Equal access to ECT hampered by income and attitudes

Social justice mandates equal access to mental health treatments like electroconvulsive therapy (ECT). ECT is a safe and effective treatment for bipolar and major depression yet its availability is based on type of insurance and on referral. In the entire DFW metroplex, there are only 4 ECT treatment centers and only 19 throughout the state of Texas. In Texas, Medicaid does not pay for any outpatient psychiatric treatments and thus none of these centers is able to bill Medicaid. Therefore, low-income Texans do not have access to ECT even though ECT has been shown to be a more effective maintenance treatment, as compared to medication alone, post acute ECT treatments. In addition to reimbursement problems, for equal access to ECT to be a reality, the public's perception of ECT as a barbaric measure must be changed. Health professionals who are reluctant to refer patients for ECT based on inadequate education and antiquated ideas must be educated. Patients and health professionals who have experience with ECT must share those experiences for ECT to lose its stigma The treatment procedure, its benefits and cognitive side effects will be discussed from both personal experience and review of the literature. Proposed methods of increasing population access to ECT will be discussed including seeking Medicaid reimbursement and improving medical and mental health professional education. The disability rates and suicide rates of depressed patients demand political action and practice changes. Social justice mandates that all bipolar patients and those with major depressions have access to ECT.