{"id":348,"date":"2016-04-04T17:27:41","date_gmt":"2016-04-04T17:27:41","guid":{"rendered":"http:\/\/cusjc.ca\/ect\/?page_id=348"},"modified":"2016-04-10T23:34:55","modified_gmt":"2016-04-10T23:34:55","slug":"canects","status":"publish","type":"page","link":"https:\/\/cusjc.ca\/ect\/canects\/","title":{"rendered":"A new benchmark for ECT in Canada"},"content":{"rendered":"<p>[et_pb_section admin_label=&#8221;section&#8221; background_image=&#8221;http:\/\/cusjc.ca\/ect\/wp-content\/uploads\/2016\/04\/CANECTS-banner-II.jpg&#8221; transparent_background=&#8221;off&#8221; allow_player_pause=&#8221;off&#8221; inner_shadow=&#8221;off&#8221; parallax=&#8221;off&#8221; parallax_method=&#8221;off&#8221; padding_mobile=&#8221;off&#8221; make_fullwidth=&#8221;off&#8221; use_custom_width=&#8221;off&#8221; width_unit=&#8221;on&#8221; make_equal=&#8221;off&#8221; use_custom_gutter=&#8221;off&#8221;][et_pb_row admin_label=&#8221;row&#8221;][et_pb_column type=&#8221;4_4&#8243;][\/et_pb_column][et_pb_column type=&#8221;4_4&#8243;][\/et_pb_column][\/et_pb_row][et_pb_row admin_label=&#8221;row&#8221;][et_pb_column type=&#8221;4_4&#8243;][\/et_pb_column][et_pb_column type=&#8221;4_4&#8243;][\/et_pb_column][\/et_pb_row][et_pb_row admin_label=&#8221;row&#8221;][et_pb_column type=&#8221;4_4&#8243;][\/et_pb_column][et_pb_column type=&#8221;4_4&#8243;][\/et_pb_column][\/et_pb_row][\/et_pb_section][et_pb_section admin_label=&#8221;Section&#8221; fullwidth=&#8221;off&#8221; specialty=&#8221;off&#8221; transparent_background=&#8221;off&#8221; background_color=&#8221;#f2f2f2&#8243; allow_player_pause=&#8221;off&#8221; inner_shadow=&#8221;off&#8221; parallax=&#8221;off&#8221; parallax_method=&#8221;off&#8221; padding_mobile=&#8221;off&#8221; make_fullwidth=&#8221;off&#8221; use_custom_width=&#8221;off&#8221; width_unit=&#8221;on&#8221; make_equal=&#8221;off&#8221; use_custom_gutter=&#8221;off&#8221;][et_pb_row admin_label=&#8221;Row&#8221;][et_pb_column type=&#8221;1_4&#8243;][\/et_pb_column][et_pb_column type=&#8221;1_2&#8243;][et_pb_post_title admin_label=&#8221;Post Title&#8221; title=&#8221;on&#8221; meta=&#8221;on&#8221; author=&#8221;off&#8221; date=&#8221;off&#8221; categories=&#8221;on&#8221; comments=&#8221;on&#8221; featured_image=&#8221;on&#8221; featured_placement=&#8221;below&#8221; parallax_effect=&#8221;on&#8221; parallax_method=&#8221;on&#8221; text_orientation=&#8221;left&#8221; text_color=&#8221;dark&#8221; text_background=&#8221;off&#8221; text_bg_color=&#8221;rgba(255,255,255,0.9)&#8221; module_bg_color=&#8221;rgba(255,255,255,0)&#8221; title_font=&#8221;PT Serif|on|||&#8221; title_font_size=&#8221;36px&#8221; title_all_caps=&#8221;off&#8221; use_border_color=&#8221;off&#8221; border_color=&#8221;#ffffff&#8221; border_style=&#8221;solid&#8221;] [\/et_pb_post_title][et_pb_text admin_label=&#8221;Text&#8221; background_layout=&#8221;light&#8221; text_orientation=&#8221;left&#8221; text_font=&#8221;Open Sans||||&#8221; text_font_size=&#8221;16&#8243; text_text_color=&#8221;#000000&#8243; use_border_color=&#8221;off&#8221; border_color=&#8221;#ffffff&#8221; border_style=&#8221;solid&#8221;]<\/p>\n<p>By the early 1980s, ECT was a widely recognized, well-established and highly effective treatment for several serious forms of mental illness, but little was known about how it was administered, where it was being delivered and what kind of patients were being treated.<\/p>\n<p>ECT had survived the backlash of the 1970s, but more work still had to be done \u2013 in Canada and around the world \u2013 to ensure that the procedure was being conducted according to the highest standards of care.<\/p>\n<p>[\/et_pb_text][\/et_pb_column][et_pb_column type=&#8221;1_4&#8243;][\/et_pb_column][\/et_pb_row][\/et_pb_section][et_pb_section admin_label=&#8221;Section&#8221; fullwidth=&#8221;off&#8221; specialty=&#8221;off&#8221; transparent_background=&#8221;off&#8221; background_color=&#8221;#4c4c4c&#8221; allow_player_pause=&#8221;off&#8221; inner_shadow=&#8221;off&#8221; parallax=&#8221;off&#8221; parallax_method=&#8221;off&#8221; padding_mobile=&#8221;off&#8221; make_fullwidth=&#8221;off&#8221; use_custom_width=&#8221;off&#8221; width_unit=&#8221;on&#8221; make_equal=&#8221;off&#8221; use_custom_gutter=&#8221;off&#8221;][et_pb_row admin_label=&#8221;Row&#8221;][et_pb_column type=&#8221;4_4&#8243;][et_pb_blurb admin_label=&#8221;Blurb&#8221; url_new_window=&#8221;off&#8221; use_icon=&#8221;off&#8221; icon_color=&#8221;#7EBEC5&#8243; use_circle=&#8221;off&#8221; circle_color=&#8221;#7EBEC5&#8243; use_circle_border=&#8221;off&#8221; circle_border_color=&#8221;#7EBEC5&#8243; icon_placement=&#8221;top&#8221; animation=&#8221;top&#8221; background_layout=&#8221;light&#8221; text_orientation=&#8221;left&#8221; use_icon_font_size=&#8221;off&#8221; header_font=&#8221;PT Sans|on|||&#8221; header_font_size=&#8221;16&#8243; header_text_color=&#8221;#ffffff&#8221; use_border_color=&#8221;off&#8221; border_color=&#8221;#ffffff&#8221; border_style=&#8221;solid&#8221; body_font=&#8221;PT Sans|on|||&#8221; body_font_size=&#8221;40&#8243; body_text_color=&#8221;#ffffff&#8221;]<\/p>\n<p style=\"text-align: center;\">A brief history of ECT<\/p>\n<p>[\/et_pb_blurb][et_pb_text admin_label=&#8221;Text&#8221; background_layout=&#8221;light&#8221; text_orientation=&#8221;left&#8221; use_border_color=&#8221;off&#8221; border_color=&#8221;#ffffff&#8221; border_style=&#8221;solid&#8221;]<\/p>\n<p>&nbsp;<\/p>\n<p><iframe loading=\"lazy\" src=\"https:\/\/cdn.knightlab.com\/libs\/timeline3\/latest\/embed\/index.html?source=19DFTKUXGWa8DmgXFM2uBPF20diD9f6JVGqIPx6m5Ezg&amp;font=Default&amp;lang=en&amp;initial_zoom=2&amp;height=650\" width=\"100%\" height=\"650\" frameborder=\"0\"><\/iframe><\/p>\n<p>[\/et_pb_text][\/et_pb_column][\/et_pb_row][\/et_pb_section][et_pb_section admin_label=&#8221;Section&#8221; fullwidth=&#8221;off&#8221; specialty=&#8221;off&#8221; transparent_background=&#8221;off&#8221; background_color=&#8221;#f2f2f2&#8243; allow_player_pause=&#8221;off&#8221; inner_shadow=&#8221;off&#8221; parallax=&#8221;off&#8221; parallax_method=&#8221;off&#8221; padding_mobile=&#8221;off&#8221; make_fullwidth=&#8221;off&#8221; use_custom_width=&#8221;off&#8221; width_unit=&#8221;on&#8221; make_equal=&#8221;off&#8221; use_custom_gutter=&#8221;off&#8221;][et_pb_row admin_label=&#8221;Row&#8221;][et_pb_column type=&#8221;1_4&#8243;][\/et_pb_column][et_pb_column type=&#8221;1_2&#8243;][et_pb_text admin_label=&#8221;Text&#8221; background_layout=&#8221;light&#8221; text_orientation=&#8221;left&#8221; text_font=&#8221;Open Sans||||&#8221; text_font_size=&#8221;16&#8243; text_text_color=&#8221;#000000&#8243; use_border_color=&#8221;off&#8221; border_color=&#8221;#ffffff&#8221; border_style=&#8221;solid&#8221;]<\/p>\n<h4><strong>ECT in the UK<\/strong><\/h4>\n<p>Between the 1960s and 1980s, ECT was a commonly used psychiatric treatment in the United Kingdom.\u00a0 But this period was also characterized by public and professional unrest over some aspects of its use.<\/p>\n<p>There was concern that ECT was provided to people who were unhappy, distressed or sad, rather than genuinely mentally ill, and there was also evidence to show that ECT was forcibly delivered to patients without their consent.<\/p>\n<p>In response to the growing discontent, the Royal College of Psychiatrists in the U.K. created a set of guidelines for ECT, which were published in the <em>British Journal of Psychiatry<\/em>.\u00a0 Among other things, the guidelines recommended anesthesia for all patients, and a second opinion for those who were unable or unwilling to provide consent for the treatment.<\/p>\n<p>In order to learn more about the procedure, the United Kingdom was among the first countries in the world to carry out a national survey of ECT.\u00a0 While the 1981 survey provided a lot of useful information about the treatment, its results were disconcerting.\u00a0 It revealed that only a handful of psychiatrists and less than half the number of clinics in the country abided by the guidelines, and that psychiatric residents regularly administered ECT unsupervised.<\/p>\n<p>Follow-up surveys were conducted in 1989 and 1995. \u00a0Although both showed significant improvements, many institutions still didn&#8217;t meet the recommended standards.<\/p>\n<p>Psychiatrists realized that the only effective way to ensure ECT was delivered optimally was to regularly inspect the sites where ECT was administered.\u00a0 In the U.K., this led to the creation of the <a href=\"http:\/\/www.rcpsych.ac.uk\/quality\/qualityandaccreditation\/ectclinics\/ectas\/ectasstandards.aspx\">Royal College of Psychiatrists-supported ECT accreditation service<\/a> in 2003, in which hospitals, clinics and doctors\u2019 offices could voluntary request regular ECT audits or inspections.