{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,22]],"date-time":"2026-10-22T02:45:31Z","timestamp":1792637131931,"version":"4.5.0"},"reference-count":38,"publisher":"Wiley","issue":"3","license":[{"start":{"date-parts":[[2021,3,16]],"date-time":"2021-03-16T00:00:00Z","timestamp":1615852800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["bpspsychub.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Psychol Psychother"],"published-print":{"date-parts":[[2021,9]]},"abstract":"<jats:sec>\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>To assess progress towards improving the administering of electroconvulsive therapy (ECT) in England since an audit covering 2011, 2013, and 2015. The same information was gathered, for 2019, on usage, demographics, consent, and adherence to national guidelines and the Mental Health Act.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Design and Methods<\/jats:title>\n                    <jats:p>Freedom of Information Act requests were sent to 56 National Health Service Trusts.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Thirty\u2010seven trusts (66%) provided data. The gradual decline in the use of ECT in England has levelled off at about 2,500 people per year. There was a 47\u2010fold difference between the Trusts with the highest and lowest rates per capita. Most recipients are still women (67%) and over 60 (58%). Only one Trust could report how many people received psychological therapy prior to ECT, as required by government (NICE) guidelines. More than a third of ECT (37%) is still given without consent, with 18% of Trusts non\u2010compliant with legislation concerning second opinions. There were slight declines, compared to a previous audit, in the use of standardized depression scales, down to 30%, and standardized measures of cognitive dysfunction, down to 24%. Only six Trusts provided any data for positive outcomes and seven for adverse effects. None provided data on efficacy or adverse effects beyond the end of treatment. Twelve Trusts used identical sentences to each other, verbatim, in response to one or more questions.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Given the apparent failure of current monitoring and accrediting of ECT clinics in England, by the Royal College of Psychiatrists\u2019 ECT Accreditation Service (ECTAS), an independent government sponsored review is urgently needed.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Practitioner points<\/jats:title>\n                    <jats:p>\n                      <jats:list list-type=\"bullet\">\n                        <jats:list-item>\n                          <jats:p>Psychologists and other mental health staff should ensure that people are offered evidence\u2010based psychological treatments before being offered E.C.T.<\/jats:p>\n                        <\/jats:list-item>\n                        <jats:list-item>\n                          <jats:p>All staff should ensure that patients are fully informed of the high risk of memory loss and the smaller risk of cardiovascular failure and mortality.<\/jats:p>\n                        <\/jats:list-item>\n                        <jats:list-item>\n                          <jats:p>Individuals receiving ECT should be closely monitored for adverse cognitive effects, and treatment immediately terminated if these become apparent.<\/jats:p>\n                        <\/jats:list-item>\n                        <jats:list-item>\n                          <jats:p>Because of increased risk of memory loss for women and older people, the use of ECT should be kept to a minimum and avoided where possible, with these two groups.<\/jats:p>\n                        <\/jats:list-item>\n                      <\/jats:list>\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/papt.12335","type":"journal-article","created":{"date-parts":[[2021,5,22]],"date-time":"2021-05-22T15:19:07Z","timestamp":1621696747000},"page":"603-619","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":29,"title":["A second independent audit of electroconvulsive therapy in England, 2019: Usage, demographics, consent, and adherence to guidelines and legislation"],"prefix":"10.1111","volume":"94","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-5159-1192","authenticated-orcid":false,"given":"John","family":"Read","sequence":"first","affiliation":[{"name":"School of Psychology University of East London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christopher","family":"Harrop","sequence":"additional","affiliation":[{"name":"West London NHS Trust UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jim","family":"Geekie","sequence":"additional","affiliation":[{"name":"NHS Education for Scotland Edinburgh UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Julia","family":"Renton","sequence":"additional","affiliation":[{"name":"West London NHS Trust UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sue","family":"Cunliffe","sequence":"additional","affiliation":[{"name":"Independent Researcher and ECT Recipient Worcester UK"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2021,3,16]]},"reference":[{"key":"e_1_2_8_2_1","doi-asserted-by":"crossref","DOI":"10.53841\/bpsrep.2020.rep133","volume-title":"Understanding depression: Why adults experience depression and what can help","author":"Bowden G.","year":"2020"},{"key":"e_1_2_8_3_1","volume-title":"Brain\u2010disabling treatments in psychiatry","author":"Breggin P.","year":"2008"},{"key":"e_1_2_8_4_1","unstructured":"Brink S.