Earlier this year (in February 2017) the Texas Department of State Health Services published their annual statistics on the use of electroconvulsive therapy (ECT) in the state.
In the fiscal year 2016, that is, from September 2015 to August 2016, there were 22 hospitals in Texas that used ECT and they submitted 2,675 reports of ECT, one per cent up on the previous year. That figure represents fewer than 2,675 people receiving ECT, or even the number of courses of ECT, because the reports are submitted quarterly and so a course that begins in one quarter and ends in the next will be counted twice. Someone undergoing maintenance ECT with, say, monthly treatments throughout the year will be counted four times.
Women accounted for 68 per cent of the ECT reports in Texas in 2016. People over the age of 65 accounted for 504 reports; those under the age of 25 for 176 reports, including fifteen reports for 16-17 year olds. People aged 25-64 accounted for 1995 reports. Overall, the age of ECT patients is younger than in, say, England or Scotland (or in Texas some years back). Nearly all ECT patients in Texas consent to treatment. There was one report of death within 14 days of treatment (at Laurel Ridge).
Six of the 22 hospitals in Texas that used ECT in 2016 are responsible for about two-thirds of all reports. They are: Cypress Creek, Texas West Oaks, Laurel Ridge, Zale Lipshy University, Seton Shoal and Green Oaks hospitals. Cypress Creek is, as in previous years, the heaviest user with 530 reports, almost one-fifth of the total for Texas. Nearly one-third of reports for under 25-year-olds came from Cypress Creek.
When submitting ECT reports, psychiatrists in Texas are supposed to include information on symptom severity and memory impairment before and after treatment. The assessments are made by the treating psychiatrists and include no information on how they are carried out or whether standard tests are used so are of limited use. One hospital, St Joseph Medical Center, submitted 25 reports. All their patients, according to the reports, had severe – extreme symptoms before ECT and none at all after ECT. And all their patients had moderate to extreme memory impairment before ECT and none at after ECT. In previous years they have submitted similar reports – all patients symptom-free after ECT and with no memory loss, in spite of memory impairment before treatment, something that is difficult to believe.