They have been widely prescribed since their introduction in the United States in 1988. Psychiatrists consider ECT to be one of the most effective treatments for major depression and some other types of severe mental illness. Unlike antidepressant medications, which can take weeks to show an effect, ECT often begins to work within a few days, although subsequent treatments are often necessary. A combined approach A combination of psychotherapy and medication may be recommended. Studies indicate that treating chronically depressed people with an antidepressant and psychotherapy can be more effective for some than either medication or counseling alone.
Most therapy occurs in a clinic, office or other outpatient setting.
In some circumstances people receive care in hospitals or residential settings. A person may be admitted to a psychiatric unit of a general hospital, a private psychiatric hospital, state or federal psychiatric hospital, or a Veterans Administration hospital. Admission may occur after treatment in an emergency room for a drug overdose or suicide attempt, or it may be arranged in advance for conditions such as severe depression or psychosis, or conditions in which a person needs medical treatment as well as therapy. People who are hospitalized work with a team that usually includes psychiatrists, social workers, nurses, recreational therapists, vocational therapists and counselors specializing in areas such as addictions. When those hospitalized improve, they may be released directly to their home or enrolled temporarily in a program that provides day and evening treatment for those stable enough to stay overnight outside the hospital.