Electroconvulsive therapy (ECT), which involves passing electricity through the brain, remains a controversial psychiatric treatment for depression and other conditions because it can cause side effects such as memory loss and is ineffective for many patients. A recent study published in Psychology and Psychotherapy: Theory, Research and Practice has examined how ECT is currently administered and monitored throughout England.
The study was based on data provided by 37 National Health Service Trusts' responses to requests under the Freedom of Information Act. The audit found that the dwindling use of ECT in England has levelled off at about 2,500 people per year. Most recipients are women and over 60 years old. Only one Trust could report how many people received psychological therapy prior to ECT, as required by government guidelines. More than a third of ECT was given without consent, and 18% of Trusts were non?compliant with legislation concerning second opinions. Only six Trusts provided any data for positive outcomes and seven for adverse effects. None provided data on efficacy or adverse effects beyond the end of treatment.
"ECT is a potentially very dangerous procedure that requires the most stringent monitoring. Our audit shows that this is not the case at most ECT clinics in England," said lead author John Read, PhD, of the University of East London. "Currently, monitoring is left to the Royal College of Psychiatrists and they are clearly not capable of ensuring patient safety." Dr. Read and a group of other ECT experts are calling for an independent enquiry into the administration and monitoring of ECT in England.