This demand and supply gap is exploited by the unregulated private health sector, notorious for its use of 'unmodified' ECT (ECT conducted without the use of adequate anesthesia or muscle relaxants, which can cause fractures, tongue bites, and an enormous amount of mental and physical anguish ). It is estimated that private sector accounts for some 70 % of national expenditure on the provision of health services. The Governmental budgetary allocation on health sector is less than 1 % of GNP mental health allocations are negligible. Among these, 943 beds are allocated in three large custodial centers in the country. There are 2,154 beds available in the Government mental health sector. Proper mental health care is provided by only a few hospitals. In a recent World Health Organization (WHO) information facts sheet it was estimated to be 0.2/100,000. The psychiatrist to population ratio is dismally low in Pakistan. Along with an inadequate post-graduate training in psychiatry, in some developing countries like Pakistan, it is responsible for the widespread unacceptability of this treatment form among patients. Since then it has been subjected to controversy and antipathy by the media and general public alike. Given the widespread applicability of ECT there is a dire need to dispel these misconceptions and improve its acceptability.Įlectroconvulsive therapy (ECT) was introduced in its current form by Cerletti and Bini in 1938. We also saw the prevalence of a variety of myths regarding ECT in our society, which we feel may be responsible for the patients' adverse attitudes. The media seemed to be the major source of information for our patients. This may be the result of an inadequate postgraduate training in Pakistan or just a lack of concern about the mentally ill patients. We identified a serious lack of dissemination of information regarding ECT by the psychiatrists and the mental health care providers. Patients' willingness to receive ECT was dependant on whether or not they were convinced of its safety (p = 0.001) and efficacy (p = 0.0001). Thirty-nine percent thought that ECT could lead to severe mental and physical illness and 37% considered it inhumane. The most popular belief about ECT was that it was a treatment of last resort (56%). Physical injuries (42%) and neurological (12%) and cognitive disturbances (11%) were the commonly feared side effects. The most common source of awareness was electronic and print media (38%), followed by relatives (24%) and doctors (23%). The study showed that the level of education had a significant impact on the awareness of ECT (p = 0.009). We interviewed 190 patients of which 140 were aware of ECT. This was a questionnaire based cross-sectional study carried out at 2 tertiary care hospitals in Karachi, Pakistan. Given this situation we aimed to assess the awareness and perceptions regarding ECT as a treatment modality among the psychiatric patients. Electroconvulsive therapy (ECT) is shown to be effective in many psychiatric illnesses, but its distorted projection by the Pakistani media and its unregulated use by many physicians across the country have adversely affected its acceptability.