It is time to reassess reporting of electroconvulsive therapy data in New Zealand: A 17-year retrospective analysis of treatment data from Waikato.

Abstract

Objective: The New Zealand Government has provided brief annual reports on electroconvulsive therapy treatment since 2004. Despite this, only limited information is made available to clinicians to guide clinical improvement and refine guidelines. Beyond an audit from Otago detailing 10 years of electroconvulsive therapy treatments, limited information is available about electroconvulsive therapy treatments in New Zealand. This paper reports on the use of electroconvulsive therapy over the past 17 years in one New Zealand District Health Board.

Methods: It covers 7126 treatments for 333 patients between 2004 and 2020.

Results: Despite an increasing number of treatments, there has been no per capita growth when corrected for the population. Despite criticism for the disproportionate use of electroconvulsive therapy in women, treatment equity for men and women has been evidenced over the latter 3 years. The majority of treatments were given under voluntary consent, even among patients admitted under the Mental Health Act. Clinical practice is moving towards bifrontal treatment over other electrode placements in response to clinical guidance.

Conclusion: While COVID-19 had broad impacts across healthcare services, it has not led to an overall change in treatments. There was, however, a noticeable shift towards more psychotic disorders treated during the pandemic. This study also provides data that Māori and Pacific Islanders are accessing electroconvulsive therapy, though rates of electroconvulsive therapy usage are still lesser on a proportional population basis. Conclusions are provided to improve national data collection and reporting standards.