\u00a0 A similar system was developed in <a href=\"http:\/\/www.sean.org.uk\/\">Scotland<\/a>.<\/p>\n<p>Over time, these audits led to the creation of an updated set of national guidelines, covering everything from consent, electrode placement, dosing, training, supervision, anesthesia, equipment and facilities.<\/p>\n<p>Today in the U.K., standards are updated annually to reflect best practices and are currently in their 12<span style=\"font-size: 11.6667px; line-height: 11.6667px;\">th<\/span>\u00a0iteration.\u00a0 Evidence shows these standards have significantly improved the quality of ECT.\u00a0 More than 78 per cent of ECT clinics in England and Wales currently participate in the accreditation program.<\/p>\n<h4><strong><br \/>\nCanada\u2019s first national survey on ECT<\/strong><\/h4>\n<p>In the early 2000s, little was known about ECT in Canada.\u00a0 While the <a href=\"http:\/\/publications.cpa-apc.org\/media.php?mid=978\">Canadian Psychiatric Association<\/a> had published broad-based position papers supporting ECT in 1980 and 1992, no comprehensive survey of ECT practice had ever been undertaken.<\/p>\n<p>At the time, <a href=\"http:\/\/www.brainrepair.ca\/researchers\/142-nicholas-delva\">Dr. Nicholas Delva<\/a>, now head of psychiatry at Dalhousie University, was living in Kingston, where he was working as an academic psychiatrist.\u00a0 In the 1980s and 1990s, he was a part of a small group of researchers who participated in a 20-year study, which examined the efficacy of various ECT electrode placements on patients in Eastern Ontario suffering from major depression.<\/p>\n<p>Immersed in the world of ECT research and aware of the efforts being made in the United Kingdom to do surveys and improve the standards for ECT, Delva felt that more needed to be done in Canada to learn about how and where ECT was being delivered.\u00a0 While the trial he undertook in the &#8217;80s and &#8217;90s was confined to a single centre in Kingston, he knew he wanted his next project to span multiple facilities and provinces.<\/p>\n<p>In an effort to move things forward, Delva and a few of his colleagues, with whom he\u2019d worked on the randomized controlled trial some years earlier, began meeting regularly to discuss how best to proceed.\u00a0 They thought a national survey, similar to the ones conducted in the U.K., might be a good idea.<\/p>\n<p>In 2004, Dr. Caroline Gosselin, a geriatric psychiatrist from Vancouver, visited Kingston in order to observe bifrontal ECT.\u00a0 She was connected with Delva, and they quickly became good friends.\u00a0 Gosselin was interested in being part of the survey, and upon her return to Vancouver, she was able to secure the funds needed to proceed from the Vancouver Coastal Health Authority.\u00a0 Gosselin, Delva, and the other members of the group began recruiting other ECT practitioners in their field from all over the country to join the efforts.<\/p>\n<p>The Canadian Electroconvulsive Therapy Survey, or <a href=\"http:\/\/www.canects.org\/\">CANECTS<\/a>, was born. \u00a0The original team consisted of eight psychiatrists, two psychologists, an anesthesiologist, a nurse and an administrator.\u00a0 The survey was a bilingual initiative and was endorsed by the Canadian Psychiatric Association.\u00a0 Its goal was to determine where ECT was available, as well as how and to whom this treatment was provided.<\/p>\n<p>[\/et_pb_text][et_pb_image admin_label=&#8221;Image&#8221; src=&#8221;http:\/\/cusjc.ca\/ect\/wp-content\/uploads\/2016\/04\/CANECTS-logo.jpg&#8221; title_text=&#8221;Used with permission&#8221; show_in_lightbox=&#8221;off&#8221; url_new_window=&#8221;off&#8221; use_overlay=&#8221;off&#8221; animation=&#8221;left&#8221; sticky=&#8221;off&#8221; align=&#8221;left&#8221; force_fullwidth=&#8221;off&#8221; always_center_on_mobile=&#8221;on&#8221; use_border_color=&#8221;off&#8221; border_color=&#8221;#ffffff&#8221; border_style=&#8221;solid&#8221;] [\/et_pb_image][et_pb_blurb admin_label=&#8221;Blurb&#8221; title=&#8221;Logo (Courtesy of CANECTS)&#8221; url_new_window=&#8221;off&#8221; use_icon=&#8221;off&#8221; icon_color=&#8221;#7EBEC5&#8243; use_circle=&#8221;off&#8221; circle_color=&#8221;#7EBEC5&#8243; use_circle_border=&#8221;off&#8221; circle_border_color=&#8221;#7EBEC5&#8243; icon_placement=&#8221;top&#8221; animation=&#8221;top&#8221; background_layout=&#8221;light&#8221; text_orientation=&#8221;left&#8221; use_icon_font_size=&#8221;off&#8221; header_font=&#8221;PT Sans|on|||&#8221; header_font_size=&#8221;16&#8243; header_text_color=&#8221;#4c4c4c&#8221; body_text_color=&#8221;#4c4c4c&#8221; use_border_color=&#8221;off&#8221; border_color=&#8221;#ffffff&#8221; border_style=&#8221;solid&#8221; body_font=&#8221;PT Sans|on|||&#8221; body_font_size=&#8221;16&#8243;] [\/et_pb_blurb][et_pb_text admin_label=&#8221;Text&#8221; background_layout=&#8221;light&#8221; text_orientation=&#8221;left&#8221; text_font=&#8221;Open Sans||||&#8221; text_font_size=&#8221;16&#8243; text_text_color=&#8221;#000000&#8243; use_border_color=&#8221;off&#8221; border_color=&#8221;#ffffff&#8221; border_style=&#8221;solid&#8221;]<\/p>\n<p>CANECTS members were not compensated for their time.\u00a0 Delva said they participated in the survey because they felt that it was their duty to raise the bar and ensure state-of-the-art ECT for all Canadians.<\/p>\n<p>[\/et_pb_text][\/et_pb_column][et_pb_column type=&#8221;1_4&#8243;][\/et_pb_column][\/et_pb_row][\/et_pb_section][et_pb_section admin_label=&#8221;Section&#8221; fullwidth=&#8221;off&#8221; specialty=&#8221;off&#8221; transparent_background=&#8221;off&#8221; background_color=&#8221;#4c4c4c&#8221; allow_player_pause=&#8221;off&#8221; inner_shadow=&#8221;off&#8221; parallax=&#8221;off&#8221; parallax_method=&#8221;off&#8221; padding_mobile=&#8221;off&#8221; make_fullwidth=&#8221;off&#8221; use_custom_width=&#8221;off&#8221; width_unit=&#8221;on&#8221; make_equal=&#8221;off&#8221; use_custom_gutter=&#8221;off&#8221;][et_pb_row admin_label=&#8221;Row&#8221;][et_pb_column type=&#8221;4_4&#8243;][et_pb_code admin_label=&#8221;Code&#8221;]&lt;iframe width=&#8221;560&#8243; height=&#8221;315&#8243; src=&#8221;https:\/\/www.youtube.com\/embed\/pP37wTKExG0?rel=0&#8243; frameborder=&#8221;0&#8243; allowfullscreen&gt;&lt;\/iframe&gt;[\/et_pb_code][\/et_pb_column][\/et_pb_row][\/et_pb_section][et_pb_section admin_label=&#8221;Section&#8221; fullwidth=&#8221;off&#8221; specialty=&#8221;off&#8221; transparent_background=&#8221;off&#8221; background_color=&#8221;#f2f2f2&#8243; allow_player_pause=&#8221;off&#8221; inner_shadow=&#8221;off&#8221; parallax=&#8221;off&#8221; parallax_method=&#8221;off&#8221; padding_mobile=&#8221;off&#8221; make_fullwidth=&#8221;off&#8221; use_custom_width=&#8221;off&#8221; width_unit=&#8221;on&#8221; make_equal=&#8221;off&#8221; use_custom_gutter=&#8221;off&#8221;][et_pb_row admin_label=&#8221;Row&#8221;][et_pb_column type=&#8221;1_4&#8243;][\/et_pb_column][et_pb_column type=&#8221;1_2&#8243;][et_pb_text admin_label=&#8221;Text&#8221; background_layout=&#8221;light&#8221; text_orientation=&#8221;left&#8221; use_border_color=&#8221;off&#8221; border_color=&#8221;#ffffff&#8221; border_style=&#8221;solid&#8221; text_font=&#8221;Open Sans||||&#8221; text_font_size=&#8221;16&#8243; text_text_color=&#8221;#000000&#8243;]<\/p>\n<p>Dr. Delva said that 1,273 registered health care centres across Canada were contacted by mail and later by follow-up telephone call to identify the centres providing ECT.<\/p>\n<p>In 2006, a bilingual questionnaire on ECT was developed and later tested at over a dozen centres.\u00a0 In 2007, the revised questionnaire was mailed to each of the 175 ECT centres previously identified.<\/p>\n<p>\u201cWe did quite a lot of preparatory work to motivate people to complete the questionnaire and we had an excellent return rate,\u201d said Delva.\u00a0 \u201cSixty-one per cent of the questionnaires were fully completed and another 10 per cent were partially completed, so we had a lot of data to work with.\u201d<\/p>\n<p>According to Delva, because of the enormous undertaking of the survey and because the CANECTS team was doing this voluntarily and weren\u2019t compensated for their time, the results weren\u2019t published in their entirety until 2013.