ECT in Scotland, Texas and Queensland

There are few places in the world that collect and publish reasonably accurate statistics on the use of electroconvulsive therapy. Scotland and Texas, USA, publish annual reports on the use of ECT; Queensland, Australia, recently published some statistics in response to a freedom of information request.

In Scotland (population approximately 5.3 million), the latest annual report from the Scottish ECT Accreditation Network shows that, in 2015, 367 patients received 448 courses of ECT (a total of 4,166 treatments). This is a very small increase from 2014, but slightly below the 2013 figure. There has been an increase in the number of patients treated without their consent – 38 per cent, up from 35 in 2014. The number of people given ECT without their consent who were objecting or resisting but deemed to lack capacity rose from 53 in 2014 to 67 in 2015.

The gender gap for ECT patients in Scotland has narrowed slightly. In 2015, 62 per cent of patients were women, compared to 68 per cent in 2014. Only about ten per cent of ECT patients were under 40 years of age; the report refers to “adults” of all ages receiving ECT, so presumably no-one under the age of 18 received ECT.

In Texas (population approximately 27 million) the Department of State Health Services publishes annual statistics on the use of ECT although for 2015 I could only find the summary. The summary shows an increase of 7.5 per cent in reports from 2014. Almost all patients consent to treatment, with only 0.6 per cent treated without their consent.

About 70 per cent of patients are women. Nearly 45 per cent of patients are aged under 44, with four patients aged under 18.

Psychiatrists in Texas, are using ECT at a slightly higher rate than psychiatrists in Scotland, but the difference is not enormous. In Texas almost all patients consent to treatment; in Scotland over one-third are deemed to lack capacity and treated without their consent. ECT patients in Texas are, on average, younger than patients in Scotland.

In Queensland (population approximately 4.7 million) the Mental Health Commission recently published figures for ECT use in 2015 in response to a freedom of information request from a newspaper. These show that, in the year July 2014-June 2015, ECT was given to 1,543 “distinct patients”, including nine under the age of 18, who received 7,698 “episodes of care” totalling 19,365 treatments. Nearly one third of patients had an “involuntary legal status”. I am not sure exactly what an “episode of care” is, but it appears that Queensland, with a slightly smaller population than Scotland, is using over four times as much ECT.

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