ECTAS survey 2016/17

Earlier this month (July 2017) the Royal College of Psychiatrists published the results of a survey of electroconvulsive therapy (ECT) use in 71 clinics in England, Wales, Northern Ireland and the Irish Republic.

They found that two thirds of the people undergoing a course of ECT were women. That proportion rose to almost three-quarters for people having maintenance ECT. The mean age of ECT patients was 61 for those having a course of treatment and 66 for those having maintenance treatment.

Over 40 per cent of those having a course of ECT were treated without their consent, after their psychiatrist had decided they lacked the capacity to make a decision. Nearly one in five of those having maintenance ECT were not consenting.

Nearly ninety per cent of people having a course of ECT had a diagnosis of depression, split fairly equally between severe and moderate. The mean number of treatments per course was 9.8, with 12 treatments being by far the most common number in a course. In about 100 courses, out of the 1821 in the survey, the patient had fewer than four treatments, whilst at the other end of the scale about 50 courses consisted of twenty or more treatments. Courses of even numbers were far more common than courses of odd numbers, presumably something to do with the way ECT clinics are run.

The 71 clinics in the survey were clinics who belong to ECTAS (ECT Accreditation Service) and chose to take part in the survey. By extrapolating from the participating English clinics the authors of the survey came up with a figure of 2135 courses for England in 2016/17, a decline from previous years.

These estimates of the total number of ECT courses for England do not tally however with figures from the Care Quality Commission on requests to use ECT on detained patients without their consent. For example, in 2014/15 the Care Quality Commission authorised the use of ECT without consent on 1554 occasions. Yet for that year the estimate of the Royal College for the total number of courses was 2302, of which about 40 per cent or 900 would have been detained, non-consenting patients who required Care Quality Commission authorisation. There is a big difference between 900 and 1554.

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