<\/p>\n<p>[\/et_pb_text][\/et_pb_column][et_pb_column type=&#8221;1_4&#8243;][\/et_pb_column][\/et_pb_row][\/et_pb_section][et_pb_section admin_label=&#8221;Section&#8221; 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pin_address=&#8221;200 Terrace Hill St, Brantford, ON N3R 1G9, Canada&#8221; pin_address_lat=&#8221;43.1519762&#8243; pin_address_lng=&#8221;-80.2762606&#8243;] [\/et_pb_map_pin][et_pb_map_pin title=&#8221;Brockville Psychiatric Hospital&#8221; pin_address=&#8221;1809 Oxford Ave, Brockville, ON K6V 3E1, Canada&#8221; pin_address_lat=&#8221;44.60326&#8243; pin_address_lng=&#8221;-75.66796729999999&#8243;] [\/et_pb_map_pin][et_pb_map_pin title=&#8221;Burnaby Hospital&#8221; pin_address=&#8221;3935 Kincaid St, Burnaby, BC V5G 1V7, Canada&#8221; pin_address_lat=&#8221;49.2498288&#8243; pin_address_lng=&#8221;-123.01591400000001&#8243;] [\/et_pb_map_pin][et_pb_map_pin title=&#8221;C.H.R. de Trois-Rivieres-Pavillon &#8221; pin_address=&#8221;1991 Boulevard du Carmel, Trois-Rivi\u00e8res, QC G8Z 3R9, Canada&#8221; pin_address_lat=&#8221;46.354993&#8243; pin_address_lng=&#8221;-72.56110799999999&#8243;] [\/et_pb_map_pin][et_pb_map_pin title=&#8221;Cape Breton District Health Authority&#8221; pin_address=&#8221;1482 George St, Sydney, NS B1P 1P3, Canada&#8221; pin_address_lat=&#8221;46.11301599999999&#8243; pin_address_lng=&#8221;-60.17413399999998&#8243;] [\/et_pb_map_pin][et_pb_map_pin title=&#8221;Capital District Health Authority&#8221; pin_address=&#8221;5909 Veterans Memorial Ln, Halifax, NS B3H 2E2, Canada&#8221; pin_address_lat=&#8221;44.6445283&#8243; pin_address_lng=&#8221;-63.58623239999997&#8243;] [\/et_pb_map_pin][et_pb_map_pin title=&#8221;Centre for Addiction and Mental Health &#8211; College Street&#8221; pin_address=&#8221;250 College St, Toronto, ON M5T 1R8, Canada&#8221; pin_address_lat=&#8221;43.6584046&#8243; pin_address_lng=&#8221;-79.39896759999999&#8243;] [\/et_pb_map_pin][et_pb_map_pin title=&#8221;Centre for Addiction and Mental Health &#8211; Queen St. &#8221; pin_address=&#8221;1001 Queen St W, Toronto, ON M6J 1H1, Canada&#8221; pin_address_lat=&#8221;43.6430754&#8243; pin_address_lng=&#8221;-79.41731920000001&#8243;] [\/et_pb_map_pin][et_pb_map_pin title=&#8221;Centre hospitalier Baie des Chaleurs&#8221; pin_address=&#8221;419 Boulevard Perron, Maria, QC G0C 1Y0, Canada&#8221; pin_address_lat=&#8221;48.16820850000001&#8243; pin_address_lng=&#8221;-65.99158829999999&#8243;] [\/et_pb_map_pin][et_pb_map_pin title=&#8221;Centre hospitalier de Charlevoix-Clinique externe de sante mentale&#8221; pin_address=&#8221;74 Rue Ambroise Fafard, Baie-Saint-Paul, QC G3Z 2J5, Canada&#8221; pin_address_lat=&#8221;47.4363506&#8243; pin_address_lng=&#8221;-70.50811139999996&#8243;] [\/et_pb_map_pin][et_pb_map_pin title=&#8221;Centre hospitalier de Gaspe, Pavillon Monseigneur-Ross&#8221; pin_address=&#8221;215 Boulevard de York O, Gasp\u00e9, QC G4X 2W2, Canada&#8221; pin_address_lat=&#8221;48.8138677&#8243; pin_address_lng=&#8221;-64.49824109999997&#8243;] [\/et_pb_map_pin][et_pb_map_pin title=&#8221;Centre hospitalier de l&#8217;Archipel&#8221; pin_address=&#8221;430 Chemin Principal, Cap-aux-Meules, QC G4T, Canada&#8221; pin_address_lat=&#8221;47.3764319&#8243; pin_address_lng=&#8221;-61.867882099999974&#8243;] [\/et_pb_map_pin][et_pb_map_pin title=&#8221;Centre hospitalier de St-Mary&#8221; pin_address=&#8221;3830 Avenue Lacombe, Montr\u00e9al, QC H3T 1L5, Canada&#8221; pin_address_lat=&#8221;45.49489579999999&#8243; pin_address_lng=&#8221;-73.6238376&#8243;] [\/et_pb_map_pin][et_pb_map_pin title=&#8221;Centre hospitalier Honore-Mercier&#8221; pin_address=&#8221;2750 Boulevard Laframboise, Saint-Hyacinthe, QC J2S 4Y8, Canada&#8221; pin_address_lat=&#8221;45.6346327&#8243; pin_address_lng=&#8221;-72.95966290000001&#8243;] [\/et_pb_map_pin][et_pb_map_pin title=&#8221;Centre hospitalier Pierre-Janet&#8221; pin_address=&#8221;20 Rue Pharand, Gatineau, QC J9A 1K7, Canada&#8221; pin_address_lat=&#8221;45.4248523&#8243; pin_address_lng=&#8221;-75.74067889999998&#8243;] [\/et_pb_map_pin][et_pb_map_pin title=&#8221;Centre hospitalier regional de Rimouski&#8221; pin_address=&#8221;150 Avenue Rouleau, Rimouski, QC G5L 5S9, Canada&#8221; pin_address_lat=&#8221;48.4469514&#8243; pin_address_lng=&#8221;-68.5315086&#8243;] [\/et_pb_map_pin][et_pb_map_pin title=&#8221;Centre hospitalier regional de Sept-Iles&#8221; pin_address=&#8221;45 Rue P\u00e8re Divet, Sept-\u00celes, QC G4R 3N7, Canada&#8221; pin_address_lat=&#8221;50.209716&#8243; pin_address_lng=&#8221;-66.38358699999998&#8243;] [\/et_pb_map_pin][et_pb_map_pin title=&#8221;Centre hospitalier Robert-Giffard, Institut universitaire en sante mentale&#8221; pin_address=&#8221;2601 Chemin de la Canardi\u00e8re, Ville de Qu\u00e9bec, QC G1J, Canada&#8221; pin_address_lat=&#8221;46.8472649&#8243; pin_address_lng=&#8221;-71.21976719999998&#8243;] [\/et_pb_map_pin][et_pb_map_pin title=&#8221;Centre hospitalier Rouyn-Noranda&#8221; pin_address=&#8221;4 9e Rue, Rouyn-Noranda, QC J9X 2B2, Canada&#8221; pin_address_lat=&#8221;48.2435816&#8243; pin_address_lng=&#8221;-79.0194841&#8243;] [\/et_pb_map_pin][et_pb_map_pin title=&#8221;Chaleur Regional Hospital&#8221; pin_address=&#8221;1750 Rue Sunset, Bathurst, NB E2A 4L7, Canada&#8221; pin_address_lat=&#8221;47.6469653&#8243; pin_address_lng=&#8221;-65.69377320000001&#8243;] [\/et_pb_map_pin][et_pb_map_pin title=&#8221;Chatham-Kent Health Alliance-Mental Health Service&#8221; pin_address=&#8221;80 Grand Ave W, Chatham, ON N7L 1B7, Canada&#8221; pin_address_lat=&#8221;42.4053677&#8243; pin_address_lng=&#8221;-82.19364350000001&#8243;] [\/et_pb_map_pin][et_pb_map_pin title=&#8221;CHAU-Hopital de l&#8217;Enfant-Jesus&#8221; pin_address=&#8221;1401 18e Rue, Ville de Qu\u00e9bec, QC G1J 1Z4, Canada&#8221; pin_address_lat=&#8221;46.8373594&#8243; pin_address_lng=&#8221;-71.2262212&#8243;] [\/et_pb_map_pin][et_pb_map_pin title=&#8221;CHAU-Hopital du Saint-Sacrement&#8221; pin_address=&#8221;1050 Ch Ste-Foy, Ville de Qu\u00e9bec, QC G1S 4L8, Canada&#8221; pin_address_lat=&#8221;46.7989249&#8243; pin_address_lng=&#8221;-71.244912&#8243;] [\/et_pb_map_pin][et_pb_map_pin title=&#8221;Chilliwack General Hospital&#8221; pin_address=&#8221;45600 Menholm Rd, Chilliwack, BC V2P, Canada&#8221; pin_address_lat=&#8221;49.1658322&#8243; pin_address_lng=&#8221;-121.96263550000003&#8243;] [\/et_pb_map_pin][et_pb_map_pin title=&#8221;CHUS-Hopital Hotel-Dieu&#8221; pin_address=&#8221;580 Rue Bowen S, Sherbrooke, QC J1G 2E3, Canada&#8221; pin_address_lat=&#8221;45.3982305&#8243; pin_address_lng=&#8221;-71.87902459999998&#8243;] [\/et_pb_map_pin][et_pb_map_pin title=&#8221;Credit Valley Hospital&#8221; pin_address=&#8221;2200 Eglinton Ave W, Mississauga, ON L5M, Canada&#8221; pin_address_lat=&#8221;43.5590961&#8243; pin_address_lng=&#8221;-79.70282639999999&#8243;] [\/et_pb_map_pin][et_pb_map_pin title=&#8221;CSSS de Chicoutimi, Pavillon Roland Saucier&#8221; pin_address=&#8221;150 Rue Pinel, Chicoutimi, QC G7G 3N8, Canada&#8221; pin_address_lat=&#8221;48.450027&#8243; pin_address_lng=&#8221;-71.076844&#8243;] [\/et_pb_map_pin][et_pb_map_pin title=&#8221;CSSS de l&#8217;Energie, Site Ste-Therese&#8221; pin_address=&#8221;1705 Avenue Georges, Shawinigan, QC G9N 2N1, Canada&#8221; pin_address_lat=&#8221;46.5528545&#8243; pin_address_lng=&#8221;-72.74664310000003&#8243;] [\/et_pb_map_pin][et_pb_map_pin title=&#8221;Dawson Creek and District Hospital&#8221; pin_address=&#8221;11100 13 St, Dawson Creek, BC V1G 3W8, Canada&#8221; pin_address_lat=&#8221;55.749706&#8243; pin_address_lng=&#8221;-120.2356901&#8243;] [\/et_pb_map_pin][et_pb_map_pin title=&#8221;Foothills Provincial General Hospital&#8221; pin_address=&#8221;1403 29 St NW, Calgary, AB T2N 4W4, Canada&#8221; pin_address_lat=&#8221;51.064121&#8243; pin_address_lng=&#8221;-114.13481050000001&#8243;] [\/et_pb_map_pin][et_pb_map_pin title=&#8221;G.R. Baker Memorial Hospital&#8221; pin_address=&#8221;543 Front St, Quesnel, BC V2J 2K7, Canada&#8221; pin_address_lat=&#8221;52.9814079&#8243; pin_address_lng=&#8221;-122.49955590000002&#8243;] [\/et_pb_map_pin][et_pb_map_pin title=&#8221;Grand River Hospital, Kitchener-Waterloo Health Centre&#8221; pin_address=&#8221;835 King St W, Kitchener, ON N2G 4K9, Canada&#8221; pin_address_lat=&#8221;43.4561999&#8243; pin_address_lng=&#8221;-80.51201300000002&#8243;] [\/et_pb_map_pin][et_pb_map_pin title=&#8221;Halton Healthcare Services Corporation &#8211; Oakville Trafalgar Memorial Hospital&#8221; pin_address=&#8221;3001 Hospital Gate, Oakville, ON L6M, Canada&#8221; pin_address_lat=&#8221;43.451179&#8243; pin_address_lng=&#8221;-79.76407259999996&#8243;] [\/et_pb_map_pin][et_pb_map_pin title=&#8221;Health Services Centre&#8221; pin_address=&#8221;771 Bannatyne Ave, Winnipeg, MB R3E 3N4, Canada&#8221; pin_address_lat=&#8221;49.905288&#8243; pin_address_lng=&#8221;-97.16101300000003&#8243;] [\/et_pb_map_pin][et_pb_map_pin title=&#8221;Health Service Association of the South Shore &#8211; South-Shore Regional Hospital&#8221; pin_address=&#8221;90 Glen Allan Dr, Bridgewater, NS B4V 