My pdoc suggested it during one of my more prolonged hospitalizations for very severe depression and suicidality. He does them himself, so in that way it wasn't too difficult; I didn't have to go see a different psychiatrist anyway. You would first have to find a pdoc who does ECT. Different pdocs have different protocols for doing ECT. Mine wants his patients to be inpatient through the first two treatments to monitor for any problems with anesthesia, severe headaches, severe disorientation, etc. Once through the first two treatments, if all is going well, the rest are done outpatient.