Response to the Royal College of Psychiatrists’ critique of our audit of ECT usage

Read, John; Harrop, Chris; Geekie, Jim; Cunliffe, Sue

doi:10.1111/papt.12379

Cited by 2 publications

(1 citation statement)

References 9 publications

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“…The equally disturbing findings of two recent audits about how ECT is administered and monitored in England (Read et al, 2021; Read, Harrop, Geekie, & Cunliffe, 2022) suggest, in conjunction with the two audits of information leaflets, that no official body is effectively monitoring or regulating ECT. The RCPsych's ‘ECT Accreditation Service’ (ECTAS) has, in fact, recently stressed that it has no monitoring or regulatory responsibilities (Read, Harrop, Geekie, & Cunliffe, 2022; Sivasanker et al, 2021). Indeed, membership of ECTAS by ECT Clinics is voluntary, ECTAS reports on clinics are not publicly available, and patients and families are not told in information leaflets whether the clinic they are attending is accredited.…”

Section: Discussionmentioning

confidence: 99%

An independent audit of electroconvulsive therapy patient information leaflets in Northern Ireland, Scotland and Wales

2023

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ObjectivesTo evaluate the accuracy of patient information leaflets about electroconvulsive therapy (ECT) used in Northern Ireland, Scotland and Wales, and their compliance with the principle of informed consent.Design and MethodsTo replicate an audit in England, Freedom of Information Act requests were sent to the 26 providers of ECT for their ECT patient information leaflet. These were scored, by two independent raters, on the same 40‐item accuracy measure used in the England audit.ResultsThe number of accurate statements (out of a possible 29) ranged from seven to 20, with a mean of 16.9. The most frequently omitted statements included: cardiovascular risks (mentioned by five leaflets), that it is not known how ECT works (3), risk of mortality (2), risks from multiple general anaesthetic procedures (2), how to access a legal advocate (2) and that that there is no evidence of long‐term benefits (1). The leaflets made between six and nine inaccurate statements (out of 11) with a mean of 7.0. Nineteen minimised memory loss, blamed the memory loss on depression, claimed that ECT is the ‘most effective treatment’ and asserted it has very high response rates without mentioning similar placebo response rates. All 23 leaflets wrongly told patients that ECT saves lives.ConclusionsElectroconvulsive therapy information leaflets in these three nations are barely more accurate than those in England and do not comply with the ethical principle of informed consent. Patients and families across the UK are systematically being misled about the risks they are taking and the limited nature of ECT's benefits.

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Section: Discussionmentioning

confidence: 99%

An independent audit of electroconvulsive therapy patient information leaflets in Northern Ireland, Scotland and Wales

2023

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Efforts to Improve the Accuracy of Information About Electroconvulsive Therapy Given to Patients and Families

Read,

Harrop,

Geekie

2023

Ethical Hum Psychol Psychiatry

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Objective:Many thousands of people still receive electroconvulsive therapy but it remains highly contested. A recent audit of the United Kingdom patient information leaflets found multiple inaccuracies and omissions, minimizing risks and exaggerating benefits (e.g., only six leaflets mentioned cardiovascular events). This study reports efforts to improve accuracy for patients and families.Methods:Letters were sent twice to managers of all 51 United Kingdom National Health Service trusts (regional bodies which deliver most health care) detailing the audit’s findings and the accuracy of their own trust’s leaflet, also asking what changes would be undertaken.Results:Only nine trusts responded and three committed to improvements. The Royal College of Psychiatrists released a slightly better but still highly misleading information sheet. Efforts to engage government and all other relevant United Kingdom bodies failed.Conclusions:Trusts are unwilling to correct misinformation/ensure balanced information.

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Response to the Royal College of Psychiatrists’ critique of our audit of ECT usage

Abstract: We thank the Royal College of Psychiatrists (RCPsych) for their response (Sivasanker et al., 2022) to our audit of electroconvulsive therapy (ECT) (Read et al., 2021).

Cited by 2 publications

References 9 publications

An independent audit of electroconvulsive therapy patient information leaflets in Northern Ireland, Scotland and Wales

An independent audit of electroconvulsive therapy patient information leaflets in Northern Ireland, Scotland and Wales

Efforts to Improve the Accuracy of Information About Electroconvulsive Therapy Given to Patients and Families

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