3S6, Canada&#8221; pin_address_lat=&#8221;44.3831672&#8243; pin_address_lng=&#8221;-64.51059570000001&#8243;] [\/et_pb_map_pin][et_pb_map_pin title=&#8221;Homewood Health Centre&#8221; pin_address=&#8221;150 Delhi St, Guelph, ON N1E 6K9, Canada&#8221; pin_address_lat=&#8221;43.5573791&#8243; pin_address_lng=&#8221;-80.25674979999997&#8243;] [\/et_pb_map_pin][et_pb_map_pin title=&#8221;Hopital Charles LeMoyne, Greenfield Park&#8221; pin_address=&#8221;3120 Boulevard Taschereau, Greenfield Park, QC J4V 2G9, Canada&#8221; pin_address_lat=&#8221;45.4969984&#8243; pin_address_lng=&#8221;-73.48599209999998&#8243;] [\/et_pb_map_pin][et_pb_map_pin title=&#8221;Hopital General de Montreal&#8221; pin_address=&#8221;1650 Avenue Cedar, Montr\u00e9al, QC H3G, Canada&#8221; pin_address_lat=&#8221;45.4970644&#8243; pin_address_lng=&#8221;-73.58903220000002&#8243;] [\/et_pb_map_pin][et_pb_map_pin title=&#8221;Hopital Louis-H. Lafontaine&#8221; pin_address=&#8221;7401 Rue Hochelaga, Montr\u00e9al, QC H1N 3M5, Canada&#8221; pin_address_lat=&#8221;45.5884937&#8243; pin_address_lng=&#8221;-73.52914120000003&#8243;] [\/et_pb_map_pin][et_pb_map_pin title=&#8221;Hopital Maisonneuve-Rosemont&#8221; pin_address=&#8221;5415 Boulevard de l&#8217;Assomption, Montr\u00e9al, QC H1T 2M4, Canada&#8221; pin_address_lat=&#8221;45.57408119999999&#8243; pin_address_lng=&#8221;-73.55944169999998&#8243;] [\/et_pb_map_pin][et_pb_map_pin title=&#8221;Hopital Montfort\/Montfort Hospital&#8221; pin_address=&#8221;713 Montreal Rd, Gloucester, ON K1A 0S2, Canada&#8221; pin_address_lat=&#8221;45.4459814&#8243; pin_address_lng=&#8221;-75.63923840000001&#8243;] [\/et_pb_map_pin][et_pb_map_pin title=&#8221;Hopital regional Dr-Georges-L.-Dumont&#8221; pin_address=&#8221;330 Avenue de l\u2019Universit\u00e9, Moncton, NB E1C 5K4, Canada&#8221; pin_address_lat=&#8221;46.0980252&#8243; pin_address_lng=&#8221;-64.78621379999998&#8243;] [\/et_pb_map_pin][et_pb_map_pin title=&#8221;Hotel-Dieu de Levis&#8221; pin_address=&#8221;143 Rue Wolfe, L\u00e9vis, QC G6V 3Z1, Canada&#8221; pin_address_lat=&#8221;46.8144734&#8243; pin_address_lng=&#8221;-71.17564199999998&#8243;] [\/et_pb_map_pin][et_pb_map_pin title=&#8221;Hotel-Dieu de Montmagny&#8221; pin_address=&#8221;350 Boulevard Tach\u00e9 O, Montmagny, QC G5V 3R8, Canada&#8221; pin_address_lat=&#8221;46.976367&#8243; pin_address_lng=&#8221;-70.59707179999998&#8243;] [\/et_pb_map_pin][et_pb_map_pin title=&#8221;Hotel-Dieu de Roberval&#8221; pin_address=&#8221;450 Rue Brassard, Roberval, QC G8H 1B8, Canada&#8221; pin_address_lat=&#8221;48.50812029999999&#8243; pin_address_lng=&#8221;-72.2206392&#8243;] [\/et_pb_map_pin][et_pb_map_pin title=&#8221;Hotel-Dieu Grace Hospital&#8221; pin_address=&#8221;1453 Prince Rd, Windsor, ON N9C 3Z4, Canada&#8221; pin_address_lat=&#8221;42.2853732&#8243; pin_address_lng=&#8221;-83.06362469999999&#8243;] [\/et_pb_map_pin][et_pb_map_pin title=&#8221;Humber River Regional Hospital&#8221; pin_address=&#8221;1235 Wilson Ave, Toronto, ON M3M, Canada&#8221; pin_address_lat=&#8221;43.72399739999999&#8243; pin_address_lng=&#8221;-79.48840539999998&#8243;] [\/et_pb_map_pin][et_pb_map_pin title=&#8221;Huron Perth Healthcare Alliance-Stratford General Hospital&#8221; pin_address=&#8221;46 General Hospital Dr, Stratford, ON N5A 2Y6, Canada&#8221; pin_address_lat=&#8221;43.368168&#8243; pin_address_lng=&#8221;-80.99548099999998&#8243;] [\/et_pb_map_pin][et_pb_map_pin title=&#8221;Joseph Brant Memorial Hospital&#8221; pin_address=&#8221;1230 North Shore Blvd E, Burlington, ON L7S 1W7, Canada&#8221; pin_address_lat=&#8221;43.3171916&#8243; pin_address_lng=&#8221;-79.80258229999998&#8243;] [\/et_pb_map_pin][et_pb_map_pin title=&#8221;Kelowna General Hospital&#8221; pin_address=&#8221;2268 Pandosy St, Kelowna, BC V1Y 1T2, Canada&#8221; pin_address_lat=&#8221;49.8735375&#8243; pin_address_lng=&#8221;-119.4918025&#8243;] [\/et_pb_map_pin][et_pb_map_pin title=&#8221;Kingston General Hospital&#8221; pin_address=&#8221;76 Stuart St, Kingston, ON K7L 2V7, Canada&#8221; pin_address_lat=&#8221;44.2243515&#8243; pin_address_lng=&#8221;-76.49268649999999&#8243;] [\/et_pb_map_pin][et_pb_map_pin title=&#8221;Lake of the Woods District Hospital&#8221; pin_address=&#8221;21 Sylvan St, Kenora, ON P0V, Canada&#8221; pin_address_lat=&#8221;49.76702400000001&#8243; pin_address_lng=&#8221;-94.4994021&#8243;] [\/et_pb_map_pin][et_pb_map_pin title=&#8221;Lakeridge Health Corporation &#8211; Oshawa Site&#8221; pin_address=&#8221;1 Hospital Ct, Oshawa, ON L1G 2B9, Canada&#8221; pin_address_lat=&#8221;43.9055977&#8243; pin_address_lng=&#8221;-78.86923200000001&#8243;] [\/et_pb_map_pin][et_pb_map_pin title=&#8221;Langley Memorial Hospital &#8221; pin_address=&#8221;22051 Fraser Hwy, Langley, BC V3A, Canada&#8221; pin_address_lat=&#8221;49.0951223&#8243; pin_address_lng=&#8221;-122.62107359999999&#8243;] [\/et_pb_map_pin][et_pb_map_pin title=&#8221;Lethbridge Regional Hospital &#8221; pin_address=&#8221;960 19 St S, Lethbridge, AB T1J 1W5, Canada&#8221; pin_address_lat=&#8221;49.68535&#8243; pin_address_lng=&#8221;-112.81518510000001&#8243;] [\/et_pb_map_pin][et_pb_map_pin title=&#8221;Lions Gate Hospital, North Vancouver&#8221; pin_address=&#8221;231 15th St E, North Vancouver, BC V7L 2L7, Canada&#8221; pin_address_lat=&#8221;49.3220039&#8243; pin_address_lng=&#8221;-123.06749969999998&#8243;] [\/et_pb_map_pin][et_pb_map_pin title=&#8221;Medicine Hat Regional Hospital&#8221; pin_address=&#8221;666 5 St SW, Medicine Hat, AB T1A 4H6, Canada&#8221; pin_address_lat=&#8221;50.0356057&#8243; pin_address_lng=&#8221;-110.70385880000003&#8243;] [\/et_pb_map_pin][et_pb_map_pin title=&#8221;Mental Health Centre &#8211; Penetanguishene&#8221; pin_address=&#8221;500 Church St, Penetanguishene, ON L9M 1G3, Canada&#8221; pin_address_lat=&#8221;44.8009085&#8243; pin_address_lng=&#8221;-79.92947720000001&#8243;] [\/et_pb_map_pin][et_pb_map_pin title=&#8221;Mental Health Services &#8211; Providence Continuing Care Centre&#8221; pin_address=&#8221;340 Union St W, Kingston, ON K7L 4E6, Canada&#8221; pin_address_lat=&#8221;44.2253926&#8243; pin_address_lng=&#8221;-76.50650889999997&#8243;] [\/et_pb_map_pin][et_pb_map_pin title=&#8221;Misericordia Community Hospital&#8221; pin_address=&#8221;16940 87 Ave NW, Edmonton, AB T5R, Canada&#8221; pin_address_lat=&#8221;53.5211137&#8243; pin_address_lng=&#8221;-113.61298820000002&#8243;] [\/et_pb_map_pin][et_pb_map_pin title=&#8221;Moose Jaw Union Hospital&#8221; pin_address=&#8221;455 Fairford St E, Moose Jaw, SK S6H, Canada&#8221; pin_address_lat=&#8221;50.3924825&#8243; pin_address_lng=&#8221;-105.52468329999999&#8243;] [\/et_pb_map_pin][et_pb_map_pin title=&#8221;Mount Saint Joseph Hospital&#8221; pin_address=&#8221;3080 Prince Edward St, Vancouver, BC V5T 3N4, Canada&#8221; pin_address_lat=&#8221;49.25761&#8243; pin_address_lng=&#8221;-123.09641499999998&#8243;] [\/et_pb_map_pin][et_pb_map_pin title=&#8221;Mount Sinai Hospital, Toronto&#8221; pin_address=&#8221;600 University Ave, Toronto, ON M5G 1X5, Canada&#8221; pin_address_lat=&#8221;43.6574564&#8243; pin_address_lng=&#8221;-79.39034730000003&#8243;] [\/et_pb_map_pin][et_pb_map_pin title=&#8221;Nanaimo Regional General Hospital&#8221; pin_address=&#8221;1200 Dufferin Crescent, Nanaimo, BC V9S 2B7, Canada&#8221; pin_address_lat=&#8221;49.1849251&#8243; pin_address_lng=&#8221;-123.97081309999999&#8243;] [\/et_pb_map_pin][et_pb_map_pin title=&#8221;New Westminster Surgical Centre&#8221; pin_address=&#8221;250 Keary St, New Westminster, BC V3L 5E7, Canada&#8221; pin_address_lat=&#8221;49.22527729999999&#8243; pin_address_lng=&#8221;-122.8925418&#8243;] [\/et_pb_map_pin][et_pb_map_pin title=&#8221;North York General Hospital&#8221; pin_address=&#8221;4001 Leslie St, North York, ON M2K 1E1, Canada&#8221; pin_address_lat=&#8221;43.7695498&#8243; pin_address_lng=&#8221;-79.36320649999999&#8243;] [\/et_pb_map_pin][et_pb_map_pin title=&#8221;Northeast Mental Health Centre &#8211; North Bay Campus&#8221; pin_address=&#8221;50 College Dr, North Bay, ON P1B 8G5, Canada&#8221; pin_address_lat=&#8221;46.3349613&#8243; pin_address_lng=&#8221;-79.49472049999997&#8243;] [\/et_pb_map_pin][et_pb_map_pin title=&#8221;Orillia Soldiers&#8217; Memorial Hospital&#8221; pin_address=&#8221;170 Colborne St W, Orillia, ON L3V 2Z3, Canada&#8221; pin_address_lat=&#8221;44.605089&#8243; pin_address_lng=&#8221;-79.42560500000002&#8243;] [\/et_pb_map_pin][et_pb_map_pin title=&#8221;Peace Arch Hospital&#8221; pin_address=&#8221;15521 Russell Ave, White Rock, BC V4B 5M2, Canada&#8221; pin_address_lat=&#8221;49.0297315&#8243; pin_address_lng=&#8221;-122.79358939999997&#8243;] [\/et_pb_map_pin][et_pb_map_pin title=&#8221;Peter Lougheed Hospital&#8221; pin_address=&#8221;3500 26 Ave NE, Calgary, AB T1Y 