The Journal of ECT

Skip Navigation LinksHome > December 2011 - Volume 27 - Issue 4 > Access to Electroconvulsive Therapy Services in Canada
Journal of ECT:
doi: 10.1097/YCT.0b013e318222b1b8
Original Studies

Access to Electroconvulsive Therapy Services in Canada

Delva, Nicholas John MD*; Graf, Peter PhD; Patry, Simon MD; Gosselin, Caroline MD§; Milev, Roumen MD; Gilron, Ian MD; Martin, Barry MD#; Lawson, James Stuart PhD**; Enns, Murray MD††; Jewell, Mark BA, RPN‡‡; Chan, Peter MD§

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Objectives: We sought to determine factors governing access to electroconvulsive therapy (ECT) in Canada.

Methods: We contacted all 1273 registered health care institutions in Canada and invited the 175 centers identified as providing ECT to complete a comprehensive questionnaire. To determine geographic access to ECT, we used a geographic information system, population density data, and road network data. Responses to 5 questions from the questionnaire were used to identify local barriers to access.

Results: Approximately 84% of the population in the 10 Canadian provinces live within a 1-hour drive of an ECT center, but 5% live more than 5 hours’ drive away. There was significant province-to-province variation, with all of the citizens of Prince Edward Island living within 2 hours of an ECT center but 12.5% of those in Newfoundland and Labrador living more than 5 hours’ distance away. There are no ECT services at all in the 3 territories, which contain 3% of the Canadian population. Nongeographic barriers to access included inadequate human resources, particularly, a lack of anesthesiologists, in 59% of the centers; logistical impedances (52%); space limitations (45%); strictures on the hiring of adequate staff (29%); imposed limits to number of treatments or to operating or postanesthetic room time (28%); and a lack of funds to purchase up-to-date ECT or related anesthesiology equipment (14%).

Conclusions: 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.

© 2011 Lippincott Williams & Wilkins, Inc.


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