ECT/TMS Availability — the article + the world, ranked

A fuller editorial guide to ect/tms availability is coming soon. For now, the ranking below compares every country we have assessed on it — open a country's report for the cited detail behind its score.

The country comparison

Which countries are best for ect/tms availability

The destinations ranked high→low under this lens — each with the reasoning behind its score, the cited evidence one click down, and its full report. The verdict is free; the report is the depth.

19 / 19 Countries ranked

Researched and assessed by the Epidaurus editorial pipeline against our published scale. A country below the rule is not yet assessed enough — never ranked last.

1 United Kingdom GB 4.5/5 Good The UK possesses exceptional ECT and TMS infrastructure with 105+ accredited ECT facilities, 15+ TMS clinics offering diverse technologies (rTMS, deep TMS, theta burst, SAINT), modern post-2015 equipment, multiple int... Full report
The evidence behind this score 5 cited points
- 105+ ECT facilities across UK (77 ECTAS-accredited in England, 5 Wales, 5 N. Ireland, 18 Scotland) with modern Ectonustim Series 6+ and Thymatron IV equipment
- 15+ TMS facilities including 9 Smart TMS clinics and multiple NHS providers offering rTMS, deep TMS (BrainsWay H-coil), theta burst stimulation, and SAINT protocol
- ECT administration mandatory training requirement for all UK psychiatry residents by CT3 level; likely 20+ certified practitioners
- Multiple internationally recognized accreditation systems: ECTAS (95 clinics), NICE guidance TA59/IPG542, CQC inspection and ratings
- Dedicated international patient services at Nightingale Hospital and Harley Street cluster, but report explicitly states 'no purpose-built package programmes' unlike competitor medical tourism destinations
Read the full United Kingdom report →
2 India IN 4.5/5 Good India demonstrates exceptional infrastructure for ECT/TMS services with 66+ institutions, 316+ trained psychiatrists, advanced TMS technology across multiple cities, and comprehensive medical tourism support through 5... Full report
The evidence behind this score 7 cited points
- 66 institutions offer ECT services; 316+ psychiatrists trained in ECT/TMS procedures across teaching hospitals
- Multiple TMS facilities with advanced technology including Brainsway Deep TMS system, MagVenture rTMS, and theta burst stimulation protocols
- 54 JCI-accredited hospitals with comprehensive international patient support: visa assistance, airport transfers, accommodations, multilingual staff, medical coordinators
- Geographic distribution across 7 major cities (Delhi, Mumbai, Bangalore, Hyderabad, Chennai, Kolkata, Pune) through multiple hospital chains (Max, Apollo, Fortis, Continental, Yashoda, Cadabam's)
- Fast-track appointment availability with minimal waiting times for international patients
- Post-2017 regulatory barriers: 52.4% of psychiatrists report decreased ECT patients; 59.1% cite anesthesia access/costs as major barrier; 137 of 468 hospitals had zero ECT patients despite listing services
- Regulatory framework ensures modified ECT with anesthesia (Mental Healthcare Act 2017 bans unsafe unmodified ECT) but creates bureaucratic barriers to treatment access
Read the full India report →
3 Israel IL 4.5/5 Good Israel demonstrates very strong ECT/TMS infrastructure with 6 documented ECT facilities and 10-13 TMS facilities offering multiple modalities (rTMS, Deep TMS, theta burst). With 50+ psychiatrists at Geha alone, multip... Full report
The evidence behind this score 5 cited points
- TMS infrastructure: 10-13 facilities offering multiple technologies (rTMS, Deep TMS H-coil, theta burst); 11 new BrainsWay installations in 2024; 45% reimbursement increase reflecting system investment
- Psychiatrist expertise: Geha Mental Health Center employs 50 psychiatrists; multiple specialty TMS unit heads; formal residency training through Hebrew University, Technion, Tel Aviv University, Ben-Gurion University
- JCI accreditation: Five facilities (Hadassah, Rambam, Sourasky, Sheba, Kfar Shaul) holding international accreditation and providing English-language international patient coordinator services
- Equipment standards: FDA-cleared and CE-marked devices; AMAR regulatory framework recognizes FDA and CE approvals; modern anesthesia protocols for ECT
