Chief Psychiatrist's annual report 2008-09 - Department of Health

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12 Chief Psychiatrist’s annual report 2008–09 Figure 10: Use of ECT from 2003–04 to 2008–09 Figure 11: Administration of ECT by sector from 2003–04 to 2008–09 Figure 11 shows that the use of ECT in public mental health services has increased by nine per cent since 2003–04. This increase appears to be broadly consistent with population growth 5 and service utilisation trends 6 over the same period. In the private sector, the use of ECT increased by 68 per cent over the same period, from 4,407 treatments in 2003–04 to 7,383 in 2008–09. This may reflect an increase in the number of beds in the private sector, combined with the increasing provision by the private sector of ECT treatment to patients who are experiencing more severe episodes of high prevalence disorders, like depression. 5 The Victorian population increased by six per cent between 2003 and 2007 (source: DHS Info Centre). 6 The number of consumers admitted to an inpatient unit rose by 12 per cent between 2003–04 and 2008–09 (source: RAPID).
Chief Psychiatrist’s annual report 2008–09 13 2.4.2 Persons receiving ECT treatment In 2008–09 a total of 1,791 people (1,146 public and 645 private) received ECT treatment, roughly the same as in the previous year. This represents three per cent of the total number of patients treated in the public mental health system annually. The average number of treatments per person was 11, which is consistent with acceptable contemporary practice. Sixty-four per cent of treatments in the public sector were administered to patients consenting to their own treatment and 36 per cent were administered to involuntary patients where the authorised psychiatrist consented on their behalf. Involuntary treatment can only occur in a public mental health service proclaimed under the Act. Women received 67 per cent of all ECT treatments in 2008–09. This finding remains consistent with previous years and international findings on ECT usage patterns by gender 7 . Figure 12: ECT treatments by age and gender in 2008–09 Women aged 50 to 59 received more ECT treatment (2,267 procedures) than other age groups. The same age bracket was also the peak decade for males receiving ECT (1,144 treatments), followed by males in their thirties (1,112 treatments). In the 10–19 year old group, 163 ECT procedures were administered to 18 and 19 year-olds. In addition, 46 treatments were administered to seven young people under 18. The Deputy Chief Psychiatrist, Child and Youth Mental Health, has discussed the use of ECT for young people under 18 with the services involved and received advice that the use of ECT in these rare cases was indicated on the basis of the diagnosis and severity of illness and that, when considering the use of ECT to treat clients under 18, a second opinion was sought in each case. At the other end of the spectrum, 131 ECT procedures were provided to persons over 90 years of age. Because of the small percentage of ECT treatment represented by these procedures (≤1 per cent), neither age group is included in figure 12. 7 Olfson M et al, 1998, ‘Use of ECT for the inpatient treatment of recurrent major depression,’ American Journal of Psychiatry, 155:22-24.
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Chief Psychiatrist's annual report 2008-09 - Department of Health

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