Electroconvulsive therapy (ECT) is one of the most effective and life-saving treatments for severe depression, catatonia, and other treatment-resistant psychiatric conditions. While historically misunderstood, modern ECT is safe, evidence-based, and recommended by all major psychiatric organizations.
In February 2025, the American Academy of Child and Adolescent Psychiatry (AACAP) released a landmark Policy Statement on ECT, reaffirming that adolescents who meet clinical criteria should have access to ECT when medically indicated. This represents a major step forward for youth mental health care nationwide and emphasizes that outdated restrictions should not stand in the way of life-saving treatment.
However, Texas remains one of the most restrictive states in the country regarding ECT for minors. This creates significant obstacles to applying AACAP’s new policy locally.
AACAP’s Key Recommendations
AACAP’s statement highlights three central principles:
Individual clinical assessment—not stigma or legislation—should determine eligibility.
AACAP explicitly opposes legal or legislative restrictions that prevent clinicians from using ECT when it is safe and appropriate.
AACAP calls for ongoing scientific studies on ECT in adolescents, emphasizing safety, outcomes, and long-term follow-up.
These recommendations reflect modern psychiatric practice and a strong evidence base demonstrating that ECT can be life-saving for adolescents with severe, treatment-resistant illness.
Why Applying AACAP’s Recommendations Is Especially Challenging in Texas
Despite clear national guidance, Texas law makes it extremely difficult—sometimes impossible—to provide ECT to minors who may urgently need it.
Regardless of:
Texas statute outright bans ECT for anyone younger than 16.
This conflicts directly with AACAP’s stance that access should be determined by medical judgment, not legislation.
Texas restrictions are written into state law, meaning:
cannot override the prohibition.
Reform requires legislative action—a process slow to change and often shaped by stigma rather than science.
Texas ECT laws were created decades ago and reflect:
These misconceptions continue to block evidence-based care for adolescents today.
Unlike other states, Texas does not allow:
Even life-threatening catatonia or suicidality cannot overcome the statutory ban.
When ECT cannot be used—even when it is the safest, fastest, or only effective treatment—patients may experience:
This stands in sharp contrast to AACAP’s emphasis on timely access to effective treatment.
Parents who want the best treatment for their child often feel helpless.
Clinicians must watch patients deteriorate despite knowing that a safe, effective treatment exists—but is prohibited by law.
Some families explore out-of-state care, but this is financially and logistically impossible for most.
Moving Forward
AACAP’s policy marks a critical step in recognizing ECT as an essential component of adolescent mental health care. But in Texas, meaningful implementation will require:
As one of the nation’s leading programs in interventional psychiatry—and one of the busiest ECT centers—UTHealth Houston is committed to advancing this dialogue and promoting access to safe, effective care for all patients who need it.
Contact
Request for Second Opinion Form: https://Go.uth.edu/CIPIntake
Phone: (713) 486-2621
Fax: (713) 500-2728
E-mail: [email protected]
Disclaimer
This article was created with the assistance of artificial intelligence (AI) to enhance clarity and readability. All medical content has been reviewed and approved by Joao L. de Quevedo, MD, PhD, Director, UTHealth Houston Center for Interventional Psychiatry. This information is provided for educational purposes only and is not a substitute for professional medical advice.