- Geographic distribution: Services across three urban clusters (Tel Aviv metropolitan, Jerusalem, Haifa) rather than concentrated in single city; both inpatient and outpatient models available
Read the full Israel report →
4 United Arab Emirates AE 4.5/5 Good The UAE demonstrates excellent ECT/TMS infrastructure that approaches or meets Score 5 standards. It clearly exceeds Score 4 requirements with 10+ ECT facilities (Medcare's 13+ locations plus Al Amal, Al Ain, NMC, Sau... Full report
The evidence behind this score 5 cited points
- At least 10+ ECT facilities: Medcare (13+ locations), Al Amal Psychiatric Hospital (JCI-accredited), Al Ain Hospital, NMC Specialty Hospital, Saudi German Hospital
- 10+ dedicated TMS providers including German Neuroscience Center (3 locations), American Wellness Center, Emirates Hospitals/London Psychiatry Centre, OpenMinds Center (700+ cases since 2013), Novomed (across 3 emirates), AEON Clinic, Ardens Medical Center
- Multiple ABPN-certified (US) psychiatrists including at American Wellness Center; German Neuroscience Center team with 20+ years experience; Novomed and other facilities with 20+ year consultants
- Comprehensive medical tourism infrastructure: dedicated coordinators at American Wellness Center, purpose-built Dubai Healthcare City facilities, English universally available, medical visas supported
- Multiple JCI-accredited facilities: Al Amal (only specialized psychiatric hospital in Middle East with JCI accreditation) and ACPN; Federal Law No. 10 of 2023 provides modern rights-based regulatory framework; FDA-cleared and CE-certified TMS equipment confirmed across multiple providers; Ministry of Health formal endorsement of TMS as FDA-approved therapy
Read the full United Arab Emirates report →
5 Spain ES 4.5/5 Good Spain demonstrates excellent ECT/TMS infrastructure well-exceeding all Score 4 criteria (10+ modern ECT facilities accessible to medical tourists, 5+ TMS clinics with rTMS and deep TMS technologies, multiple JCI-accre... Full report
The evidence behind this score 5 cited points
- Over 20 public hospitals in Catalonia providing ECT; 84.2% of Spanish psychiatric units have ECT access with all using modern brief-pulse equipment [PubMed - 2024]
- Eight TMS facilities across major cities offering rTMS (HM CINAC, Bellvitge, Institut Guttmann, Quirónsalud) and deep TMS (Neurocavis since 2014) with FDA/CE approval; <48-hour appointments available [Clinics on Call - 2025]
- ECT training mandatory at 56.5% of centers; Bellvitge Hospital running ECT certification course since 1993 (47th edition); MIR-trained psychiatrists required for all neuromodulation [PubMed - 2015]
- Five JCI-accredited hospitals offering international services: Clínica Universidad de Navarra (110+ countries), Quirónsalud Teknon (Barcelona), Quirónsalud Madrid with dedicated multilingual coordinators and <48-hour appointment availability [CUN - 2025]
- Competitive pricing ($3,000-$6,000 for TMS versus $10,000-$15,000 in US/UK, representing up to 60% savings) with both inpatient and outpatient ECT/TMS services available in multiple cities beyond Madrid and Barcelona [Clinics on Call - 2025]
Read the full Spain report →
6 United States US 4.0/5 Good The United States maintains exceptional ECT and TMS infrastructure that substantially exceeds facility and practitioner requirements for this tier, with hundreds of ECT facilities, 600+ TMS clinics, multiple FDA-appro... Full report
The evidence behind this score 5 cited points
- Approximately 100,000 ECT patients treated annually across hundreds of hospitals in all 50 states, with both inpatient and outpatient models available
- Over 600 clinics offering Deep TMS treatment from one manufacturer alone, with seven total FDA-approved TMS device companies and multiple technology types (rTMS, Deep TMS, theta burst stimulation) available
- Comprehensive practitioner training infrastructure including APA-mandated observation requirements, multiple week-long fellowships at Duke, Emory, UPMC, Michigan, and Harvard, plus annual ISEN certification courses
- Medical tourism infrastructure is limited—explicit report statement that US 'attracts international patients primarily through reputation' unlike Thailand and India that 'actively market to cost-conscious medical tourists,' with 'most U.S. ECT/TMS providers' lacking dedicated international patient infrastructure
