ECT: Qualiry of care for depression demands equal access

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.