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.