- FDA regulatory oversight with Class II designation for ECT (treatment-resistant depression/catatonia) and multiple FDA-cleared TMS devices, but lack of documented JCI accreditation for ECT/TMS facilities specifically
Read the full United States report →
7 Brazil BR 4.0/5 Good Brazil demonstrates strong ECT and TMS infrastructure exceeding score 4 minimums: 16 ECT institutions with modern equipment (Mecta SpECTrum 5000Q, Thymatron System IV), 4+ TMS facilities with rTMS and theta-burst prot... Full report
The evidence behind this score 5 cited points
- 16 ECT institutions documented in 2024 national survey with modern equipment (Mecta SpECTrum 5000Q, Thymatron System IV) at private sites exceeding score 4 minimum of 5-9 facilities
- 4+ dedicated TMS facilities (TMS Brasil, IPq/HCFMUSP, IPAN, Clínica Higashi) with rTMS and theta-burst SAINT protocols; 20+ TMS practitioners in São Paulo alone
- TMS Brasil explicitly targets international patients with USD 2,000 pricing (one-third US cost), English website, hotel recommendations, and travel logistics partnerships
- International accreditation at JCI-certified hospitals (Albert Einstein ranked top 30 globally since 1999; Sírio-Libanês) with multilingual staff and International Patient Centers, though ECT/TMS not marketed as specialties
- Both inpatient and outpatient services available across multiple facilities; geographic distribution to Goiânia, João Pessoa, Palmas, Brasília, and Rio de Janeiro, though concentrated in São Paulo
Read the full Brazil report →
8 Germany DE 4.0/5 Good Germany demonstrates excellent ECT infrastructure (178+ hospitals with modern CE-marked equipment, 60,000+ annual treatments) and adequate TMS availability (10-11 centers with multiple technology types) supported by w... Full report
The evidence behind this score 5 cited points
- 178 of 396 psychiatric hospitals (45%) perform ECT with 60,000 annual treatments; modern CE-marked equipment including Thymatron System IV documented in clinical use [Electroconvulsive Therapy in Germany: Development Over 8 Years - Journal of ECT - 2021]
- 10-11 hospitals offer rTMS with multiple technology types (rTMS, deep TMS via BrainsWay); confirmed centers in Berlin, Munich, Frankfurt, Hamburg [Current Clinical Practice of ECT and rTMS - PMC - 2021]
- Strong practitioner expertise: DGPPN (11,500+ members) provides highest-grade guideline endorsement; DGHP certifies rTMS practitioners through annual structured workshops with freely available English training materials [rTMS Training Materials of the DGHP - PMC - 2025]
- International patient offices at Charité Berlin, Uniklinik Düsseldorf (English/Arabic/Russian), Uniklinikum Dresden; third-party facilitators (BookingHealth, AiroMedical) provide coordinator and visa support [International Patients - Charité - 2024]
- World-class safety: 0.097% life-threatening adverse event rate per session over 3,106 treatments with zero deaths; board-certified anesthesiologists required at every ECT session [Risk Assessment of ECT - Frontiers in Psychology - 2021]
Read the full Germany report →
9 South Korea KR 4.0/5 Good South Korea demonstrates good ECT/TMS availability with multiple major university hospitals offering both treatments, exceptional TMS infrastructure (500+ facilities with modern FDA/CE-approved devices), and strong me... Full report
The evidence behind this score 6 cited points
- 500+ hospitals and clinics using Remed's ALTMS device with 90% market share domestically; device FDA-approved and CE-certified
- Multiple major university hospitals offering both ECT and TMS: Seoul National University Hospital, Samsung Medical Center, Asan Medical Center, Kyung Hee University Medical Center
- 31 JCI-accredited medical tourism providers with dedicated international patient departments and English-speaking staff
- ECT prevalence increased 240% from 0.405 to 0.974 per 10^5 inhabitants between 2008 and 2018, showing growing utilization
- Both inpatient and outpatient ECT services available; ECT guidelines established by Ministry of Health and Welfare in 2021
- Geographic concentration: 758 of 2,901 mental health facilities in Seoul; services primarily in major urban centers
Read the full South Korea report →
10 Malaysia MY 4.0/5 Good Malaysia demonstrates strong ECT infrastructure with 36 of 53 psychiatric hospitals offering services, exceeding standards for a Good destination. TMS services are available at 14-16 facilities with transparent pricin... