ECT in Ontario – is it making a startling comeback?

Yesterday the Toronto Star published an article entitled “Electroshock therapy more prevalent in Ontario, but guidelines are minimal”, with accompanying eRead called “Shock: an investigation into the startling comeback of ECT”. According to the article:

“Data released to the Toronto Star by the Ministry of Health show an almost incomprehensible spike in what is conventionally referred to as electroconvulsive therapy, or ECT….

In the fiscal year 2010-2011, the most recent year for which statistics are available, 16,259 ECT treatments were administered throughout Ontario, an increase of more than 350 per cent in seven years. A breakdown by age and gender reveals startling subsets, especially a 1,300-per-cent treatment increase for patients in the 55-59 age cohort. The statistics also reveal that women outnumber men nearly two to one in the 60-to-64 age bracket.”

I am not in the least startled by the figure of 16,259 treatments. In Canada as a whole, according to CANECTS (the Canadian Electroconvulsive Therapy Survey) about 75,000 treatments are delivered annually. Ontario has slightly more than a third of the population of the whole country, so 16,259 treatments mean that it is using ECT at a lower than average rate for Canada. Looking further afield, this rate of use would put Ontario higher than Scotland and Texas but well below Victoria, Australia, in its use of ECT.

What does startle me is the claim that this use of ECT represents an increase of more than 350 per cent in seven years, as the article claims. This means that the figure for seven years ago (2003/2004) would be under 4,000 treatments. A four and a half fold increase in the number of treatments would indeed a startling increase. In fact, so startling, that I would want to investigate the figures a little further. Unfortunately I have been unable to find the Ontario Ministry of Health figures on-line, so can’t work out exactly what is going on, but here are a few statistics that suggest that the claim of a 350 per cent rise needs to be treated with caution.
An article published in the Canadian Medical Association Journal
in 2008 gave these figures: “In Ontario, treatments have also been on the rise, from 7800 to 10 800 between 1999 and 2005.”
While this article, counting patients rather than individual treatments found a relatively stable use of ECT in Ontario between 1992 and 2004.

And figures compiled by Don Weitz for the late 1990s to early 200s show a higher number of treatments than the ones in the Canadian Medical Association Journal, in fact figures close to the 16, 259 one in the Toronto Star article.

Perhaps it is a simple typo, with the article meaning to say a 35 per cent increase rather than a 350 per cent increase. That would be less startling and could be accounted for by more people receiving ECT, or the same number of people receiving longer courses of ECT, or a change in the way statistics are collected. Without seeing the original statistics, it is impossible to say.

Statistics apart, the article made some interesting points (and, to its credit, was not illustrated with a photograph of Jack Nicholson). One woman described her memory loss in simple but compelling terms:

“You know that you lived. You went places. You made friends. You talked to people. You went to parties. You had values. You had ideas. You had beliefs. And now they’re not there.”

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One Response to ECT in Ontario – is it making a startling comeback?

  1. Doug Weir says:

    The Star article is inaccurate. From 2001 to 2011 there were 23% more patients who received ECT which compares over that same period of time to 26% more patients seen for any kind of psychiatric service over that same 10 years. Not the 350% increase over seven years that the Star article claimed.

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