Adapting electroconvulsive therapy service delivery: Insights from providers’ experiences during the COVID-19 pandemic in Australia and beyond

Objectives: The COVID-19 pandemic significantly disrupted healthcare delivery, including the highly effective treatment of electroconvulsive therapy (ECT). This study aims to explore the perspectives of ECT service providers at Western Health, a metropolitan hospital in Melbourne, Australia during the COVID-19 pandemic. Materials and Methods: Surveys were distributed to Western Health staff involved in ECT delivery during the pandemic, gathering insights on changes in demand, protocols, patient attitudes, support received, and challenges faced. ECT delivery data from 2017 to 2022 was also analysed. Results: Nineteen out of 38 responses were complete for analysis from 100 people surveyed. The median respondent age was 38, with 5 years of ECT experience and a median of 25 sessions delivered in the past year. Key challenges reported by clinicians included the use of personal protective equipment (PPE), screening procedures, and managing infection risks, with 79% reporting significant protocol changes. In addition, 21% noted patient hesitance due to cumbersome procedures, though 89% felt adequately supported by health services. Conclusion: While disruptions occurred, ECT was deemed essential, and protocols were developed to ensure continued delivery. Concerns about delays for urgent cases and patient reluctance highlight areas for improvement. Reflecting on provider feedback and revising guidelines may enhance future pandemic preparedness.