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California Figures From the Department of Mental Health

Statistics from the Department of Mental Health about the use and effects of Electroconvulsive Therapy (ECT).Despite the American Psychiatric Association's claim that only 0.5 percent (1 in 200) of electroconvulsive therapy (ECT) patients suffer memory loss, statistics from California show that the actual figure is 40 times that amount. California is one of a small number of states that require reporting of ECT statistics.

It is estimated that between 100,000 and 200,000 patients undergo ECT in the United States every year. Why is it only an estimate? Because only four states (Colorado, California, Texas, Massachusetts) require reporting on ECT statistics.

The National Alliance for the Mentally Ill (NAMI) opposes such reporting, despite the fact that such reporting is anonymous. There is only one reason for such opposition - NAMI apparently wants to silence any revelations such reporting might reveal.

In California, statistics are gathered quarterly and maintained by the California Department of Mental Health. The following statistics are gathered: number of patients receiving treatment, their age, sex and race, number of treatments given, complications, and any "excessive treatments" (any patients receiving more than 15 treatments within a 30-day period, or anyone receiving more than 30 treatments in one year).

Complications are limited to:

a) non-fatal cardiac arrests or arrhythmias which required resuscitative efforts.
b) fractures
c) apnea persisting 20 minutes or more after initiation of treatment
d) memory loss reported by the patient extending more than 3 months following the completed course of treatment.
e) deaths which occur during or within the first 24 hours after a treatment.

The following is from California for a period of six years, 1989 through 1994. 1993 figures were unavailable. (Or you can go directly to the full statistics, directly from CDMH. If your browser does not support tables, you may email me and I'll send them to you directly in an MS Word file.)

During this period, over 12 thousand persons received ECT. Of those, 445 (3.6%) were involuntary patients. Of all persons receiving ECT during these five years in California, 364 (3%) received ECT without consent. Of those who did not consent to treatment, 287 were deemed by the state to be incapable of providing consent, and 77 were judged to have the capacity, but refused to provide consent (the treatment was forced completely against their will).

Approximately 50 percent were age 65 or older. 21 (1.7%) were under the age of 18. 68 percent of all patients were female. Slightly more than 90 percent were white, with 2.3 percent black, and 4.5 percent Hispanic. The remaining were categorized as "other" ethnic groups.

Medicaid/Medicare paid for over half of these patients' treatments, with private insurance and private pay each paying for slightly over 20 percent.

More than one-fifth of all patients had serious complications. The most often reported complication (19.7% of all patients and 93.6% of all complications) was extended memory loss. For reporting purposes, this consisted of memory loss lasting longer than three months. The second most common complication was apnea (cessation of breathing) lasting longer than 20 minutes (1.25% of all patients, and 5.9% of all complications).

Other complications included non-fatal cardiac arrest and fractures. No deaths attributed to ECT were reported in this period, but the conditions of reporting mandate that the death must occur within 24 hours of treatment.

Figures from California Dept. of Mental Health as reported to the California State Legislature 1989-1994 (1993 not available)

Number Of Patients Who Received ECT By Patient Type

Year Total Voluntary Voluntary Involuntary Involuntary
- - With Consent Without Consent With Consent Without Consent
1989 2,503 2,403 4 33 63
1990 2,671 2,566 12 26 67
1991 2,251 2,160 11 34 46
1992 2,356 2,233 9 42 72
1994 2,529 2,426 41 23 39
Totals 12,310 11,788 77 158 287

Number Of Patients By Age, Gender, Ethnicity, Payer

By Age Group

Age 1989 1990 1991 1992 1994 Total
12-15 2
(0.1%)
2
(0.1%)
2
(0.1%)
0 0 6
(0.04%)
16-17 2
(0.1%)
7
(0.3%)
3
(0.1%)
2
(0.1%)
1
(0.04%)
15
(0.1%)
18-24 63
(2.5%)
95
(3.6%)
62
(2.8%)
40
(1.7%)
42
(1.7%)
302
(2.5%)
25-44 627
(25%)
710
(26.6%)
531
(23.6%)
566
(24%)
518
(20.5%)
2,952
(24%)
45-64 607
(24.3%)
583
(21.8%)
515
(22.9%)
599
(25.4%)
677
(26.8%)
2,981
(24.2%)
65+ 1,202
(48%)
1,274
(47.7%)
1,133
(50.3%)
1,149
(48.8%)
1,280
(50.6%)
6,038
(49%)
Unknown 0 0 5
(0.2%)
0 11
(0.4%)
16
(0.1%)

