How many people have ECT each year?

Complete data regarding ECT is difficult to ascertain. Only a handful of US states require reporting, and many other countries either do not collect data at all, or do so partially. Figures from the Department of Health in the United Kingdom show a decline in the last decade, from 105,000 ECT treatments (approximately 22,000 patients) in 1991 in England, to 66,000 treatments (11,340 patients) in 1999. No data was collected between those years. The decline appears to have continued into 2002 (the latest data as of this writing). (1)

Statistics in Canada are nearly nonexistent with the exception of Ontario, where activist Don Weitz meticulously hand counts records from the Province. The most commonly cited figure in the US is 100,000 patients receiving ECT annually. This number originates from a 1995 study that makes the estimate based on samples from psychiatric hospitals throughout the country, surveys by psychiatrists and other methods. Sometimes the figure quoted is 200,000, but these numbers are estimates only, not precise. (2)

Worldwide, Richard Abrams has guessed that 1 to 2 million people receive ECT annually, though he gives no references or reason for the estimate, other than to say "ECT is given in virtually every other country of the world - and not infrequently at much higher rates of use than in the United States..." (11) Harold Sackeim, who has a history of taking estimated numbers and passing them off as hard statistics, said the figure was likely 2 million. He claimed to "know" this, but when challenged, he backtracked and said he "estimated" and had said estimated. (The video doesn't lie...he first said he knew, then claimed he'd said estimated.) Regardless, hard statistics on the number of ECT patients do not exist. Any numbers are simply guesses Interestingly, the American Psychiatric Association suggests that ECT practitioners use this "sound bite" when talking with media: "Psychiatrists are very selective in their use of ECT. According to the National Institute of Mental Health, about 36,500 hospitalized Americans received ECT in 1986, the most recent year for which figures are available." (12) The state of Texas has a model law that requires ECT reporting, and gathers figures on the number of treatments, gender, ethnicity, age, as well as gathering information about the type of treatment and side effects.

While there is no real way to know exact numbers of patients receiving ECT, certain trends exist in the UK and North America:

- the majority of patients are female
- many of those are over the age of 65. (1,3,4,5,6)

Critics of the ECT industry have pointed out that in North America, the use of ECT is rising because insurance and government health plans pay for ECT. In 2001, a staff psychiatrist at Vancouver's Riverview Hospital went public with his concerns that the use of ECT there had more than doubled after the Canadian health plan increased payments to doctors for ECT treatments. He contacted the Minister of Health after he said his job was threatened over his attempt to blow the whistle. He was fired from Riverview in December 2001. (7,8)

Additionally, critics claim that the trend towards managed care in the US has caused psychiatrists' incomes to decline substantially, and ECT can provide a financial incentive to abuse its use. (9)

The use of ECT varies in other countries: it is rarely used in Italy, Japan, Germany, the Netherlands and Austria. Unmodified ECT (without anesthetic) is still used in India, Greece, Turkey, Japan, China, and some African countries. (10)


References

1. UK Department of Health: Electro Convulsive Therapy: Survey covering the period from January 2002 to March 2002. 2002.

2. Hermann RC DR, Hoover CW, Brody J: Variation in ECT use in the United States. Am J Psychiatry 1995(152(6)):869-75.

3. Weitz D: Electroconvulsive Therapy/ECT: Ontario 1995-2001 (Partial and Approximate), Ministry of Health and Long-Term Care, Government of Ontario, 2002.

4. Weitz D: Ontario ECT Statistics 2000-2002. Toronto, Ministry of Health and Long-Term Care, Government of Ontario, 2004

5. Figures from California Dept. of Mental Health as reported to the California State Legislature, 1989-1994

6. Texas Department of Mental Health and Retardation: Initial ECT Quarterly Summary For Treatments Given, 1993-1999.

7. Fong: Doctor Loses Job After Electroshock Controversy, in Vancouver Sun. Vancouver, 2001.

8. Matas R: DoctorÕs departure spotlights therapy/MD ÔalarmedÕ by rise in shock procedure, in Globe and Mail. Toronto, 2001.

9. Wise MG: Managed Care: How Are Psychiatrists Surviving? Psychiatric Times 1996.

10. Johnstone L: Users and Abusers of Psychiatry. London, Routledge, 2000.

11. Abrams R: Electroconvulsive Therapy. USA, Oxford University Press, 2002.

12. American Psychiatric Association: Sound Bites to use when talking with media, 1997.

Updated August 12, 2006