The use of electroconvulsive therapy (ECT) for those in deep depression, where drugs do not seem to help is still highly controversial. However, there are several highly-committed, highly-trained and utterly principled practitioners who feel it can help in a few cases. While it is clearly not in my competence here to debate the efficacy of ECT, it is in my competence as an academic media researcher, to comment on the reported evidence of standards in Scotland and elsewhere with a view, as often before, to remind readers again of the actual high quality of NHS Scotland contrary to BBC Reporting Scotland’s running scare stories based on incompetent or just biased reporting.
First, however, it interesting to note the level of controversy around ECT when it is by no means the only practise where there is debate. I’m thinking, for example, of methadone treatment, breast cancer scanning and the once routine cutting out of non-cancerous prostate glands which longitudinal studies have shown to cause severe negative consequences for many of those operated on.
The Scottish ECT Accreditation Centre Network works to maintain the highest standards for ECT therapy in Scotland. As early as 2004, a National Audit, reported in the BJPsych Bulletin, asserted:
‘ECT is effective in a routine clinical setting and standards of ECT in Scotland are higher than the UK average.’
The report also stated encouragingly:
‘All centres were using acceptable ECT machines by the end of phase 1 of the audit. Anaesthetic equipment was generally of a high standard, the majority of units provided a level well above the College criteria for adequacy…there was regular core of one to three senior anaesthetists and the standard of nursing was high.’
In 1998, only 30% of English units met the standard (BJPsychBulletin, 2004). By 2016, The Royal College of Psychiatrists could only report 78% of English centres as having even been accredited. I know this does not mean that the others are unsafe but it is still a matter of concern, surely?
‘In 2016, all [19] ECT Clinics in Scotland achieved “Accreditation”, 89% achieved “Accreditation with Excellence”. (Information Services Division /SEAN, 2016
Did BBC Reporting Scotland report this? They did report generally on ECT in 2016, see link below, but just to keep the tabloid controversy pot boiling. They made no reference to the above audits – so much for their Royal Charter to inform and to educate?
Sources:
BJPsychBulletin (2004) at: http://pb.rcpsych.org/content/27/4/137
Royal College of Psychiatrists (2016) at: http://www.rcpsych.ac.uk/workinpsychiatry/qualityimprovement/ccqiprojects/ectclinics/ectas.aspx
Information Services Division SEAN (2016) at: http://www.sean.org.uk/AuditReport/_docs/SEAN-Report-2016.pdf?2
BBC on ECT in (2016) at: http://www.bbc.co.uk/news/uk-northern-ireland-35606073
Talking-up Scotland 