ECT in England, Wales and Ireland 2018/19: detained patients outnumber informal patients

The latest survey (2018-19) from the Royal College of Psychiatrists’ Electroconvulsive Therapy Accreditation Service (ECTAS) shows that, for the first time, over half of ECT patients were detained. The proportion of people given ECT without their consent however remained at about 45 per cent, as a few detained patients consented to treatment.

The survey does not tell us about the total number of people undergoing ECT in England, Wales, Northern Ireland and the Republic of Ireland as it only applies to clinics which belong to ECTAS and not all of ECTAS clinics respond to the survey. By comparing the survey statistics on ECT without consent with those from the Care Quality Commission, I would say that, very roughly, the survey has picked up about half of the total number of ECT courses in 2018/19.

In the survey, a total of 2004 courses of ECT given to 1862 patients were included in the survey. The median age of patients was about 65 and two-thirds were women. Forty-five per cent of courses were given for “severe depression” while 43 per cent were given for “moderate depression (treatment resistant)”.

The mean number of treatments in a course was 10. The most common number of treatments in a course was 12, with more than a quarter of courses having this number. Over 17 treatments were given in 141 courses, while 98 courses consisted of fewer than 4 treatments.

Of the 45 per cent of people who were deemed to lack capacity at the start of a course of ECT, over half still lacked capacity at the end. No explanation is offered for this statistic. If people lack capacity due to, for example, dementia or a learning disability, then you would not expect this to change with treatment. But if a lack of capacity is seen as resulting from illness, then the statistic raises a question about the effectiveness of ECT.

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1 Response to ECT in England, Wales and Ireland 2018/19: detained patients outnumber informal patients

  1. Welton says:

    Elderly women — of course, who else? Elderly women with dementia? Good grief. Sounds like ageism and the desire to shut them up or at least make them compliant. One of my psychotherapists, the first one I saw after I had been shocked for almost 4 years, told me that he thought the reason electroshock seemed to “work” in some cases was that patients made a decision after a few treatments, either a conscious or an unconscious decision — “If they’re going to to do this to me if I act strangely, I will stop acting strangely.” Of course for someone with dementia, that may not be the case, but I guess if the shocks destroy enough brain cells and the doctors stuff the dementia patients full of major tranquilizers (Seroquel, etc) the elderly dementia patients wouldn’t have much energy to “misbehave” or “cause trouble” to the staff.

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