B.E.C.T. and Its Use in the Mental Health Services of Salford.

5.10 E.C.T. and its use in Salford.

1. The use of E.C.T. in Salford peaked in 1987 and had significantly declined since then, although this change was exacerbated by the reduction and eventual closure of the large Regional Long-Stay Service.

2. Part of the reduction in the use of E.C.T. was also due to depression being identified earlier and also the introduction and use of more effective drugs for depressive and manic conditions.

3. The Mental Health Services of Salford N.H.S. Trust was treating fewer patients with E.C.T. than other N.H.S. trusts in Greater Manchester for which information was made available. A relatively high proportion of these patients were, however, treated while detained under the Mental Health Act.

4. While fewer patients now receive E.C.T., those that do receive a similar number of treatments for a similar length of time as in previous years.

5. The figures provided by the Trust suggest a rate of 250-280 E.C.T. treatments per 100 000 population. This is in the mid-range for reported rates across England and Wales.

6. There were clear variations in the use of E.C.T. for individual consultants year-on-year, but also between consultants. There was no information held by the Trust to compare these rates with consultants in other N.H.S. trusts.

7. Consultants in the Trust claim to prescribe E.C.T. according to diagnosis and mainly for depression and rarely for conditions such as catatonic schizophrenia.

8 .Consultants in the Trust state that they use the presence of delusion and biological symptoms as the criteria to determine the likely effectiveness of E.C.T.

9. E.C.T. appears to be prescribed when depression is very severe, other treatments have previously produced negative results for individual patients, or for people who cannot tolerate antidepressants.

10. The vast majority of patients receiving E.C.T. in Salford are Salford residents.

11. An average of 69.6% of all E.C.T. patients in the Mental Health Services of Salford N.H.S. Trust were female and only 30.4% male. These proportions did not vary greatly for patients under 65 and those over 65. With the exception of one other N.H.S. trust, this difference was similar to other N.H.S. trusts in Greater Manchester for which information was made available.

12. The gender difference was reported as being due to more women experiencing depression and also living longer.

13. No detailed information about the age of E.C.T. patients was available. This was limited to whether patients were under 65 years or over 65 years.

14. There is no evidence of E.C.T. being given to anyone under 18 years of age in the recent past.

15. On average, 60.2% of all E.C.T. patients were over 65 years and 39.8% under 65. This age difference varied only slightly between male and female patients. With the exception of one other N.H.S. trust, this difference varied from other N.H.S. trusts in Greater Manchester for which information was made available, where a significantly higher proportion of patients getting E.C.T. were under 65.

16. The Trust reported that it did not record the ethnicity of patients receiving E.C.T., but a 1997 survey of N.H.S. trusts in Greater Manchester stated that 2.1% of patients receiving E.C.T. in the Trust were from an ethnic minority. This was a very low rate compared with other N.H.S. trusts in Greater Manchester (with one exception) where information was made available, and reflects the relative proportion of people from black and ethnic minorities within the Salford population.