Mclean Hospital

Electroconvulsive Therapy (ECT) Service

Helping Individuals Fight Depression

Overview

McLean’s Electroconvulsive Therapy (ECT) Service is dedicated to improving the quality of life for individuals with a broad range of mental health conditions. ECT is a highly effective conventional intervention for chronic depression, mania, catatonia, and schizophrenia.

With components in clinical care, research, and education, McLean Hospital is a leading specialty center for electroconvulsive therapy, having conducted ECT treatments for over 60 years. Using a collaborative team approach, we aim to maximize the effectiveness of other treatments offered at McLean using emerging techniques and technologies.

Our dedicated and compassionate staff are committed to helping patients find the care they need.

For more information or to make a referral, please call 617.855.2355.

McLean’s ECT treatment is best suited to adults who:

  • Have severe or treatment resistant depression, or other mental health conditions such as mania, catatonia, and schizophrenia
  • Seek relief from their symptoms after trying treatment options that have not been effective

ECT Service in the News

60 Minutes recently highlighted ECT and treatment at McLean Hospital. Watch the video.

Read more about why ECT shouldn’t be a last-resort treatment.

A recent series of stories highlight ECT:

The New York Times highlights McLean in this article about ECT advocate Kitty Dukakis.

Dr. Charles Welch is featured on WBUR’s OnPoint, along with Kitty Dukakis, clarifying how ECT works.

“Dr. Stephen Seiner, along with the entire ECT staff (from the secretary to every nurse), have been available to answer any questions and have done everything they can to put both my husband and me at ease.”
– A McLean ECT patient

Treatment Approach

Patients may have an entire series of treatments either on an inpatient or outpatient basis. The outpatient service allows patients to be treated and on their way home within two and a half hours.

Most patients who come to McLean to receive ECT will have 8-12 treatments over a period of three to four weeks. If you have excellent results, it is possible to transition to continued or maintenance ECT, if indicated. Your psychiatrist will work with you to decide how many treatments are needed.

After years of providing treatment and listening to feedback from patients, our program’s staff can ensure that your ECT treatment will be as comfortable as possible. Our staffing model allows patients to have their own nurses throughout the treatment and recovery period.

Guide to ECT Treatment

From how to know whether ECT is right for you to what to wear to your appointment, this helpful guide provides detailed information for patients and their families about electroconvulsive therapy treatment.

“I was someone who was deathly afraid of ECT, but you and your wonderful staff helped me to overcome my fears. The treatments clearly helped me and it is so wonderful to be able to laugh, smile and enjoy my life again.”
– A McLean ECT patient

About ECT

Although ECT was introduced in the 1930s, its therapeutic use today is very different from what is portrayed as “shock treatment” in books and films. ECT is a relatively safe and effective procedure, providing relief from serious psychiatric symptoms much sooner than other therapies, such as medication and psychotherapy.

ECT is reserved for patients who have not responded to medication, who are having excessive side effects from medication or who are severely suicidal. Statistically, approximately 80% of patients treated with ECT respond well and get relief from their symptoms. An initial consultation with one of McLean Hospital’s ECT psychiatrists offers the opportunity to get information about ECT.

During electroconvulsive therapy, a patient is anesthetized and a small amount of electrical current is used to stimulate the brain. This produces a modified seizure, which, in turn, changes the activity of the brain. Some of these changes are similar to those seen with certain antidepressant medications in the way they relieve symptoms. The medications used for anesthesia prevent injury and patients feel no discomfort during the procedure.

ECT treatment at McLean
ECT treatment at McLean is supported by a team of mental health professionals dedicated to patient care and comfort

Like any medical procedure, ECT does pose some risk. To minimize the risk, every patient has a medical clearance, including a physical examination, blood tests and an electrocardiogram (EKG) before beginning ECT. The physical examination is performed at McLean by a clinician from the Internal Medicine and Primary Care Clinic.

ECT has some possible side effects, such as headache, muscle pain, memory problems, and, rarely, nausea and vomiting. Most people who have treatments report very few side effects.