6J4, Canada&#8221; pin_address_lat=&#8221;51.0783008&#8243; pin_address_lng=&#8221;-113.9838676&#8243;] [\/et_pb_map_pin][et_pb_map_pin title=&#8221;Prince County Hospital, Summerside&#8221; pin_address=&#8221;65 Roy Boates Avenue, Summerside, PE C1N 6M8, Canada&#8221; pin_address_lat=&#8221;46.4179435&#8243; pin_address_lng=&#8221;-63.774032000000034&#8243;] [\/et_pb_map_pin][et_pb_map_pin title=&#8221;Prince George Regional Hospital &#8221; pin_address=&#8221;1475 Edmonton St, Prince George, BC V2M 1S2, Canada&#8221; pin_address_lat=&#8221;53.9115651&#8243; pin_address_lng=&#8221;-122.76458059999999&#8243;] [\/et_pb_map_pin][et_pb_map_pin title=&#8221;Queen Elizabeth Hospital&#8221; pin_address=&#8221;60 Riverside Dr, Charlottetown, PE C1A 0A9, Canada&#8221; pin_address_lat=&#8221;46.255737&#8243; pin_address_lng=&#8221;-63.102351999999996&#8243;] [\/et_pb_map_pin][et_pb_map_pin title=&#8221;Queensway Carleton Hospital, Nepean&#8221; pin_address=&#8221;3045 Baseline Rd, Nepean, ON K2H 8P4, Canada&#8221; pin_address_lat=&#8221;45.3351992&#8243; pin_address_lng=&#8221;-75.8078774&#8243;] [\/et_pb_map_pin][et_pb_map_pin title=&#8221;Red Deer Regional Hospital Centre&#8221; pin_address=&#8221;3942 50a Ave, Red Deer, AB T4N 4E7, Canada&#8221; pin_address_lat=&#8221;52.2606537&#8243; pin_address_lng=&#8221;-113.81744470000001&#8243;] [\/et_pb_map_pin][et_pb_map_pin title=&#8221;Regina General Hospital&#8221; pin_address=&#8221;1440 14 Ave, Regina, SK S4P 0W5, Canada&#8221; pin_address_lat=&#8221;50.44347519999999&#8243; pin_address_lng=&#8221;-104.60114069999997&#8243;] [\/et_pb_map_pin][et_pb_map_pin title=&#8221;Riverview Hospital&#8221; pin_address=&#8221;2601 Lougheed Hwy, Coquitlam, BC V3C 4J2, Canada&#8221; pin_address_lat=&#8221;49.259535&#8243; pin_address_lng=&#8221;-122.79910760000001&#8243;] [\/et_pb_map_pin][et_pb_map_pin title=&#8221;Rockyview General Hospital&#8221; pin_address=&#8221;7007 14 St SW, Calgary, AB T2V 1P9, Canada&#8221; pin_address_lat=&#8221;50.9898221&#8243; pin_address_lng=&#8221;-114.096632&#8243;] [\/et_pb_map_pin][et_pb_map_pin title=&#8221;Rouge Valley Health System &#8211; Centenary Site&#8221; pin_address=&#8221;2867 Ellesmere Rd, Scarborough, ON M1E 4B9, Canada&#8221; pin_address_lat=&#8221;43.7803978&#8243; pin_address_lng=&#8221;-79.20454919999997&#8243;] [\/et_pb_map_pin][et_pb_map_pin title=&#8221;Royal Alexandra Hospital&#8221; pin_address=&#8221;10240 Kingsway NW, Edmonton, AB T5H 3V9, Canada&#8221; pin_address_lat=&#8221;53.556936&#8243; pin_address_lng=&#8221;-113.49680539999997&#8243;] [\/et_pb_map_pin][et_pb_map_pin title=&#8221;Royal Columbian Hospital&#8221; pin_address=&#8221;330 E Columbia St, New Westminster, BC V3L 3W7, Canada&#8221; pin_address_lat=&#8221;49.2263903&#8243; pin_address_lng=&#8221;-122.89136860000002&#8243;] [\/et_pb_map_pin][et_pb_map_pin title=&#8221;Royal Inland Hospital &#8211; Kamloops Mental Health Centre&#8221; pin_address=&#8221;311 Columbia St, Kamloops, BC V2C 2T3, Canada&#8221; pin_address_lat=&#8221;50.6701949&#8243; pin_address_lng=&#8221;-120.33459240000002&#8243;] [\/et_pb_map_pin][et_pb_map_pin title=&#8221;Royal Jubilee Hospital &#8211; Department of Psychiatry&#8221; pin_address=&#8221;1952 Bay St, Victoria, BC V8R 1J8, Canada&#8221; pin_address_lat=&#8221;48.4331909&#8243; pin_address_lng=&#8221;-123.3268031&#8243;] [\/et_pb_map_pin][et_pb_map_pin title=&#8221;Royal Ottawa Hospital&#8221; pin_address=&#8221;1145 Carling Ave, Ottawa, ON K1Z 7K4, Canada&#8221; pin_address_lat=&#8221;45.3890056&#8243; pin_address_lng=&#8221;-75.7301564&#8243;] [\/et_pb_map_pin][et_pb_map_pin title=&#8221;Royal University Hospital&#8221; pin_address=&#8221;103 Hospital Dr, Saskatoon, SK S7N 0W8, Canada&#8221; pin_address_lat=&#8221;52.1304581&#8243; pin_address_lng=&#8221;-106.64120000000003&#8243;] [\/et_pb_map_pin][et_pb_map_pin title=&#8221;Saint John Regional Hospital&#8221; pin_address=&#8221;400 University Ave, Saint John, NB E2K 5B4, Canada&#8221; pin_address_lat=&#8221;45.3027199&#8243; pin_address_lng=&#8221;-66.08517490000003&#8243;] [\/et_pb_map_pin][et_pb_map_pin title=&#8221;Selkirk Mental Health Centre&#8221; pin_address=&#8221;825 Manitoba Ave, Selkirk, MB R1A 0Z3, Canada&#8221; pin_address_lat=&#8221;50.1530832&#8243; pin_address_lng=&#8221;-96.88807689999999&#8243;] [\/et_pb_map_pin][et_pb_map_pin title=&#8221;Seven Oaks General Hospital&#8221; pin_address=&#8221;2300 McPhillips St, Winnipeg, MB R2V 3M3, Canada&#8221; pin_address_lat=&#8221;49.9551773&#8243; pin_address_lng=&#8221;-97.14886519999999&#8243;] [\/et_pb_map_pin][et_pb_map_pin title=&#8221;Southlake Regional Health Centre&#8221; pin_address=&#8221;596 Davis Dr, Newmarket, ON L3Y 2P9, Canada&#8221; pin_address_lat=&#8221;44.0600889&#8243; pin_address_lng=&#8221;-79.45252920000001&#8243;] [\/et_pb_map_pin][et_pb_map_pin title=&#8221;St. Boniface General Hospital&#8221; pin_address=&#8221;409 Tache Ave, Winnipeg, MB R2H 2A6, Canada&#8221; pin_address_lat=&#8221;49.8843833&#8243; pin_address_lng=&#8221;-97.12485500000003&#8243;] [\/et_pb_map_pin][et_pb_map_pin title=&#8221;St. Joseph&#8217;s General Hospital&#8221; pin_address=&#8221;2137 Comox Ave, Comox, BC V9M 1G6, Canada&#8221; pin_address_lat=&#8221;49.6744637&#8243; pin_address_lng=&#8221;-124.9415684&#8243;] [\/et_pb_map_pin][et_pb_map_pin title=&#8221;St. Joseph&#8217;s Healthcare Hamilton-Centre for Mountain Health Services&#8221; pin_address=&#8221;100 W 5th St, Hamilton, ON L8P 3R2, Canada&#8221; pin_address_lat=&#8221;43.2409294&#8243; pin_address_lng=&#8221;-79.88497310000002&#8243;] [\/et_pb_map_pin][et_pb_map_pin title=&#8221;St. Michael&#8217;s Hospital&#8221; pin_address=&#8221;30 Bond St, Toronto, ON M5B 1W8, Canada&#8221; pin_address_lat=&#8221;43.6543249&#8243; pin_address_lng=&#8221;-79.37788769999997&#8243;] [\/et_pb_map_pin][et_pb_map_pin title=&#8221;St. Paul&#8217;s Hospital &#8211; Providence Health Care&#8221; pin_address=&#8221;1081 Burrard St, Vancouver, BC V6Z 1Y6, Canada&#8221; pin_address_lat=&#8221;49.2805622&#8243; pin_address_lng=&#8221;-123.1281904&#8243;] [\/et_pb_map_pin][et_pb_map_pin title=&#8221;St. Therese Health Centre&#8221; pin_address=&#8221;4713 48 Ave, St. Paul, AB T0A 3A3, Canada&#8221; pin_address_lat=&#8221;53.9889259&#8243; pin_address_lng=&#8221;-111.29052200000001&#8243;] [\/et_pb_map_pin][et_pb_map_pin title=&#8221;Sunnybrook Health Sciences Centre&#8221; pin_address=&#8221;2075 Bayview Ave, Toronto, ON M4N 3M5, Canada&#8221; pin_address_lat=&#8221;43.7249074&#8243; pin_address_lng=&#8221;-79.37377270000002&#8243;] [\/et_pb_map_pin][et_pb_map_pin title=&#8221;Swift Current Regional Hospital&#8221; pin_address=&#8221;2004 Saskatchewan Dr, Swift Current, SK S9H 5M8, Canada&#8221; pin_address_lat=&#8221;50.3109709&#8243; pin_address_lng=&#8221;-107.77557239999999&#8243;] [\/et_pb_map_pin][et_pb_map_pin title=&#8221;The Nova Scotia Hospital&#8221; pin_address=&#8221;300 Pleasant St, Dartmouth, NS B2Y 0A5, Canada&#8221; pin_address_lat=&#8221;44.6532168&#8243; pin_address_lng=&#8221;-63.54892229999996&#8243;] [\/et_pb_map_pin][et_pb_map_pin title=&#8221;The Ottawa Hospital &#8211; General Campus&#8221; pin_address=&#8221;501 Smyth Rd, Ottawa, ON K1H 8L6, Canada&#8221; pin_address_lat=&#8221;45.4017451&#8243; pin_address_lng=&#8221;-75.6469098&#8243;] [\/et_pb_map_pin][et_pb_map_pin title=&#8221;The Ottawa Hospital &#8211; Civic Campus&#8221; pin_address=&#8221;Carling Ave, Ottawa, ON K1Y, Canada&#8221; pin_address_lat=&#8221;45.3889297&#8243; pin_address_lng=&#8221;-75.72774809999999&#8243;] [\/et_pb_map_pin][et_pb_map_pin title=&#8221;The Salvation Army Grace General Hospital&#8221; pin_address=&#8221;300 Booth Dr, Winnipeg, MB R3J 3M7, Canada&#8221; pin_address_lat=&#8221;49.8822632&#8243; pin_address_lng=&#8221;-97.27744580000001&#8243;] [\/et_pb_map_pin][et_pb_map_pin title=&#8221;The Scarborough Hospital &#8211; Grace Division&#8221; pin_address=&#8221;3030 Lawrence Ave E #108, Scarborough, ON M1P 2T7, Canada&#8221; pin_address_lat=&#8221;43.7565097&#8243; pin_address_lng=&#8221;-79.24794639999999&#8243;] [\/et_pb_map_pin][et_pb_map_pin title=&#8221;The Toronto General Hospital&#8221; pin_address=&#8221;Eaton Building, 200 Elizabeth St, Toronto, ON M5G 2C4, Canada&#8221; pin_address_lat=&#8221;43.6586363&#8243; pin_address_lng=&#8221;-79.38847899999996&#8243;] [\/et_pb_map_pin][et_pb_map_pin title=&#8221;Thunder Bay Regional Health Sciences Centre&#8221; pin_address=&#8221;980 Oliver Rd, Thunder Bay, ON P7B 5E1, Canada&#8221; pin_address_lat=&#8221;48.4247133&#8243; pin_address_lng=&#8221;-89.26909699999999&#8243;] [\/et_pb_map_pin][et_pb_map_pin title=&#8221;Timmins and District Hospital&#8221; pin_address=&#8221;700 Ross Ave E, Timmins, ON P4N 