By Gender

Sex 1989 1990 1991 1992 1994 Total
Male 798
(31.9%)
903
(33.8%)
671
(29.8%)
814
(32.2%)
751
(31.9%)
3,937
(32%)
Female 1,705
(68.1%)
1,768
(66.2%)
1,580
(70.2%)
1,715
(67.8%)
1,605
(68.1%)
8,373
(68%)

By Ethnic Group

Ethnicity 1989 1990 1991 1992 1994 Total
White 2,271
(90.7%)
2,394
(89.6%)
2,050
(91.1%)
2,140
(90.8%)
2,279
(90.1%)
11,134
(90.4%)
Black 58
(2.3%)
60
(2.2%)
58
(2.6%)
49
(2.1%)
64
(2.5%)
289
(2.3%)
Hispanic 108
(4.3%)
133
(5%)
82
(3.6%)
104
(4.4%)
122
(4.8%)
549
(4.5%)
Other 66
(2.6%)
84
(3.1%)
61
(2.7%)
63
(2.7%)
64
(2.5%)
338
(2.7%)

Source of Payment

Source 1989 1990 1991 1992 1994 Total
Private 669
(26.7%)
652
(24.4%)
515
(22.9%)
522
(22.2%)
432
(17.1%)
2,790
(22.6%)
3rd Party 549
(21.9%)
528
(19.8%)
458
(20.3%)
507
(21.5%)
652
(25.8%)
2,694
(21.8%)
Public 1,146
(45.8%)
1,322
(49.5%)
1,192
(53.0%)
1,274
(54.1%)
1,240
(49.0%)
6,174
(50.2%)
Other 139
(5.8%)
169
(6.3%)
86
(3.8%)
53
(2.2%)
205
(8.1%)
652
(5.3%)

Number of Complications Resulting from ECT

For reporting purposes: memory loss lasting longer than three months after final treatment; apnea must last longer than 20 minutes; deaths must occur within 24 hours of treatment

1989

Total Complications: 520, 20% of Patients

Type of Complication Number Percent
Cardiac Arrest 0 0
Memory Loss 498 95.8
Fractures 0 0
Apnea 22 4.2
Deaths 0 0

1990

Total Complications: 656, 24.7% of Patients

Type of Complication Number Percent
Cardiac Arrest 1 0.2
Memory Loss 538 82.0
Fractures 3 0.5
Apnea 114 17.4
Deaths 0 0

1991

Total Complications: 530, 23.5% of Patients

Type of Complication Number Percent
Cardiac Arrest 1 0.2
Memory Loss 510 96.2
Fractures 2 0.4
Apnea 17 3.2
Deaths 0 0

 

1992

Total Complications: 252, 10.7% of Patients

Type of Complication Number Percent
Cardiac Arrest 2 0.8
Memory Loss 249 98.8
Fractures 0 0
Apnea 1 0.4
Deaths 0 0

1994

Total Complications: 631, 25% of Patients

Type of Complication Number Percent
Cardiac Arrest 2 0.3
Memory Loss 629 99.7
Fractures 0 0
Apnea 0 0
Deaths 0 0

Total Complications, 1989-1994

Totals: 2,589, 21% of all patients suffered complications

Complication Number % of all patients % of all complications
Cardiac Arrest 6 0.04 0.23
Memory Loss 2,424 19.7 93.6
Fractures 5 0.04 0.2
Apnea 154 1.25 5.9
Deaths 0 0 0

 

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APA Reference
Staff, H. (2007, February 19). California Figures From the Department of Mental Health, HealthyPlace. Retrieved on 2024, March 28 from https://www.healthyplace.com/depression/articles/california-figures-from-the-department-of-mental-health

Last Updated: April 10, 2013

Medically reviewed by Harry Croft, MD

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