About this release

This release by Public Health Scotland (PHS) presents a summary of the Scottish Electroconvulsive Therapy Accreditation Network (SEAN) data for 2021.

Main points

  • 63% of episodes of electroconvulsive therapy (ECT) treatment were completed as planned in 2021, compared to the revised figure of 54% in 2020. While COVID-19 continues to have an impact across all healthcare sectors, the delivery of ECT as a safe and effective treatment has continued across Scotland.
  • Compared to 2020, there was a small decrease (14% from 18%) in patients receiving lifesaving ECT in 2021. Possible reasons for this include the revised indications for ECT in the context of reduced ECT capacity, infection control and social distancing.

Percentage of patients receiving ECT, by age group and sex (2021)

  • Half of treatment episodes (51%) involved patients deemed to have capacity to understand and able to give consent. This percentage is slightly higher than that for 2020 (44%).
  • Just under two thirds of episodes (63%) indicated patients showed a significant improvement following treatment. This figure is lower than the 78% reported for 2020.
  • The most common indication for treatment involved a diagnosis of depression without psychosis, recorded in 35% of episodes, a similar proportion to 2020.
  • In 2021, treatment resistance to antidepressant medication at 45% remained the most common indication for treatment. This percentage is lower than the 54% reported in the 2020 data.
  • Headache remains the most common side effect after ECT treatment, reported in almost a quarter of treatment episodes (24%) in 2021. This has consistently been the most common side effect reported in previous years.


The Scottish Electroconvulsive Therapy Accreditation Network (SEAN) began in 1996 as a national audit project examining the clinical practice of ECT in Scotland.

SEAN engages support from a variety of clinical staff, including consultant psychiatrists, consultant anaesthetists, clinical psychologists, ECT nurses, operating department practitioners and recovery nurses.

Our ambition is to work towards increasing the opportunities for gathering the experiences of service users in a way that suits them best.

Further information

The next release of this publication will be  November 2023.

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Older versions of this publication

Versions of this publication released before 16 March 2020 may be found on the Data and Intelligence, Health Protection Scotland or Improving Health websites.

Last updated: 21 November 2022
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