Today's post is meant as a shout-out to our colleagues in Italy, during the terrible pandemic which has caused such suffering there.
This new  article from JECT articulately and comprehensively describes the state of ECT in Italy:

Electroconvulsive Therapy in Italy-Current Dissemination of Treatment and Determining Factors of the Past
J ECT 2020 Mar 20[Online ahead of print] PMID: 32205733

The pdf is here.

This article presents a survey of ECT practice in Italy in 2017, comparing it to 2009. Only 9/145 mental health facilities offered ECT in 2017 (5 public, 4 private), down from 14 in 2009. Only 293 patients were treated in Italy in one year, this out of a population of 60 million. There was no outpatient ECT at all. 
The historical context of the reasons for the near-absence of ECT in Italy are well presented here.
Some hope is offered that the Italian Association for Somatic Therapy in Psychiatry (started in 2013) can help promote appropriate use of ECT in the future.

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