UH South to debut new ECT unit
A new mental health treatment unit in University Hospital South will expand the availability of a highly-effective therapy for people with severe forms of depression and other illnesses.
On July 11, the Department of Psychiatry will open its new location for electroconvulsive therapy, or ECT — an approach that can help patients who haven’t benefited from any other treatment.
A $3.6 million project converted a 9,500-square-foot area of UH South from unused operating rooms to a state-of-the-art ECT suite. Demand for ECT care at UMHS has more than doubled since early 2000s.
“For those who have exhausted other treatment options, and for their families, we’re proud to open this enhanced, expanded facility,” said Daniel Maixner, M.D., an associate professor of psychiatry at the U-M Medical School and director of the UMHS ECT Program. “In our new unit, we will be able to provide three to four ECT treatments per hour, greatly expanding our current capacity of about 2,000 treatments per year — perhaps by 50 percent or more.”
Patients come to U-M from several states, and sometimes beyond, to receive a course of ECT treatments that can bring remission-level relief from symptoms of severe illness. ECT is based on electrical stimulation of the brain, delivered while a patient is under sedation.
The program treats adult and teen patients with treatment-resistant depression, intense mania associated with bipolar disorder, psychosis in psychotic disorders like schizophrenia, and those in catatonic states due to a mood disorder, psychosis-causing conditions or neurological crises. It also uses ECT to quell self-injury behaviors in people of any age with severe autism. Patients must be referred to the program by a psychiatrist.
The new unit is designed to provide a much better patient experience and consolidates services that had been spread between the ninth and first floors of University Hospital. It will also help ease congestion for other patients in those areas.
The new unit’s enhancements will improve patient and family experience through features such as:
- Quiet, comfortable surroundings with improved patient flow
- Individual interview rooms and specialized staff for pre- and post-treatment care
- Increased capacity for inpatient and outpatient treatments
- More of a central medical campus location with convenient access to parking structures
Using highly-regulated equipment under carefully-controlled conditions with anesthesia and muscle relaxation, ECT induces brief seizures that have numerous biological effects. In essence, the electrical impulses “reset” electrical activity among nerve cells in areas of the brain related to crushing depression, uncontrolled mania, deeply disturbed thoughts, or catatonic states.
The name “electroconvulsive therapy” may conjure up old movie scenes of psychiatric patients undergoing “shock therapy.”
But the modern form of the therapy has evolved over several decades, with thousands of studies showing ECT’s power to ease devastating, even life-threatening symptoms. Insurance coverage for ECT is generally very good as evidence of its impact has been well established.
Doctors at U-M and other centers continue to refine ECT’s use. A U-M team recently published an analysis of results from 32 studies, which reveals key factors that might help doctors better target ECT for those who can benefit the most.
For many people who receive ECT, a single course of treatments can give results that last months or even years. But some patients require a longer, tapered course of treatment in a “maintenance” mode to keep their symptoms at bay.
UMHS is one of few programs offering ECT for adolescents. ”For families searching for alternatives because their child’s mental health condition hasn’t responded to other treatments, ECT can be a lifeline,” Maixner says. “Families travel hundreds of miles to U-M to get treatment for teens who have exhausted all other options.”
Maixner is a member of the U-M Depression Center and of a U-M team that also offers other forms of psychiatric neuromodulation, including vagus nerve stimulation and repetitive transcranial magnetic stimulation.
In 2013, U-M psychiatrist Neera Ghaziuddin, M.D., co-edited a book published by Oxford University Press, on ECT in children and adolescents with contributions from a number of U-M ECT faculty. The first of its kind, it provides guidance on the use of the modern ECT technique in a subgroup of young people with severe psychiatric disorders.