❓ A WA parliamentary question on notice investigates the use of Electroconvulsive Therapy (ECT) in Western Australia, covering aspects like frequency, patient demographics, protocols, costs, and monitoring. The response provides data and explanations regarding ECT practices.
AnsweredQoN 3753Legislative Council
QuestionView source ↗
I refer to the use of Electroconvulsive Therapy (ECT) in Western Australia, and I ask -
(1) How many people were hospitalised for ECT treatments annually since 2008?
(2) How many people received ECT treatments during these years?
(3) If there is no data available on (1) and/or (2), why did the Minister not ensure such data was gathered?
(4) How many patients receiving ECT treatment in these years were:
(a) female;
(b) male;
(c) minors between 12 and 18;
(d) children under 12; and
(e) over 65?
(5) Are there any, -
(a) controlled evaluations;
(b) randomized controlled trials;
(c) controlled clinical trials; and/or
(d) single case studies, that report outcome data from electroshock given under scientific conditions to minors?
(6) How many patients received ECT treatments in private hospitals since 2008?
(7) What are the trends in ECT use?
(8) Is the ECT treatment administered under a standardised protocol for all public service providers?
(9) If yes to (8), when did the protocol come in force?
(10) If no to (8), why not?
(11) Does the protocol or do the protocols specify, -
(a) voltage;
(b) area of administration; and
(c) number of treatments?
(12) Are there any evaluations of administering ECT using different protocols (for example unilateral versus bilateral administration)?
(13) Are records kept of the diagnosis of patients treated with ECT?
(14) What are the current full costs involved in administering ECT per patient?
(15) What are the rates of administration of ECT in different hospitals?
(16) What are the suicide rates of patients who have received ECT?
(17) What committees are involved in monitoring the use of ECT?
(1) How many people were hospitalised for ECT treatments annually since 2008?
(2) How many people received ECT treatments during these years?
(3) If there is no data available on (1) and/or (2), why did the Minister not ensure such data was gathered?
(4) How many patients receiving ECT treatment in these years were:
(a) female;
(b) male;
(c) minors between 12 and 18;
(d) children under 12; and
(e) over 65?
(5) Are there any, -
(a) controlled evaluations;
(b) randomized controlled trials;
(c) controlled clinical trials; and/or
(d) single case studies, that report outcome data from electroshock given under scientific conditions to minors?
(6) How many patients received ECT treatments in private hospitals since 2008?
(7) What are the trends in ECT use?
(8) Is the ECT treatment administered under a standardised protocol for all public service providers?
(9) If yes to (8), when did the protocol come in force?
(10) If no to (8), why not?
(11) Does the protocol or do the protocols specify, -
(a) voltage;
(b) area of administration; and
(c) number of treatments?
(12) Are there any evaluations of administering ECT using different protocols (for example unilateral versus bilateral administration)?
(13) Are records kept of the diagnosis of patients treated with ECT?
(14) What are the current full costs involved in administering ECT per patient?
(15) What are the rates of administration of ECT in different hospitals?
(16) What are the suicide rates of patients who have received ECT?
(17) What committees are involved in monitoring the use of ECT?
AnswerView source ↗
Answered
18 May 2011
Responded by
Minister for Mental Health
Response time
57 days
(1) From July 2007 to June 2010, 916 people had a hospital episode where Electro Convulsive Treatment (ECT) was performed.
(2) 2007/08: 375
2008/09: 338
2009/10: 429
Note: A person is counted once if they had an ECT procedure in more than one year thus the three year total is 916.
(3) Not applicable.
(4)
(a) Female: 603
(b) Male: 313
(c) Persons aged between 12 and 17: <5
(d) Nil.
(e) Over 65: 291
(5)
(a) Yes.
(b) No.
(c) Yes.
(d) Yes.
(6) There were 483 people who received ECT in private hospitals from July 2007 to June 2010.
(7) ECT is generally used for people with severe and persistent mental illness when other forms of therapy such as medications or psychotherapy have not been effective, cannot be tolerated or in life-threatening cases. Over the last five years, there has been a reduction in the number of people who have received ECT.
(8-10) While there are no standardised protocols, a guide to the use of ECT in Western Australia was published by the Chief Psychiatrist in 2006. There is also a Guide provided by the Royal Australian and New Zealand College of Psychiatrists that was published in 2011.
(11)
(a) No. The aim of ECT is to initiate a generalised seizure and with individual patients this will occur at different voltages.
