The latest annual statistics on the use of electroconvulsive therapy (ECT) have been published by the Texas Department of State Health Services. They cover the period 1st September 2011 to 31st August 2012. During the period there were a total of 12,843 individual treatments, of which 3,373 were maintenance treatments, compared to 12,815 and 3,697 respectively for the previous year.
It is impossible to say exactly how many people underwent ECT in Texas last year because the statistics are collected quarterly and people may appear in more than one quarter. But the number of reports, which will be slightly higher than the number of people, was 2,079, down from 2,126 for the previous period. The reduction was almost entirely accounted for by a reduction in the number of men receiving ECT. Women now account for just over 70 per cent of those receiving ECT in Texas.
In 3 hospitals (the Texas Health Presbyterian Hospital, the Methodist Richardson Centre, and the Methodist Specialty and Transplant Hospital) more than three-quarters of the ECT patients were women. Terrell State Hospital was the only hospital where more men than women received ECT. They were also responsible for 10 of the 12 patients who did not consent to treatment, with Texas West Oaks Hospital and Zale Lipshy University Hospital being responsible for the other two patients who did not consent. The low proportion of non-consenting patients means that in Texas ECT is being used in a different way to how it is used in, for example, Australia and the United Kingdom, where a much larger proportion of patients have not consented to treatment (about 20 per cent in Victoria, Australia, and an even greater proportion in the United Kingdom).
The highest users of ECT were the same as last year, Cypress Creek Hospital with 302 reports and Texas West Oaks Hospital with 291 reports, although both had reduced their use. Other high users , Green Oaks Hospital, Zale Lipshy University Hospital, Seton Shoal Hospital and Laurel Ridge Hospital, had all increased their use since last year.
About 20 per cent of patients were over 65 years of age, a similar figure to last year. Twenty years ago about 50 per cent of ECT patients in Texas were over the age of 65. Yet this switch from giving ECT to older people to giving it to younger people does not appear to have been commented on, much less has anyone attempted to come up with an explanation for it. Five patients were under the age of 18: one at the Methodist Hospital, one at Texas West Oaks Hospital, and three at Seton Shoal Creek Hospital.
There were just two reports of magnetic seizure therapy (MST), both of them from Zale Lipshy University Hospital. Last year this hospital carried out MST on 22 patients. Perhaps a research project came to an end; perhaps a psychiatrist who was interested in the treatment moved away; or perhaps someone just decided it wasn’t such a good idea after all.