8P2, Canada&#8221; pin_address_lat=&#8221;48.4860224&#8243; pin_address_lng=&#8221;-81.31316079999999&#8243;] [\/et_pb_map_pin][et_pb_map_pin title=&#8221;Toronto East General Hospital&#8221; pin_address=&#8221;825 Coxwell Ave, East York, ON M4C 3E7, Canada&#8221; pin_address_lat=&#8221;43.6897586&#8243; pin_address_lng=&#8221;-79.32592249999999&#8243;] [\/et_pb_map_pin][et_pb_map_pin title=&#8221;Trillium Health Centre &#8211; Mississauga Site&#8221; pin_address=&#8221;100 Queensway W, Mississauga, ON L5B 1B8, Canada&#8221; pin_address_lat=&#8221;43.5713758&#8243; pin_address_lng=&#8221;-79.60833450000001&#8243;] [\/et_pb_map_pin][et_pb_map_pin title=&#8221;UBC Hospital, Mood Disorders Inpatient Unit, Detwiller Pavillion&#8221; pin_address=&#8221;2255 Wesbrook Mall, Vancouver, BC V6T, Canada&#8221; pin_address_lat=&#8221;49.2644807&#8243; pin_address_lng=&#8221;-123.2440565&#8243;] [\/et_pb_map_pin][et_pb_map_pin title=&#8221;University of Alberta Hospital&#8221; pin_address=&#8221;Clinical Sciences Building, 8440 112 St NW, Edmonton, AB T6G 2B7, Canada&#8221; pin_address_lat=&#8221;53.5197424&#8243; pin_address_lng=&#8221;-113.52326340000002&#8243;] [\/et_pb_map_pin][et_pb_map_pin title=&#8221;Valley Regional Hospital&#8221; pin_address=&#8221;150 Exhibition St, Kentville, NS B4N 1C3, Canada&#8221; pin_address_lat=&#8221;45.0840529&#8243; pin_address_lng=&#8221;-64.50059060000001&#8243;] [\/et_pb_map_pin][et_pb_map_pin title=&#8221;Vancouver General Hospital, General Psychiatry&#8221; pin_address=&#8221;899 W 12th Ave, Vancouver, BC V5Z 1M9, Canada&#8221; pin_address_lat=&#8221;49.260803&#8243; pin_address_lng=&#8221;-123.12399399999998&#8243;] [\/et_pb_map_pin][et_pb_map_pin title=&#8221;Victoria General Hospital&#8221; pin_address=&#8221;2340 Pembina Hwy, Winnipeg, MB R3T 2E8, Canada&#8221; pin_address_lat=&#8221;49.8067986&#8243; pin_address_lng=&#8221;-97.1527764&#8243;] [\/et_pb_map_pin][et_pb_map_pin title=&#8221;Victoria Hospital&#8221; pin_address=&#8221;1200 24 St W, Prince Albert, SK S6V 4B2, Canada&#8221; pin_address_lat=&#8221;53.1919847&#8243; pin_address_lng=&#8221;-105.78430679999997&#8243;] [\/et_pb_map_pin][et_pb_map_pin title=&#8221;Waterford Hospital &#8211; Mental Health Program&#8221; pin_address=&#8221;306 Waterford Bridge Rd, St. John&#8217;s, NL A1E 4J8, Canada&#8221; pin_address_lat=&#8221;47.528947&#8243; pin_address_lng=&#8221;-52.74943099999996&#8243;] [\/et_pb_map_pin][et_pb_map_pin title=&#8221;Western Memorial Hospital&#8221; pin_address=&#8221;1 Brookfield Ave, Corner Brook, NL A2H 2X4, Canada&#8221; pin_address_lat=&#8221;48.948203&#8243; pin_address_lng=&#8221;-57.92898300000002&#8243;] [\/et_pb_map_pin][et_pb_map_pin title=&#8221;Whitby Mental Health Centre&#8221; pin_address=&#8221;700 Gordon St, Whitby, ON L1N 9X4, Canada&#8221; pin_address_lat=&#8221;43.8484247&#8243; pin_address_lng=&#8221;-78.94572619999997&#8243;] [\/et_pb_map_pin][et_pb_map_pin title=&#8221;William Osler Health Centre&#8221; pin_address=&#8221;89 Humber College Blvd, Etobicoke, ON M9V 4B8, Canada&#8221; pin_address_lat=&#8221;43.7306434&#8243; pin_address_lng=&#8221;-79.59766389999999&#8243;] [\/et_pb_map_pin][et_pb_map_pin title=&#8221;Yarmouth Regional Hospital &#8221; pin_address=&#8221;60 Vancouver St, Yarmouth, NS B5A 2P5, Canada&#8221; pin_address_lat=&#8221;43.85064690000001&#8243; pin_address_lng=&#8221;-66.1217646&#8243;] [\/et_pb_map_pin][et_pb_map_pin title=&#8221;York County Hospital, Richmond Hill&#8221; pin_address=&#8221;10 Trench St, Richmond Hill, ON L4C 4Z3, Canada&#8221; pin_address_lat=&#8221;43.87054819999999&#8243; pin_address_lng=&#8221;-79.45038590000001&#8243;] [\/et_pb_map_pin][et_pb_map_pin title=&#8221;Yorkton Mental Health Centre&#8221; pin_address=&#8221;270 Bradbrooke Dr, Yorkton, SK S3N 2K6, Canada&#8221; pin_address_lat=&#8221;51.2022464&#8243; pin_address_lng=&#8221;-102.48061230000002&#8243;] [\/et_pb_map_pin] [\/et_pb_map][et_pb_divider admin_label=&#8221;Divider&#8221; color=&#8221;#ffffff&#8221; show_divider=&#8221;off&#8221; divider_style=&#8221;solid&#8221; divider_position=&#8221;top&#8221; hide_on_mobile=&#8221;on&#8221;] [\/et_pb_divider][et_pb_blurb admin_label=&#8221;Blurb&#8221; title=&#8221;The Canadian ECT Survey was distributed to all 175 identified treatment centres across the country and the group received responses from 107. The map shows that ECT is less prevalent in rural and remote communities. Click on any of the red drop points on the map above to see the names of the responding centres.&#8221; url_new_window=&#8221;off&#8221; use_icon=&#8221;off&#8221; icon_color=&#8221;#7EBEC5&#8243; use_circle=&#8221;off&#8221; circle_color=&#8221;#7EBEC5&#8243; use_circle_border=&#8221;off&#8221; circle_border_color=&#8221;#7EBEC5&#8243; icon_placement=&#8221;top&#8221; animation=&#8221;top&#8221; background_layout=&#8221;light&#8221; text_orientation=&#8221;left&#8221; use_icon_font_size=&#8221;off&#8221; header_font=&#8221;PT Sans|on|||&#8221; header_font_size=&#8221;16&#8243; header_text_color=&#8221;#ffffff&#8221; body_text_color=&#8221;#ffffff&#8221; use_border_color=&#8221;off&#8221; border_color=&#8221;#ffffff&#8221; border_style=&#8221;solid&#8221; body_font=&#8221;PT Sans|on|||&#8221; body_font_size=&#8221;16&#8243;] [\/et_pb_blurb][\/et_pb_column][et_pb_column type=&#8221;4_4&#8243;][\/et_pb_column][\/et_pb_row][\/et_pb_section][et_pb_section admin_label=&#8221;Section&#8221; fullwidth=&#8221;off&#8221; specialty=&#8221;off&#8221; transparent_background=&#8221;off&#8221; background_color=&#8221;#f2f2f2&#8243; allow_player_pause=&#8221;off&#8221; inner_shadow=&#8221;off&#8221; parallax=&#8221;off&#8221; parallax_method=&#8221;off&#8221; padding_mobile=&#8221;off&#8221; make_fullwidth=&#8221;off&#8221; use_custom_width=&#8221;off&#8221; width_unit=&#8221;on&#8221; make_equal=&#8221;off&#8221; use_custom_gutter=&#8221;off&#8221;][et_pb_row admin_label=&#8221;Row&#8221; make_fullwidth=&#8221;off&#8221; use_custom_width=&#8221;off&#8221; width_unit=&#8221;on&#8221; use_custom_gutter=&#8221;off&#8221; padding_mobile=&#8221;off&#8221; allow_player_pause=&#8221;off&#8221; parallax=&#8221;off&#8221; parallax_method=&#8221;off&#8221; make_equal=&#8221;off&#8221; parallax_1=&#8221;off&#8221; parallax_method_1=&#8221;off&#8221; parallax_2=&#8221;off&#8221; parallax_method_2=&#8221;off&#8221; parallax_3=&#8221;off&#8221; parallax_method_3=&#8221;off&#8221; column_padding_mobile=&#8221;on&#8221;][et_pb_column type=&#8221;1_4&#8243;][\/et_pb_column][et_pb_column type=&#8221;1_2&#8243;][et_pb_text admin_label=&#8221;Text&#8221; background_layout=&#8221;light&#8221; text_orientation=&#8221;left&#8221; text_font=&#8221;Open Sans||||&#8221; text_font_size=&#8221;16&#8243; text_text_color=&#8221;#000000&#8243; use_border_color=&#8221;off&#8221; border_color=&#8221;#ffffff&#8221; border_style=&#8221;solid&#8221;]<\/p>\n<h4><strong>Results<\/strong><\/h4>\n<p>With 107 ECT centres responding to the survey, the CANECTS team was able to determine rates of ECT utilization between 2006 and 2007.<\/p>\n<p>[\/et_pb_text][et_pb_number_counter admin_label=&#8221;Number Counter&#8221; title=&#8221;approximate # of patients treated with ECT in Canada over a one-year period&#8221; number=&#8221;7,700&#8243; percent_sign=&#8221;off&#8221; counter_color=&#8221;#40b529&#8243; background_layout=&#8221;light&#8221; use_border_color=&#8221;off&#8221; border_color=&#8221;#ffffff&#8221; border_style=&#8221;solid&#8221; number_font_size=&#8221;50&#8243; title_font=&#8221;Open Sans|on|||&#8221; title_font_size=&#8221;15&#8243;] [\/et_pb_number_counter][et_pb_divider admin_label=&#8221;Divider&#8221; color=&#8221;#ffffff&#8221; show_divider=&#8221;off&#8221; divider_style=&#8221;solid&#8221; divider_position=&#8221;top&#8221; hide_on_mobile=&#8221;on&#8221;] [\/et_pb_divider][et_pb_number_counter admin_label=&#8221;Number Counter&#8221; title=&#8221;approximate # of ECT treatments delivered in Canada over a one-year period &#8221; number=&#8221;67,000&#8243; percent_sign=&#8221;off&#8221; counter_color=&#8221;#dd3333&#8243; background_layout=&#8221;light&#8221; use_border_color=&#8221;off&#8221; border_color=&#8221;#ffffff&#8221; border_style=&#8221;solid&#8221; number_font_size=&#8221;50&#8243; title_font=&#8221;Open Sans|on|||&#8221; title_font_size=&#8221;15&#8243;] [\/et_pb_number_counter][et_pb_text admin_label=&#8221;Text&#8221; background_layout=&#8221;light&#8221; text_orientation=&#8221;left&#8221; text_font=&#8221;Open Sans||||&#8221; text_font_size=&#8221;16&#8243; text_text_color=&#8221;#000000&#8243; use_border_color=&#8221;off&#8221; border_color=&#8221;#ffffff&#8221; border_style=&#8221;solid&#8221;]<\/p>\n<p>\u201cOur survey showed that ECT in Canada is quite well done, and people should be reassured by that,\u201d said Delva.