Surely – if true – that requires some explanation.
Another statistic that looks improbable is the average number of treatments for each course. Overall it comes to 4.3 treatments, which seems rather on the low side, and the figures for some of the DHBs seem very odd. There are two DHBs, Hawkes Bay and Nelson Marlborough, where the average number of treatments per course is fewer than three. And all the DHBs except for two had patients who received just one treatment. In 2004/5 the average number of treatments per course was 7, and no-one had just one treatment. Either there has been a significant change in the way ECT is used or there is a problem with reporting its use.
“What was picked up by the press was regional variation in ECT use. This article in the Otago Daily Times began:
The Southern District Health Board’s rate of electroconvulsive therapy, at more than double the national average, is the highest in New Zealand, the latest report of the director of mental health shows.”
The increase in ECT use since the last annual statistics has been greater amongst men than amongst women, although women still account for 64 per cent of those given ECT in New Zealand. Three people over the age of 90 received ECT in 2011. No-one under the age of 20 received ECT, unlike in Australia where ECT patients include children and teenagers.