The great majority of patients will have only minor problems with memory, though some will experience no difficulties at all. While these problems usually subside, there is no way to predict their extent. The psychiatrist will discuss this potential side effect in greater detail during consultation.

treatment team

Program Leadership

Stephen J. Seiner, MDStephen J. Seiner, MD, Medical Director, Electroconvulsive Therapy (ECT) Service

Dr. Seiner serves as director of McLean’s Psychiatric Neurotherapeutics Program, which includes ketamine, electroconvulsive therapy, and transcranial magnetic stimulation. He is also the director of Medical Student Education at McLean Hospital and an assistant professor of psychiatry at Harvard Medical School.


Paula Bolton, MS, APRN-BCPaula Bolton, MS, APRN-BC, Program Director

A nurse practitioner in the Internal Medicine Department at McLean Hospital for more than 25 years, Ms. Bolton has focused on health promotion and disease prevention for psychiatric patients. She was instrumental in both the expansion of the inpatient and outpatient Electroconvulsive Therapy (ECT) Service and the development of the Transcranial Magnetic Stimulation (TMS) Service.


John B. Roseman, MD, Associate Director

Dr. Roseman has interests spanning a broad range, with expertise in bioinformatics, medical education, and neurotherapeutics, particularly ECT. As the associate director of the ECT Service, Dr. Roseman shares oversight of the busiest ECT service in the country (more than 10,000 ECT treatments per year). He is also the McLean psychiatry clerkship director for Harvard Medical School, helping train medical students at McLean.

Staff and Associates

A highly qualified staff of psychiatrists and registered nurses, along with anesthesia experts from the Massachusetts General Hospital, have extensive experience in administering ECT and in caring for patients who undergo the procedure for such treatment-resistant conditions as depression, mania, catatonia, and some psychotic illnesses.

Admission & cost

Admission

ECT is a highly effective conventional intervention and is ideal for individuals struggling with chronic depression, mania, catatonia, and schizophrenia. ECT treatment can also be effective for those who have not met with success with other types of care.

For further information about our program or to refer a patient, please call:

Phone: 617.855.2355 (press 2 to speak to an ECT nurse during business hours)

Referral Form

Referring clinicians should fill out the ECT Referral Form so that we may determine whether the program is good fit for the individual and gather the appropriate patient information.

Cost

McLean accepts Medicare, Massachusetts Medicaid, and many private insurance and managed care plans.

More information on insurance providers accepted by McLean Hospital may be found on the Partners HealthCare website. You may also find it beneficial to review McLean’s patient billing and financial assistance information.

FAQ

Where is Electroconvulsive Therapy Service located?

The program is located on the Belmont campus, in the de Marneffe Building. For more information on directions, parking, and local accommodations, please visit our Maps & Directions page.

Who benefits most from Electroconvulsive Therapy?

ECT is an outpatient service that focuses on treating individuals struggling with depression or other mental illness who are not responding to medications and psychotherapy. In addition, those who are experiencing severe symptoms of depression or other mental illness that are threatening their health or safety may be good candidates for ECT, which can often work more quickly than medication.

Is family involved in treatment?

Family can be involved in the consultation for ECT and are welcome in the ECT suite. Family members are invited to join meetings with the doctor after each treatment to review the treatment plan.

Is smoking permitted?

Smoking is allowed in designated outdoor areas only. No smoking is allowed inside any of our buildings.

Are cell phones and other electronics allowed?

Cell phones are allowed in the ECT suite, but cell signal is poor. There is a cordless phone in the recovery room or staff can place a call. Additionally we are just below the cafeteria—which does get a better signal—and family members who want to wait there can take a pager from the ECT suite and will be paged when the treatment is complete.

Can former patients access their medical records?

All requests for medical records should be directed to McLean’s Health Information Management Department.

Are support groups offered?

To complement our programs’ services and encourage individuals’ initiatives in their own treatment course, many self-help groups are hosted by McLean.

There is a monthly ECT support group meeting at McLean, which patients, family members, and/or those contemplating ECT are welcome to attend.