High compliance with ECT Rules and Code of Practice in 2022

There was an overall decrease in the administration of electro-convulsive therapy (ECT) in 2022 across Irish mental health centres, with centres once again achieving high compliance with the relevant Rules and Code of Practice, according to an annual monitoring report published by the Mental Health Commission (MHC) this morning.

The report, titled ‘The Administration of Electro-convulsive Therapy in Approved Centres: Activity Report 2022’, provides information on how often ECT is used, the people who receive it, the services providing it, and the quality and safety of the service. It is the 13th such report published by the MHC on the use of ECT in approved mental health centres and includes previously published 2020 and 2021 data for comparative purposes.

“The purpose of publishing this report is to assure the public that this service is monitored and regulated by the MHC,” said Gary Kiernan, Director of Regulation for the Mental Health Commission. “Our primary function is to promote, encourage and foster the establishment and maintenance of high standards and good practices in the delivery of mental health services. We commend those service providers who closely monitor their compliance and initiate improvements in the area of ECT. We encourage them to continue to do so in order to provide the best possible service and protect the interests of persons who require the service.”

This year, the report shows that in 2022, 93% of applicable services (those administering ECT to involuntary patients) were compliant with all aspects of the ‘Rules Governing the Use of ECT’, while 100% of relevant services were compliant with all aspects of the ‘Code of Practice Governing the Use of ECT’ in 2022.

The report also shows that there were 265 programmes of ECT administered to 206 residents in 2022. This represents a decrease on figures from 2021, which saw 296 programmes of ECT administered to 219 residents. In addition, there was a total of 2,109 individual treatments of ECT administered in 2022, representing a 7.5% decrease in comparison to 2021, when 2,291 individual treatments were administered.

A programme of ECT may involve up to 12 treatments of ECT prescribed by a consultant psychiatrist, with the total number of treatments administered in a programme of ECT varying from one to 12 treatments.

In 2022, 44 ECT programmes (16.6%) involved one or more treatments without consent, compared to 43 (15%) programmes in 2021. Section 3.4 of the Rules Governing the Use of ECT outlines the requirements for the administration of ECT in the absence of patient consent. Just over 1,760 ECT treatments (83.8%) were administered with consent in 2022, while 342 (16.2%) were administered without consent. In comparison, in 2021, 1,985 treatments (87%) were administered with consent while 296 treatments (12.9%) were administered without consent. In 2022, just five residents (1.5%) withdrew consent during their programme of ECT in comparison to 15 residents (5%) in 2021.

The report is available through this link, The Administration of Electro-convulsive Therapy in Approved Centres: Activity Report 2022.

Our full statement is available through this link, Mental Health Commission ECT Report 2022 official statement.