(b) Yes. ECT can only occur in an E CT suite or an operating theatre in a hospital or an operating room in a clinic.
(c) No. The number of the treatments is a clinical decision depending on the ongoing response of the underlying mental disorder which may be adequate early in a course of ECT treatments, or there may not be an adequate response until later in the course of treatment. The protocol specifies points where a review must be undertaken to make the clinical decision as to the response of the individual to the ECT.
(12) Yes.
(13) Yes.
(14) The modelled cost for ECT in WA hospitals in 2009/10 is $794.
(15) ECT treatments are provided to patients on a specific case by case basis, following a careful clinical assessment for the indications for treatment and likely response in that individual patient. Therefore the rates provided below can only be calculated by dividing the number of people who received ECT treatments by the number of people who were admitted to hospital during 2009/10 for a mental disorder as defined in the International Classification of Diseases and Related Health Problems, Tenth Revision, Australian Modification, Sixth Edition or admitted to a specialised mental health unit. As such, the rate of ECT treatments in public hospitals in 2009/10 ranges from 1 to 7%.
(16) Correlations between a particular outcome such as suicide and treatment provided cannot be achieved without extensive investigation. The number of variables such as when the treatment was provided, response rates and other factors such as alternative treatment options make any correlation between suicide and the provision of ECT unsubstantiated.
(17) The Chief Psychiatrist's Clinical Governance Monitoring program includes reviewing the use of ECT as part of a review of the mental health service. Each service which provides ECT keeps a register of treatments and data is provided to the Department of Health - Health Information Systems.
Notice: This document is created or edited using unregistered or evaluation copy of rtLib valid for testing or development purposes only. To use it for productive or any other purposes please register it. You may purchase the license on
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(2) 2007/08: 375
2008/09: 338
2009/10: 429
Note: A person is counted once if they had an ECT procedure in more than one year thus the three year total is 916.
(3) Not applicable.
(4)
(a) Female: 603
(b) Male: 313
(c) Persons aged between 12 and 17: <5
(d) Nil.
(e) Over 65: 291
(5)
(a) Yes.
(b) No.
(c) Yes.
(d) Yes.
(6) There were 483 people who received ECT in private hospitals from July 2007 to June 2010.
(7) ECT is generally used for people with severe and persistent mental illness when other forms of therapy such as medications or psychotherapy have not been effective, cannot be tolerated or in life-threatening cases. Over the last five years, there has been a reduction in the number of people who have received ECT.
(8-10) While there are no standardised protocols, a guide to the use of ECT in Western Australia was published by the Chief Psychiatrist in 2006. There is also a Guide provided by the Royal Australian and New Zealand College of Psychiatrists that was published in 2011.
(11)
(a) No. The aim of ECT is to initiate a generalised seizure and with individual patients this will occur at different voltages.
(b) Yes. ECT can only occur in an E CT suite or an operating theatre in a hospital or an operating room in a clinic.
(c) No. The number of the treatments is a clinical decision depending on the ongoing response of the underlying mental disorder which may be adequate early in a course of ECT treatments, or there may not be an adequate response until later in the course of treatment. The protocol specifies points where a review must be undertaken to make the clinical decision as to the response of the individual to the ECT.
(12) Yes.
(13) Yes.
(14) The modelled cost for ECT in WA hospitals in 2009/10 is $794.
(15) ECT treatments are provided to patients on a specific case by case basis, following a careful clinical assessment for the indications for treatment and likely response in that individual patient. Therefore the rates provided below can only be calculated by dividing the number of people who received ECT treatments by the number of people who were admitted to hospital during 2009/10 for a mental disorder as defined in the International Classification of Diseases and Related Health Problems, Tenth Revision, Australian Modification, Sixth Edition or admitted to a specialised mental health unit. As such, the rate of ECT treatments in public hospitals in 2009/10 ranges from 1 to 7%.
(16) Correlations between a particular outcome such as suicide and treatment provided cannot be achieved without extensive investigation. The number of variables such as when the treatment was provided, response rates and other factors such as alternative treatment options make any correlation between suicide and the provision of ECT unsubstantiated.
(17) The Chief Psychiatrist's Clinical Governance Monitoring program includes reviewing the use of ECT as part of a review of the mental health service. Each service which provides ECT keeps a register of treatments and data is provided to the Department of Health - Health Information Systems.
Notice: This document is created or edited using unregistered or evaluation copy of rtLib valid for testing or development purposes only. To use it for productive or any other purposes please register it. You may purchase the license on
http://www.rtlib.com
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