<\/p>\n<p>For example, he said the data showed that there is a routine use of up-to-date equipment and that no psychiatric resident delivers ECT unsupervised in Canada.<\/p>\n<p>However, the data also indicated a large variation in dosing practices between ECT centres.\u00a0 This means that there were vast differences in electrode placement and intensity of the electrical stimulus, making it hard for researchers to determine best practices.<\/p>\n<p>\u201cVariation in medicine is generally not a good idea,\u201d said Delva.\u00a0 \u201cIf there\u2019s a way to do things right then it should be more consistently done.\u201d<\/p>\n<p>Delva used caesarian sections in the United States as an example.\u00a0 When first measured in 1965, the national C-section birth rate was 4.5 per cent.\u00a0 By 2009, it had increased sevenfold, to 32.9 per cent.\u00a0 The spike in C-section rates occurred despite leading professionals in obstetric societies around the world concluding that C- sections can increase the likelihood of adverse effects in both mothers and babies.\u00a0 Significant regional variations in this practice, Delva said, points to inconsistent\u00a0utilization of this important, but high risk treatment, demonstrating the risk of variation in medicine.<\/p>\n<p>Furthermore, many ECT treatment centres reported that they didn\u2019t have backup devices or equipment loan arrangements with other institutions.\u00a0 The CANECTS team found this to be particularly worrisome, because when equipment breaks, it usually takes a long time to repair.\u00a0 With no backup devices or loan arrangements, doctors have to send their patients to neighbouring communities.<\/p>\n<p>Access to ECT was also identified as an area of concern in the survey.\u00a0 The results revealed that 12.5 per cent of those living in Newfoundland and Labrador would have to drive more than 5 hours away to reach an ECT clinic.\u00a0 What&#8217;s more, no ECT is delivered in Canada&#8217;s three northern territories &#8211; Yukon, Northwest Territories and Nunavut.<\/p>\n<p>[\/et_pb_text][et_pb_counters admin_label=&#8221;Bar Counters&#8221; background_layout=&#8221;light&#8221; background_color=&#8221;#ded9e2&#8243; bar_bg_color=&#8221;#7EBEC5&#8243; use_percentages=&#8221;on&#8221; title_text_color=&#8221;#000000&#8243; use_border_color=&#8221;off&#8221; border_color=&#8221;#ffffff&#8221; border_style=&#8221;solid&#8221; title_font=&#8221;Open Sans|on|||&#8221; title_font_size=&#8221;15&#8243; border_radius=&#8221;0&#8243; percent_font_size=&#8221;15&#8243;] [et_pb_counter percent=&#8221;84.3&#8243; bar_background_color=&#8221;#8224e3&#8243;] Canadians living within a one-hour drive of an ECT centre [\/et_pb_counter][et_pb_counter percent=&#8221;91.5&#8243; bar_background_color=&#8221;#1e73be&#8221;] Canadians living within a two-hour drive of an ECT centre [\/et_pb_counter][et_pb_counter percent=&#8221;4.7&#8243; bar_background_color=&#8221;#ed36dd&#8221;] Canadians living within a five-hour drive of an ECT centre [\/et_pb_counter] [\/et_pb_counters][et_pb_blurb admin_label=&#8221;Blurb&#8221; url_new_window=&#8221;off&#8221; use_icon=&#8221;off&#8221; icon_color=&#8221;#7EBEC5&#8243; use_circle=&#8221;off&#8221; circle_color=&#8221;#7EBEC5&#8243; use_circle_border=&#8221;off&#8221; circle_border_color=&#8221;#7EBEC5&#8243; icon_placement=&#8221;top&#8221; animation=&#8221;top&#8221; background_layout=&#8221;light&#8221; text_orientation=&#8221;left&#8221; use_icon_font_size=&#8221;off&#8221; header_font=&#8221;PT Sans|on|||&#8221; header_font_size=&#8221;16&#8243; body_text_color=&#8221;#4c4c4c&#8221; use_border_color=&#8221;off&#8221; border_color=&#8221;#ffffff&#8221; border_style=&#8221;solid&#8221; body_font=&#8221;PT Sans|on|||&#8221; body_font_size=&#8221;16&#8243;]<\/p>\n<p style=\"text-align: right;\">Source: Access to ECT in Canada, Journal of ECT, 2011<\/p>\n<p>[\/et_pb_blurb][et_pb_text admin_label=&#8221;Text&#8221; background_layout=&#8221;light&#8221; text_orientation=&#8221;left&#8221; text_font=&#8221;Open Sans||||&#8221; text_font_size=&#8221;16&#8243; text_text_color=&#8221;#000000&#8243; use_border_color=&#8221;off&#8221; border_color=&#8221;#ffffff&#8221; border_style=&#8221;solid&#8221;]<\/p>\n<p>There were also a number of non-geographic barriers to ECT.<\/p>\n<p>[\/et_pb_text][\/et_pb_column][et_pb_column type=&#8221;1_4&#8243;][\/et_pb_column][\/et_pb_row][\/et_pb_section][et_pb_section admin_label=&#8221;Section&#8221; fullwidth=&#8221;off&#8221; specialty=&#8221;off&#8221; transparent_background=&#8221;off&#8221; background_color=&#8221;#4c4c4c&#8221; allow_player_pause=&#8221;off&#8221; inner_shadow=&#8221;off&#8221; parallax=&#8221;off&#8221; parallax_method=&#8221;off&#8221; padding_mobile=&#8221;off&#8221; make_fullwidth=&#8221;off&#8221; use_custom_width=&#8221;off&#8221; width_unit=&#8221;on&#8221; make_equal=&#8221;off&#8221; use_custom_gutter=&#8221;off&#8221;][et_pb_row admin_label=&#8221;Row&#8221;][et_pb_column type=&#8221;4_4&#8243;][et_pb_code admin_label=&#8221;Code&#8221;]&lt;iframe width=&#8221;560&#8243; height=&#8221;315&#8243; src=&#8221;https:\/\/www.youtube.com\/embed\/u_S6E3Q5pOI?rel=0&#8243; frameborder=&#8221;0&#8243; allowfullscreen&gt;&lt;\/iframe&gt;[\/et_pb_code][\/et_pb_column][\/et_pb_row][\/et_pb_section][et_pb_section admin_label=&#8221;Section&#8221; fullwidth=&#8221;off&#8221; specialty=&#8221;off&#8221; transparent_background=&#8221;off&#8221; background_color=&#8221;#f2f2f2&#8243; allow_player_pause=&#8221;off&#8221; inner_shadow=&#8221;off&#8221; parallax=&#8221;off&#8221; parallax_method=&#8221;off&#8221; padding_mobile=&#8221;off&#8221; make_fullwidth=&#8221;off&#8221; use_custom_width=&#8221;off&#8221; width_unit=&#8221;on&#8221; make_equal=&#8221;off&#8221; use_custom_gutter=&#8221;off&#8221;][et_pb_row admin_label=&#8221;Row&#8221;][et_pb_column type=&#8221;1_4&#8243;][\/et_pb_column][et_pb_column type=&#8221;1_2&#8243;][et_pb_text admin_label=&#8221;Text&#8221; background_layout=&#8221;light&#8221; text_orientation=&#8221;left&#8221; use_border_color=&#8221;off&#8221; border_color=&#8221;#ffffff&#8221; border_style=&#8221;solid&#8221; text_font=&#8221;Open Sans||||&#8221; text_font_size=&#8221;16&#8243; text_text_color=&#8221;#000000&#8243;]<\/p>\n<p>What was most concerning for members of the CANECTS team was that the data showed a huge variation in levels of ECT training.\u00a0 While some hospitals required residents to attend lectures and observe a minimum number of ECT treatments, others required no training whatsoever.\u00a0 The data showed that most of the training residents receive is in the classroom rather than hands-on.<\/p>\n<h4><\/h4>\n<h4><strong>Guidelines<\/strong><\/h4>\n<p>The completion of the Canadian ECT Survey and accompanying analysis of the findings marked the end of the first phase of the CANECTS groups\u2019 initiative.<\/p>\n<hr \/>\n\n\t\t<div class='et_quote'>\n\t\t\t<div class='et_right_quote'>\n\t\t\t\tThe Canadian ECT Standards will provide a new kind of benchmark for all centres. <span class=\"et_quote_name\">\u2013 Dr. Nick Delva<\/span>\n\t\t\t\t\n\t\t\t<\/div>\n\t\t\t<span class='et_quote_sign'><\/span>\n\t\t<\/div>\n\t\n<hr \/>\n<p>But the work is far from over.<\/p>\n<p>CANECTS II, Canadian ECT Standards, is currently underway and is close to completion as of March 2016. \u00a0Delva explained that the standards will be based on both the findings of the survey and the collective clinical experience of the CANECTS team.\u00a0 It will culminate in one document, which will include a preamble and 17 chapters, each one listing a set of guidelines about an area of ECT practice.<\/p>\n<p>The guidelines will cover everything from consent and confidentiality, to policies, protocols and documentation, patient preparation, equipment, treatment technique, follow-up care and maintenance ECT, said Delva.<\/p>\n<p>The guidelines dealing with <a href=\"http:\/\/cusjc.ca\/ect\/training\/\">training<\/a> and <a href=\"http:\/\/cusjc.ca\/ect\/facilities-and-environment\/\">facilities\/environment<\/a>\u00a0are expanded on in detail in subsequent sections of this website.<\/p>\n<p>In addition, the standards document will also address more controversial topics, such as the decision to prescribe ECT in the first place. For example, Delva explained that a clinician would be unlikely to suggest ECT for someone who has a case of mild depression, which could be treated using alternative therapies.<\/p>\n<p>\u201cThe Canadian ECT Standards will provide a new kind of benchmark for all centres,\u201d said Delva.