NNDC Urges Medical Officials to Consider ECT an Essential Medical Service
The recent COVID-19 pandemic represents a major challenge to health care delivery systems throughout the USA and worldwide. This crisis has impacted the care and well-being of individuals with severe mental illness. In response to the need to conserve scarce medical resources and to protect medical personnel, the Center for Medicare Services (CMS) and many state health care entities have called for cancellation of all ‘elective’ procedures and surgery during the height of the present pandemic (https://www.cms.gov/files/document/cms-non-emergent-elective-medical-recommendations.pdf [as revised April 7, 2020]), (https://www.ascassociation.org/asca/resourcecenter/latestnewsresourcecenter/covid-19/covid-19-state , [as updated April 13, 2020]). Adoption of these guidelines has been widespread and has been associated with constraints on ECT utilization*. However, evidence indicates that ECT is often an urgently needed and highly effective clinical intervention for the management of severely ill individuals with major depression and certain other diagnostic indications where acute mortality from suicide or life-threatening medical debilitation due to mental illness, including catatonia, or substantially elevated morbidity from psychosis or otherwise incapacitating dysfunction is high. In their guidance document, CMS makes it clear that clinically indicated medical procedures for those suffering from a high level of acuity should be provided without delay. ECT is the most powerful and effective treatment in psychiatry, and particularly life-saving for suicidal depression and other conditions. As such, ECT must be classified as a vital, life-saving treatment, not an “elective” procedure, and must be maintained as an essential medical service.
* Espinoza RT, Kellner CH, McCall WV. ECT during COVID-19: An Essential Medical Procedure – Maintaining Service Viability and Accessibility.