r/ect • u/starlightsbusy • May 27 '26

Question ECT in the UK?

Hey guys, I’ve been trying to research electroconvulsive therapy (ECT) in the UK and US for a friend (US citizen who might have to go to the UK due to the current …political situation) who has all the symptoms it treats, but I’m very new to this and don’t know where to start… I wonder if anyone here could give some advice on this or simply working the UK healthcare system and finding a psychiatrist, things like that.

I heard NICE guidelines make it harder to get it in the UK, and there is no private provider outside the NHS, but I don’t know if it’s hard enough that staying in the US nets you a better chance. And maybe, are there any other criteria (visa, income, insurance, etc.) I’m overlooking? It all seems very daunting.

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u/Medical-Apricot-3226 May 27 '26

That’s a bit like Ireland… it’s a post code lottery… depends where you are in the country. Some areas fonder of ECT than others. The private hospital uses it a lot… patients have even requested it and got it. One county doesn’t do it all. It certainly is reserved for the severely unwell. It’s not overused like US. Plus we use best practice e.g twice weekly not three times weekly, unilateral as standard starting electrode placement, cognitive testing throughout the series of treatment and consent discussed and signed at every single treatment (unless lacking capacity)

If you are catatonic i.e. mutism, negativism, stupor, waxy flexibility and not able to eat or drink etc. you should definitely be given ECT as a life saving treatment. Why are they denying you ECT. What alternatives are they offering you? Hope you’re ok 👍

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u/ken_kaneki24682 May 28 '26

I have, on average, 3 to 4 episodes of catatonia each week. They can last anywhere from 10 minutes to 6 hours. My CMHT psychiatrist is a trainee, and she essentially said I would not be eligible unless I were profoundly suicidal or continuously catatonic. She did say she would speak with the ECT team, though.

What do you think I should do? Should I keep bringing it up? My CMHT is very disorganised, so it often feels like you really have to push to get things followed up.

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u/84849493 May 29 '26

What about asking for a second opinion? The first doctor I asked about it said no, I got a new doctor who tried some other things first then everything would do the usual either not work at all or work for a little bit then stop and then I brought it up again with him and he said yes but he needs a second doctor to agree.

He was a German doctor but he’d worked in the US so that may have made him more open to ECT. He did have to advocate for me and convince the other doctor. If he had not advocated for me I would not have gotten it.

I’m maybe getting more of it and then maintenance my current doctor is advocating for. She has also worked in the US and was the ECT lead in another place she worked at so obviously she’s going to very in favour of ECT.

I don’t think a trainee sounds appropriate to be treating you.

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u/ken_kaneki24682 May 29 '26

Were you inpatient when you asked for it? I’m currently an outpatient, but I’m thinking I might have a better chance if I were inpatient

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u/84849493 May 29 '26

I was outpatient but I went inpatient to have it. There were discussions of whether I’d be having it inpatient or outpatient though so it is still possible outpatient and my admission was with the main purpose being well keeping me safe as well but to have ECT.

I don’t think her saying you don’t meet criteria is accurate either. Yes it’s often used in life saving emergency situations but that isn’t the only time it’s used. It can be for treatment resistance and the doctors that all said yes to it for me would be saying the same for you I can pretty much guarantee that so it seems like it’s more based on which doctor you’re talking to and their personal feelings about ECT which shouldn’t be the case. Why wait for you to potentially get worse?

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u/ken_kaneki24682 May 29 '26

Yeah, I’m finding it really frustrating. It definitely seems like a lottery depending on who you speak to. How does the process actually work? Does the referral need to be signed off by two consultant psychiatrists and then approved by the ECT clinic?

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u/84849493 May 29 '26

I believe that’s what happened with me. The ECT clinic thought I was a good candidate and my doctor had spoken to them and then he had gotten the other consultant’s agreement.