<\/p>\n<p>While Delva was the chair of the ECT survey, he handed over the reins for this next phase to two of his CANECTS colleagues, Dr. Caroline Gosselin, a clinical professor of psychiatry at the University of British Columbia, and <a href=\"http:\/\/umanitoba.ca\/faculties\/health_sciences\/medicine\/units\/psychiatry\/research\/about_murray_enns.html\">Dr. Murray Enns<\/a>, head of the Department of Psychiatry at the University of Manitoba.<\/p>\n<p>Gosselin said now that the guidelines have been penned from the point of view of the CANECTS team, the next step is to seek feedback from external stakeholders.<\/p>\n<p>[\/et_pb_text][et_pb_team_member admin_label=&#8221;Person&#8221; name=&#8221;Dr. Caroline Gosselin&#8221; position=&#8221;Professor of Geriatric Psychiatry, University of British Columbia&#8221; image_url=&#8221;http:\/\/cusjc.ca\/ect\/wp-content\/uploads\/2016\/04\/Gosselin-image.jpg&#8221; animation=&#8221;left&#8221; background_layout=&#8221;light&#8221; use_border_color=&#8221;off&#8221; border_color=&#8221;#ffffff&#8221; border_style=&#8221;solid&#8221; header_font=&#8221;PT Sans|on|||&#8221; header_font_size=&#8221;16&#8243; header_text_color=&#8221;#4c4c4c&#8221; body_text_color=&#8221;#4c4c4c&#8221; body_font=&#8221;PT Sans||||&#8221;] [\/et_pb_team_member][et_pb_text admin_label=&#8221;Text&#8221; background_layout=&#8221;light&#8221; text_orientation=&#8221;left&#8221; use_border_color=&#8221;off&#8221; border_color=&#8221;#ffffff&#8221; border_style=&#8221;solid&#8221; text_font=&#8221;Open Sans||||&#8221; text_font_size=&#8221;16&#8243; text_text_color=&#8221;#000000&#8243;]<\/p>\n<p>In late February 2016, the document was distributed to a wide array of clinicians, hospital administrators and ECT educators.<\/p>\n<p>\u201cThe more eyes that see a document from different perspectives, the richer and more accurate the document becomes,\u201d said Gosselin.<\/p>\n<p>Gosselin said she expects the review process to take about six months.<\/p>\n<p>Following the feedback process, the CANECTS team will review the stakeholder comments, and will then decide whether or not to make changes to the standards document.<\/p>\n<p>Once finalized, it will then be sent to the Canadian Psychiatric Association for review.<\/p>\n<p>\u201cIt was important for us to attach our document to a recognized and well respected body in psychiatry, like the CPA,\u201d said Gosselin.<\/p>\n<p>The CPA had expressed interest in endorsing and eventually publishing the guidelines and Gosselin believes that its seal of approval will go a long way in encouraging ECT centres to voluntary comply.<\/p>\n<p>Gosselin said the CANECTS team looks forward to receiving feedback, especially because some of the standards outlined in the document weren\u2019t fully agreed upon by members of the group.<\/p>\n<p>\u201cThat was something we were very transparent about when we sent the document out to stakeholders for comment,\u201d said Gosselin.<\/p>\n<p>One of the sources of contention stemmed from the 24-hour period following ECT, in which the patient is discharged into the care of a responsible adult.\u00a0 Canadian anesthesia guidelines stipulate that patients must be monitored for 24 hours following the administration of a general anesthetic.\u00a0 But some psychiatrists feel that people are generally able to conduct themselves normally within a few hours of the procedure, and that stringent and inconvenient monitoring requirements may lead people to abandon the treatment altogether.<\/p>\n<p>Another thing the CANECTS team made sure to clarify with stakeholders is that the standards document is in no way set in stone.<\/p>\n<p>\u201cThis is something that will change and grow overtime because the field is changing and how medicine is delivered in Canada is changing,\u201d said Gosselin.\u00a0 \u201cThis is just the first crack to get us going and hopefully people will carry the torch and move this forward in the coming years.\u201d<\/p>\n<p>Gosselin said that she and the CANECTS team want the standards document to be completely transparent and accessible to everyone.\u00a0 Following the peer-review process, her hope is that the document will be placed online, included as an attachment to relevant medical journals and made available to all ECT practitioners to consult while in the ECT suite performing the procedure on patients.<\/p>\n<h4><strong>Then what?<\/strong><\/h4>\n<p>In the coming years, Gosselin and Delva envision adopting the U.K. approach to ECT by conducting regular audits of centres throughout the country.<\/p>\n<p>\u201cThe whole idea is to just provide better patient care, so instead of us coming to the centres with the stick, it would be us coming to support and guide,\u201d said Gosselin.<\/p>\n<p>Over the past 10 years, Gosselin\u2019s had the opportunity to teach ECT to a wide array of practitioners throughout the country and said that there are a lot of ECT clinicians who already deliver state-of-the-art care and who are very proud of the work they do.<\/p>\n<p>\u201cI think that needs to be endorsed and validated through some kind of certification or accreditation,\u201d she said.<\/p>\n<p>Furthermore, Gosselin explained, there are also ECT centres that are very motivated to do better, and she feels that the standards and audits will help them reach their full potential.<\/p>\n<p>On the other hand, she said some smaller centres have expressed concern that their limited resources might not allow them to comply with the standards and may result in them being shut down.\u00a0 This is particularly worrisome for facilities in rural areas, which struggle to attract enough psychiatrists to their community to provide ECT in the first place.<\/p>\n<p>Delva acknowledged that the guidelines may have to be somewhat more malleable for the smaller centres, but Gosselin didn\u2019t rule out the possibility of closures if patient care is at risk.<\/p>\n<p>\u201cIt would have to be an extraordinary circumstance for that to happen, but if the audit raised awareness of something that was involved with patient safety, then there would have to be a very fast response,\u201d she said.<\/p>\n<p>While still in the early stages, Gosselin has had some preliminary discussions with <a href=\"https:\/\/accreditation.ca\/\">Accreditation Canada<\/a>, the national body that certifies hospitals throughout the country, to see how ECT can be incorporated into the hospital audit process.\u00a0 She explained that each hospital\/facility would be accredited for housing the ECT clinic.\u00a0 Receiving that certification and having accreditors conduct audits based on the standards document would be paid for by the hospital, so CANECTS wouldn\u2019t have to absorb any of the costs.\u00a0 Ultimately, the cost would be borne by the taxpayer \u2014 like nearly all other health quality and patient safety initiatives in Canadian health environments, Delva explained.<\/p>\n<p>Gosselin said that while some members of the CANECTS team are interested in acting as accreditors, there is ultimately going to be a lot more manpower needed than the team alone can provide.<\/p>\n<p>\u201cI\u2019m very committed to this process and I plan on remaining involved to see it all through,\u201d said Gosselin.<\/p>\n<p>[\/et_pb_text][\/et_pb_column][et_pb_column type=&#8221;1_4&#8243;][\/et_pb_column][\/et_pb_row][\/et_pb_section]<\/p>\n","protected":false},"excerpt":{"rendered":"<p>By the early 1980s, ECT was a widely recognized, well-established and highly effective treatment for several serious forms of mental illness, but little was known about how it was administered, where it was being delivered and what kind of patients were being treated. ECT had survived the backlash of the 1970s, but more work still [&hellip;]<\/p>\n","protected":false},"author":2,"featured_media":0,"parent":0,"menu_order":0,"comment_status":"closed","ping_status":"closed","template":"","meta":{"_et_pb_use_builder":"on","_et_pb_old_content":"","_et_gb_content_width":"","footnotes":""},"class_list":["post-348","page","type-page","status-publish","hentry"],"_links":{"self":[{"href":"https:\/\/cusjc.ca\/ect\/wp-json\/wp\/v2\/pages\/348","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/cusjc.ca\/ect\/wp-json\/wp\/v2\/pages"}],"about":[{"href":"https:\/\/cusjc.ca\/ect\/wp-json\/wp\/v2\/types\/page"}],"author":[{"embeddable":true,"href":"https:\/\/cusjc.ca\/ect\/wp-json\/wp\/v2\/users\/2"}],"replies":[{"embeddable":true,"href":"https:\/\/cusjc.ca\/ect\/wp-json\/wp\/v2\/comments?post=348"}],"version-history":[{"count":156,"href":"https:\/\/cusjc.ca\/ect\/wp-json\/wp\/v2\/pages\/348\/revisions"}],"predecessor-version":[{"id":887,"href":"https:\/\/cusjc.ca\/ect\/wp-json\/wp\/v2\/pages\/348\/revisions\/887"}],"wp:attachment":[{"href":"https:\/\/cusjc.ca\/ect\/wp-json\/wp\/v2\/media?parent=348"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}