220713 ECT: Qualiry of care for depression demands equal access

Monday, November 8, 2010 : 10:45 AM - 11:00 AM

Patricia Bradley, RN MSN DNS , College of Nursing, Texas Chrisitian University, Fort Worth, TX
Electroconvulsive therapy (ECT) is the most effective treatment for medication-resistant depression. Administered in a series of ECT treatments in the acute-care setting, this is followed by a maintenance regimen of gradually decreasing treatments along with medication. Suicide rates and disability rates for bipolar and major depression dictate that all possible treatment means be utilized. Prejudice towards ECT abounds with archaic notions based on horror movies imbedded in the public's minds, but also in those of mental health professionals. Lack of timely and appropriate referral for ECT and lack of Medicaid reimbursement for ECT limit one's access to it. Texas does not provide Medicaid reimbursement for any outpatient psychiatric treatment thus, only private pay and private insurance populations can access ECT in Texas. Side effects will be discussed from personal experience and review of literature. Recipients of ECT and health professionals must bring ECT into the limelight of open discussion in order to make access a reality. Implications for health policy, mental health practice and changes in medical and health professional education will be explored.

Learning Areas:
Advocacy for health and health education
Chronic disease management and prevention
Provision of health care to the public
Public health or related education
Public health or related nursing
Public health or related public policy

Learning Objectives:
1.Compare the outcomes of maintenance electroconvulsive (ECT) treatment with medication therapy as compared to medication therapy alone or placebo-ECT following ECT treatments for bipolar and major depression. 2. Discuss the side effects of ECT. 3. Analyze the barriers to ECT for low-income persons. 4. Discuss the barriers to referral for ECT 5. Analyze access to ECT as a social justice issue.

Keywords: Depression, Treatment Outcomes

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I am a doctorally-prepared nurse specializing in Community Health Nursing and Health Policy. I have extensive experience in teaching Community Health Nursing and am a patient of ECT
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.