[Accessibility to Electroconvulsive Therapy in Hungary]

Area of Science:

• Psychiatry
• Neurology
• Health Services Research

Background:

• Electroconvulsive therapy (ECT) is an effective psychiatric treatment, yet its utilization has decreased in Hungary.
• This decline raises concerns about patient access to necessary mental healthcare interventions.

Purpose of the Study:

• To investigate the reasons behind the declining accessibility of ECT in Hungarian psychiatric departments.
• To identify the specific barriers hindering the provision of ECT services.

Main Methods:

• A comprehensive survey was conducted using semi-structured questionnaires distributed to all psychiatric departments in Hungary.
• A secondary questionnaire targeted departments not performing ECT in 2014 to ascertain reasons and alternative treatments.

Main Results:

• 31 out of 58 departments did not offer ECT in 2014.
• Key barriers included lack of ECT machines (17 departments), insufficient anesthesiologist availability (12), inadequate budget (6), and lack of trained staff (5).
• Patients needing ECT were either transferred (12 departments) or treated with pharmacotherapy (7 departments).

Conclusions:

• ECT use in Hungary decreased by 20% between 2002 and 2014.
• Primary reasons for decline are the absence of modern ECT devices, insufficient funding, and limited access to anesthesiologists and experienced personnel.
• Centralizing ECT services and establishing clear patient referral pathways are proposed solutions to enhance accessibility.