Access to Electroconvulsive Therapy Services in Canada

Abstract

Electroconvulsive therapy is geographically accessible for most Canadians. Even when geography is not a factor, however, there are significant barriers to access resulting from inadequate availability of qualified professional staff, treatment areas, and funding.

Electroconvulsive Therapy Practice in the Province of Quebec: Linked Health Administrative Data Study from 1996 to 2013

“…9 A previous national survey, the Canadian Electroconvulsive Therapy Survey, also provided interesting information on ECT practices in Canada. 7,8,24,30 Geographical access to ECT in Canada was good, with 84% of Canadians living within 1 h of an ECT facility; however, the study identified other limitations to optimal access, such as organizational, logistical, and staffing difficulties. 30 We observed wide variations in ECT caseload per hospital across the country.…”

“…7,8,24,30 Geographical access to ECT in Canada was good, with 84% of Canadians living within 1 h of an ECT facility; however, the study identified other limitations to optimal access, such as organizational, logistical, and staffing difficulties. 30 We observed wide variations in ECT caseload per hospital across the country. 8 Based on these observations, the authors 7,8,24 concluded that an accreditation process and a standardisation of collected data would be necessary to ensure high-quality practices.…”

Barriers to Brain Stimulation Therapies for Treatment-Resistant Depression: Beyond Cost Effectiveness

“…Although a national survey of 175 ECT services across Canada, based on 2006 data, reported that 84% of the Canadian population lived within a 1-hr drive to an ECT center, geographic proximity is not the same as access. 7 The study points to numerous other pragmatic barriers, including lack of funding for modern equipment, lack of anesthesiology support, space limitations capping the numbers of people treated, and logistical challenges to delivering this treatment on an outpatient basis (which markedly reduces associated costs). This national survey also provided an important snapshot on utilization and treatment practices in 2006.…”

<p>Electroconvulsive Therapy for Patients with Catatonia: Current Perspectives</p>

“…[178][179][180] Globally, use of ECT is heterogeneous, [181][182][183][184][185][186][187] and geographic limitations, lack of training, lack of anesthesiologists, cost, stigma, health-care inequity, and national laws have been described as obstacles to access. 183,[188][189][190][191][192] Outdated treatment protocols and heavy use for conditions less responsive to ECT (ie, schizophrenia) are common across Asia, based on a study of 334 institutions in 29 Asian countries. 193 In Scandinavia, ECT is widely available and tends to follow updated treatment guidelines, but unequal geographic distribution can limit access.…”