We report the results of a survey of second-year medical students concerning attitudes and basic knowledge of electroconvulsive therapy (ECT). It appeared that there were significant negative biases against ECT in a portion of the group. Forty percent of the students who participated felt that psychiatrists often misused ECT, while 31% actually thought ECT was used to punish violent or uncooperative patients. Few students knew the typical frequency or duration of treatment or even that it was done under general anesthesia. It was interesting that the group describing themselves as highly knowledgeable about psychiatric illness had a greater bias against ECT. Students in the negative group did not differ in the sources of their information about ECT. The most common sources of this information about ECT were movies or college classes. The results document the need for appropriate coverage of ECT in medical school curriculum.
For veterans presenting for emergency psychiatric care, this research tested the hypothesis that patients with poor geographic accessibility to ambulatory mental health services would be more likely to be hospitalized. Logistic regression results indicated that distant patients (> 60 miles) were 4.8 times more likely (p < .05) to be admitted for acute psychiatric treatment than were proximal patients (< 60 miles), controlling for clinical and demographic case-mix factors. This finding suggests that the Department of Veterans Affairs might be less effective in its effort to substitute intensive outpatient care in place of expensive inpatient treatment for rural veterans with emergent mental health problems.
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