Mental Health Today (MHT) has been trying to get some statistics about electroconvulsive (ECT) use from NHS Digital. Although MHT asks for donations on their website, it is not a charity but rather a publishing company, Pavilion Publishing and Media Ltd. MHT has taken their case to the Information Commissioner’s Office: “an investigation involving Mental Health Today and the Information Commission enters its eighth month”.
NHS Digital (the new name of the Health and Social Care Information Centre) apparently wanted £21,000 to provide MHT with statistics. They are quoted as saying:
“ECT is within [our] scope. However, we do not have statistics available for use of ECT and this is not currently a priority agreed with NHS England and the Department of Health and Social Care for development. In theory, if ECT is used by providers it should be being submitted to [NHS Digital] by providers. However we cannot confirm the quality of any data held without first undertaking a large piece of work. The work involved would lead to the cost of [Freedom of Information] compliance exceeding the appropriate limit.”
Until 1991 the Department of Health collected and published reasonably accurate statistics on the use of ECT. In 1991 there were about 16,000 courses of ECT in England. But then there was a switch to a new system, which only picked up a fraction of the ECT used. Why? There are several reasons: some psychiatric hospitals decided to simply opt out of the system, or didn’t realise they were meant to be part of it; some didn’t understand the coding system. There may be other reasons. The Department of Health have been aware of the problem for over twenty years but have failed to do anything about it. (I have written about it here.)
MHT identified a rise in the statistics published by NHS Digital between 2013 and 2014 and assume this represents an increase in ECT use, although in fact most of the increase was due to a “data quality issue” with the data submitted by the Northamptonshire Healthcare NHS Foundation Trust, featured here.
Apparently, according to MHT, NHS Digital has not been publishing statistics on ECT use since 2014. (I haven’t looked at their website recently so cannot verify this). Perhaps no statistics are better than very inaccurate ones.
As well as labouring under the misapprehension that ECT use is rising dramatically, MHT has also miscalculated the numbers of people undergoing ECT while detained under the Mental Health Act. “It represents about one in twelve of those detained in hospital” they say. In fact, the figure is nearer to one in thirty. MHT seem to have overlooked the fact that a little over half of the people undergoing ECT are not detained and consent to treatment. Neither do they seem to be aware of the fact that the Care Quality Commission publish annual statistics on people being treated with ECT under the Mental Health Act.
In 2005 Parliament was told that no repeats of the 1999 and 2002 surveys of ECT use would be carried out as “In future, information on the use of electroconvulsive therapy will be available from the mental health minimum dataset” (Hansard, 12 September 2005, column 2712W). But reasonably accurate statistics on ECT use from the mental health minimum dataset never materialised.
I will be interested to see what the Information Commissioner’s Office makes of all this when they conclude their investigation.