Interventional Psychiatry and Neurotechnologies: Education and Ethics Training

Abstract

ABSTRACT:The last two decades have seen dramatic growth in the application of procedurally based interventions for treating refractory psychiatric conditions, leading to interest in developing the foundations for the subspecialty of “Interventional Psychiatry.” However, there is cause for concern that the rate of expansion of clinical advances in this field may be outpacing the ability of postgraduate curricula to provide sufficient exposure to and teaching and supervision of these treatments. The paucity of adequately trained practitioners in Interventional Psychiatry further exacerbates inequities in the ability of eligible patients to access and benefit from these approaches. This paper explores the rates of utilization of Interventional Psychiatry treatments, the current state of education in these treatments, and the role that training can play in translating scientific advances in this area to ensure equitable access and maximum impact at a population level. The majority of the discussion is centered on electroconvulsive therapy (ECT), the most established and available of these treatments, highlighting how enhancing education and training in ECT can reduce barriers to its utilization. It is argued that innovations in pedagogical approaches for disseminating the learning of these procedures are needed to increase the current low rates of competency in these treatments and can facilitate the more rapid dissemination of other Interventional Psychiatry approaches and neurotechnologies, such as repetitive transcranial magnetic stimulation, ketamine, deep brain stimulation, and focused ultrasound.

East Asian perspective of responsible research and innovation in neurotechnology

“…From the time neuroethics was established as an academic discipline in Europe and the U.S., educational opportunities such as workshops and summer schools for doctoral personnel were provided to obtain professional human resources at an early stage. Additionally, in response to technological innovations, the importance of ethics education for neuroscience researchers and clinicians of neuropsychiatric disorders has been recognized ( Giacobbe et al, 2023 , Sahakian and Morein-Zamir, 2009 ), and there has been much trial and error in developing not only academic research systems but also educational systems in universities. ( Abu-Odeh et al, 2015 , Elkin et al, 2012 ).…”

Ketamine in the effective management of chronic pain, depression, and posttraumatic stress disorder for Veterans: A meta-analysis and systematic review

“…These include variabilities in the routes of administration, duration of ketamine treatments, dosage, and population groups targeted. Indeed, a scarce amount of training for interventional practitioners exists for the administration of ketamine, despite a growing interest ( 5 ). These heterogeneities underscore the lack of clear consensus in the standards of use for different populations, pain conditions, and in different contexts ( 1 , 6 ).…”