Changes in ECT services in India since the implementation of its mental health care act 2017: a clinician’s perspective
Abstract Background The large treatment gap in mental disorders in India also includes a lack of access to electroconvulsive therapy (ECT), a potentially lifesaving treatment. With the introduction of the Mental Health Care Act (MHCA) 2017 in India, an impact was speculated on the utilisation of ECT...
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BMC
2025-07-01
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| Series: | BMC Psychiatry |
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| Online Access: | https://doi.org/10.1186/s12888-025-07109-3 |
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| author | Preeti Sinha Vanteemar S. Sreeraj Shyam Sundar Arumugham Jagadisha Thirthalli |
| author_facet | Preeti Sinha Vanteemar S. Sreeraj Shyam Sundar Arumugham Jagadisha Thirthalli |
| author_sort | Preeti Sinha |
| collection | DOAJ |
| description | Abstract Background The large treatment gap in mental disorders in India also includes a lack of access to electroconvulsive therapy (ECT), a potentially lifesaving treatment. With the introduction of the Mental Health Care Act (MHCA) 2017 in India, an impact was speculated on the utilisation of ECT due to the ban on unmodified ECT and the regularisation of ECTs in children. Methods We planned this survey to identify the current status of ECT services in India as perceived by psychiatrists and to explore the barriers to providing ECT, particularly those influenced by the enactment of the MHCA 2017 in India. The psychiatrists practising in India were invited to complete an online questionnaire distributed through social media and professional group forums. A total of 225 consenting participants completed the survey. Results A majority of the participating psychiatrists (n = 160; 71.11%) were from urban areas, and 102 (45.33%) worked in private hospitals. Approximately half of the respondents (n = 118; 52.44%) could provide ECT to less than a quarter of patients for whom ECT was recommended. Furthermore, 52.4% of psychiatrists (n = 118) reported a decrease in the number of patients receiving ECT following post MHCA 2017 in India, while 44.9% (n = 101) observed no change. Additionally, 114 psychiatrists (50.67%) noted a reduction in the use of ECT for children since MHCA 2017. A substantial proportion (78.22%; n = 176) regarded patient refusal of consent as a significant factor. Access to anaesthesia services and associated costs was identified as a major barrier by 59.1% of psychiatrists (n = 133), significantly influencing their opinion on the reduction of ECT services post-MHCA 2017 (Odds ratio = 2.024, p = 0.018). Conclusions The limited availability of anaesthesia services and associated expenses are significant barriers to using ECT in developing countries such as India. This issue became more pronounced after the implementation of the MHCA 2017 and should be addressed promptly. Training psychiatrists in ECT anaesthetic skills via task-sharing and telementoring can help resolve this issue. |
| format | Article |
| id | doaj-art-e127147ef7cc441da4d769a0d98345f2 |
| institution | DOAJ |
| issn | 1471-244X |
| language | English |
| publishDate | 2025-07-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Psychiatry |
| spelling | doaj-art-e127147ef7cc441da4d769a0d98345f22025-08-20T03:03:41ZengBMCBMC Psychiatry1471-244X2025-07-012511810.1186/s12888-025-07109-3Changes in ECT services in India since the implementation of its mental health care act 2017: a clinician’s perspectivePreeti Sinha0Vanteemar S. Sreeraj1Shyam Sundar Arumugham2Jagadisha Thirthalli3Department of Psychiatry, National Institute of Mental Health and Neurosciences (NIMHANS)Department of Psychiatry, National Institute of Mental Health and Neurosciences (NIMHANS)Department of Psychiatry, National Institute of Mental Health and Neurosciences (NIMHANS)Department of Psychiatry, National Institute of Mental Health and Neurosciences (NIMHANS)Abstract Background The large treatment gap in mental disorders in India also includes a lack of access to electroconvulsive therapy (ECT), a potentially lifesaving treatment. With the introduction of the Mental Health Care Act (MHCA) 2017 in India, an impact was speculated on the utilisation of ECT due to the ban on unmodified ECT and the regularisation of ECTs in children. Methods We planned this survey to identify the current status of ECT services in India as perceived by psychiatrists and to explore the barriers to providing ECT, particularly those influenced by the enactment of the MHCA 2017 in India. The psychiatrists practising in India were invited to complete an online questionnaire distributed through social media and professional group forums. A total of 225 consenting participants completed the survey. Results A majority of the participating psychiatrists (n = 160; 71.11%) were from urban areas, and 102 (45.33%) worked in private hospitals. Approximately half of the respondents (n = 118; 52.44%) could provide ECT to less than a quarter of patients for whom ECT was recommended. Furthermore, 52.4% of psychiatrists (n = 118) reported a decrease in the number of patients receiving ECT following post MHCA 2017 in India, while 44.9% (n = 101) observed no change. Additionally, 114 psychiatrists (50.67%) noted a reduction in the use of ECT for children since MHCA 2017. A substantial proportion (78.22%; n = 176) regarded patient refusal of consent as a significant factor. Access to anaesthesia services and associated costs was identified as a major barrier by 59.1% of psychiatrists (n = 133), significantly influencing their opinion on the reduction of ECT services post-MHCA 2017 (Odds ratio = 2.024, p = 0.018). Conclusions The limited availability of anaesthesia services and associated expenses are significant barriers to using ECT in developing countries such as India. This issue became more pronounced after the implementation of the MHCA 2017 and should be addressed promptly. Training psychiatrists in ECT anaesthetic skills via task-sharing and telementoring can help resolve this issue.https://doi.org/10.1186/s12888-025-07109-3Electroconvulsive therapyTreatment gapMental health care act 2017Task-sharing approachAnaesthesia services |
| spellingShingle | Preeti Sinha Vanteemar S. Sreeraj Shyam Sundar Arumugham Jagadisha Thirthalli Changes in ECT services in India since the implementation of its mental health care act 2017: a clinician’s perspective BMC Psychiatry Electroconvulsive therapy Treatment gap Mental health care act 2017 Task-sharing approach Anaesthesia services |
| title | Changes in ECT services in India since the implementation of its mental health care act 2017: a clinician’s perspective |
| title_full | Changes in ECT services in India since the implementation of its mental health care act 2017: a clinician’s perspective |
| title_fullStr | Changes in ECT services in India since the implementation of its mental health care act 2017: a clinician’s perspective |
| title_full_unstemmed | Changes in ECT services in India since the implementation of its mental health care act 2017: a clinician’s perspective |
| title_short | Changes in ECT services in India since the implementation of its mental health care act 2017: a clinician’s perspective |
| title_sort | changes in ect services in india since the implementation of its mental health care act 2017 a clinician s perspective |
| topic | Electroconvulsive therapy Treatment gap Mental health care act 2017 Task-sharing approach Anaesthesia services |
| url | https://doi.org/10.1186/s12888-025-07109-3 |
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