(2020).Comment (August 7) on M. Vlessides. Experts call for immediate suspension of ECT: Others push back Medscape July 24.https:\/\/www.medscape.com\/viewarticle\/934536"},{"key":"e_1_2_8_5_1","volume-title":"ECT minimum dataset 2016\u201317: Activity data report \u2013 England, Wales, Northern Ireland & Republic of Ireland","author":"Buley N.","year":"2017"},{"key":"e_1_2_8_6_1","volume-title":"ECTAS update","author":"Cartwright V.","year":"2019"},{"key":"e_1_2_8_7_1","volume-title":"Second National Report. October 2005 \u2013 October 2007","author":"Cresswell J.","year":"2007"},{"key":"e_1_2_8_8_1","doi-asserted-by":"publisher","DOI":"10.1007\/978-1-137-29589-7_9"},{"key":"e_1_2_8_9_1","unstructured":"Davies N. &Duncan P.(2017).Electroconvulsive therapy on the rise again in England.The Guardian April 17."},{"key":"e_1_2_8_10_1","volume-title":"ECT: England \u2013 Financial year 1988\/1989","author":"Department of Health","year":"1989"},{"key":"e_1_2_8_11_1","volume-title":"ECT: Survey covering the period from January 1999 to March 1999, England","author":"Department of Health","year":"1999"},{"key":"e_1_2_8_12_1","volume-title":"ECT: Survey covering the period from January 2002 to March 2002, England","author":"Department of Health","year":"2003"},{"key":"e_1_2_8_13_1","unstructured":"Department of Health Ministry of Justice. (2009).Mental Health Act 2007. Chapter 3 27. 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Clinical guideline [CG90]","author":"National Institute of Clinical and Health Excellence","year":"2009"},{"key":"e_1_2_8_26_1","volume-title":"Depression in adults: Recognition and management","author":"National Institute of Clinical and Health Excellence","year":"2017"},{"key":"e_1_2_8_27_1","doi-asserted-by":"publisher","DOI":"10.1097\/00124509-200403000-00004"},{"key":"e_1_2_8_28_1","doi-asserted-by":"publisher","DOI":"10.1097\/YCT.0000000000000665"},{"key":"e_1_2_8_29_1","volume-title":"ECT in Great Britain, 1980","author":"Pippard J.","year":"1981"},{"key":"e_1_2_8_30_1","doi-asserted-by":"publisher","DOI":"10.4324\/9780203527160"},{"key":"e_1_2_8_31_1","doi-asserted-by":"publisher","DOI":"10.1111\/papt.12160"},{"key":"e_1_2_8_32_1","doi-asserted-by":"publisher","DOI":"10.1891\/EHPP-D-19-00014"},{"key":"e_1_2_8_33_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.326.7403.1363"},{"key":"e_1_2_8_34_1","doi-asserted-by":"publisher","DOI":"10.1038\/sj.npp.1301180"},{"key":"e_1_2_8_35_1","volume-title":"DK Law Group announces ECT settlement","author":"Schwartzkopff D.","year":"2018"},{"key":"e_1_2_8_36_1","volume-title":"Regulatory update to Thymatron system IV instruction manual","author":"Somatics","year":"2018"},{"key":"e_1_2_8_37_1","first-page":"CD003593","article-title":"Electroconvulsive therapy for the depressed elderly","volume":"2003","author":"Wurff F.","year":"2003","journal-title":"Cochrane Database of Systematic Reviews"},{"key":"e_1_2_8_38_1","first-page":"200","article-title":"Psychological treatments for depression and anxiety disorders in low\u2010 and middle\u2010income countries: A meta\u2010analysis","volume":"14","author":"van t\u2019Hof E.","year":"2011","journal-title":"African Journal of Psychiatry"},{"key":"e_1_2_8_39_1","volume-title":"The ECT Handbook","author":"Waite J.","year":"2013"}],"container-title":["Psychology and Psychotherapy: Theory, Research and Practice"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/papt.12335","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1111\/papt.12335","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/bpspsychub.onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/papt.12335","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,11,4]],"date-time":"2025-11-04T11:43:40Z","timestamp":1762256620000},"score":1,"resource":{"primary":{"URL":"https:\/\/bpspsychub.onlinelibrary.wiley.com\/doi\/10.1111\/papt.12335"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2021,3,16]]},"references-count":38,"journal-issue":{"issue":"3","published-print":{"date-parts":[[2021,9]]}},"alternative-id":["10.1111\/papt.12335"],"URL":"https:\/\/doi.org\/10.1111\/papt.12335","archive":["Portico"],"relation":{},"ISSN":["1476-0835","2044-8341"],"issn-type":[{"value":"1476-0835","type":"print"},{"value":"2044-8341","type":"electronic"}],"subject":[],"published":{"date-parts":[[2021,3,16]]},"assertion":[{"value":"2020-11-20","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2021-03-16","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}