{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,5,13]],"date-time":"2025-05-13T21:59:48Z","timestamp":1747173588414,"version":"3.40.5"},"reference-count":48,"publisher":"Cambridge University Press (CUP)","issue":"2","license":[{"start":{"date-parts":[[2021,12,13]],"date-time":"2021-12-13T00:00:00Z","timestamp":1639353600000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/www.cambridge.org\/core\/terms"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["CNS Spectr."],"published-print":{"date-parts":[[2023,4]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec id=\"S1092852921001061_sec1\"><jats:title>Background<\/jats:title><jats:p>To examine socioeconomic disparities in use of electroconvulsive therapy (ECT) among homeless or unstably housed (HUH) veterans with mental illness.<\/jats:p><\/jats:sec><jats:sec id=\"S1092852921001061_sec2\" sec-type=\"methods\"><jats:title>Methods<\/jats:title><jats:p>National data from medical records in years 2000 to 2019 on 4 to 6\u00a0million veterans with mental illness, including 140\u00a0000 to 370\u00a0000 homeless veterans served annually from the U.S. Department of Veterans Affairs (VA) healthcare system, were analyzed to examine ECT utilization and changes in utilization over time.<\/jats:p><\/jats:sec><jats:sec id=\"S1092852921001061_sec3\" sec-type=\"results\"><jats:title>Results<\/jats:title><jats:p>ECT utilization was higher among HUH veterans (58\u2013104 per 1000) than domiciled veterans with mental illness (9\u201315 per 1000) across years with a trend toward increasing use of ECT use among HUH veterans over time. Among HUH and domiciled veterans who received ECT, veterans received an average of 5 to 9 sessions of ECT. There were great regional differences in rates of ECT utilization among HUH and domiciled veterans with the highest overall rates of ECT use at VA facilities in the Northeast and Northwest regions of the country.<\/jats:p><\/jats:sec><jats:sec id=\"S1092852921001061_sec4\" sec-type=\"discussion\"><jats:title>Discussion<\/jats:title><jats:p>ECT is commonly and safely used in HUH veterans in a comprehensive healthcare system, but geographic and local factors may impede access to ECT for veterans who may benefit from this treatment. Efforts should be made to reduce barriers to ECT in the HUH population.<\/jats:p><\/jats:sec>","DOI":"10.1017\/s1092852921001061","type":"journal-article","created":{"date-parts":[[2021,12,13]],"date-time":"2021-12-13T10:56:05Z","timestamp":1639392965000},"page":"183-189","source":"Crossref","is-referenced-by-count":1,"title":["Twenty-year trends in use of electroconvulsive therapy among homeless and domiciled veterans with mental illness"],"prefix":"10.1017","volume":"28","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-0329-648X","authenticated-orcid":false,"given":"Jack","family":"Tsai","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Dorota","family":"Szymkowiak","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Samuel T.","family":"Wilkinson","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Paul E.","family":"Holtzheimer","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"56","published-online":{"date-parts":[[2021,12,13]]},"reference":[{"key":"S1092852921001061_r34","doi-asserted-by":"publisher","DOI":"10.1080\/10530789.2020.1753914"},{"key":"S1092852921001061_r3","doi-asserted-by":"publisher","DOI":"10.1002\/brb3.37"},{"key":"S1092852921001061_r36","unstructured":"36. National Institute for Health and Care Excellence. Guidance on the use of electroconvulsive therapy. https:\/\/www.nice.org.uk\/guidance\/ta59\/chapter\/3-the-technology. Updated October 1, 2009. Accessed April 7, 2021."},{"key":"S1092852921001061_r2","doi-asserted-by":"publisher","DOI":"10.1016\/S0010-440X(99)90000-7"},{"key":"S1092852921001061_r39","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajem.2021.02.038"},{"key":"S1092852921001061_r33","doi-asserted-by":"publisher","DOI":"10.1016\/j.amepre.2020.12.012"},{"key":"S1092852921001061_r38","doi-asserted-by":"publisher","DOI":"10.1177\/2150131914560610"},{"key":"S1092852921001061_r42","unstructured":"42. Wilkinson, ST , Rhee, TG , Tsai, J. Utilization of electroconvulsive therapy for older homelessness adults covered by Medicare. J. ECT. 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United States Department of Veterans Affairs. Secretary Shinseki details plans to end homelessness for veterans. http:\/\/www.va.gov\/opa\/pressrel\/pressrelease.cfm?id=1807. Updated November 3, 2009. 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