Geographic Disparities and Socioeconomic Barriers to Electroconvulsive Therapy in the United States: A Nationwide GIS Analysis and Manual Audit.

IF 2.4 4区医学 Q3 BEHAVIORAL SCIENCES

Journal of Ect Pub Date : 2026-09-21 DOI:10.1097/YCT.0000000000001332

Davis Whaley

{"title":"Geographic Disparities and Socioeconomic Barriers to Electroconvulsive Therapy in the United States: A Nationwide GIS Analysis and Manual Audit.","authors":"Davis Whaley","doi":"10.1097/YCT.0000000000001332","DOIUrl":null,"url":null,"abstract":"Objectives: To quantify the geographic distribution of verified electroconvulsive therapy (ECT) facilities in the United States, analyze the relationship between facility proximity and county-level socioeconomic status, and disseminate these findings using a public-access locator tool at mapofect.com.Methods: A multistage manual audit was conducted between January and April 2026. After exhaustive internet searches, facilities were contacted by telephone to verify active ECT services. Straight-line Euclidean distance was calculated from every US zip code centroid to the nearest verified facility. Distances were merged with 2020 American Community Survey 5-year estimates for socioeconomic analysis.Results: The audit identified 627 potential sites and verified 328 active ECT facilities. Notably, 26% of facilities listed in federal directories as ECT providers were found to no longer offer the service. Socioeconomic analysis revealed a significant negative correlation between median income and distance to care (r=-0.281, P<0.001). Residents in the poorest quartile of zip codes live an average of 75.3 miles from a facility, compared to 44.4 miles for the wealthiest quartile.Conclusions: Geographic scarcity and data inaccuracies are primary barriers to ECT access. A 30.9-mile \"access gap\" exists between the wealthiest and poorest Americans. Publicly accessible, verified tools like mapofect.com are necessary to improve mental health equity.","PeriodicalId":54844,"journal":{"name":"Journal of Ect","volume":" ","pages":""},"PeriodicalIF":2.4000,"publicationDate":"2026-09-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Journal of Ect","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1097/YCT.0000000000001332","RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q3","JCRName":"BEHAVIORAL SCIENCES","Score":null,"Total":0}

引用次数: 0

Abstract

Objectives: To quantify the geographic distribution of verified electroconvulsive therapy (ECT) facilities in the United States, analyze the relationship between facility proximity and county-level socioeconomic status, and disseminate these findings using a public-access locator tool at mapofect.com.

Methods: A multistage manual audit was conducted between January and April 2026. After exhaustive internet searches, facilities were contacted by telephone to verify active ECT services. Straight-line Euclidean distance was calculated from every US zip code centroid to the nearest verified facility. Distances were merged with 2020 American Community Survey 5-year estimates for socioeconomic analysis.

Results: The audit identified 627 potential sites and verified 328 active ECT facilities. Notably, 26% of facilities listed in federal directories as ECT providers were found to no longer offer the service. Socioeconomic analysis revealed a significant negative correlation between median income and distance to care (r=-0.281, P<0.001). Residents in the poorest quartile of zip codes live an average of 75.3 miles from a facility, compared to 44.4 miles for the wealthiest quartile.

Conclusions: Geographic scarcity and data inaccuracies are primary barriers to ECT access. A 30.9-mile "access gap" exists between the wealthiest and poorest Americans. Publicly accessible, verified tools like mapofect.com are necessary to improve mental health equity.

查看原文本刊更多论文

美国电休克治疗的地理差异和社会经济障碍：全国GIS分析和人工审计。

目的：量化美国经验证的电痉挛治疗（ECT）设施的地理分布，分析设施邻近度与县级社会经济地位之间的关系，并使用mapofect.com.公共访问定位工具传播这些发现。方法：在2026年1月至4月期间进行了多阶段人工审计。在详尽的互联网搜索之后，我们通过电话联系了相关机构，以核实有效的电痉挛治疗服务。从每个美国邮政编码质心到最近的验证设施计算直线欧几里得距离。距离与2020年美国社区调查5年的估计值合并，用于社会经济分析。结果：审核确定了627个潜在场所，并验证了328个有效的ECT设施。值得注意的是，在联邦目录中被列为ECT提供者的机构中，有26%被发现不再提供这项服务。社会经济分析显示，收入中位数与就诊距离呈显著负相关（r=-0.281, p）。结论：地理稀缺性和数据不准确是ECT获得的主要障碍。最富有和最贫穷的美国人之间存在着30.9英里的“收入差距”。像mapofect.com这样可公开获取、经过验证的工具对于改善精神卫生公平性是必要的。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

求助全文

约1分钟内获得全文求助全文

来源期刊

Journal of Ect 医学-行为科学

CiteScore

3.70

自引率

20.00%

发文量

154

审稿时长

6-12 weeks

期刊介绍： The Journal of ECT covers all aspects of contemporary electroconvulsive therapy, reporting on major clinical and research developments worldwide. Leading clinicians and researchers examine the effects of induced seizures on behavior and on organ systems; review important research results on the mode of induction, occurrence, and propagation of seizures; and explore the difficult sociological, ethical, and legal issues concerning the use of ECT.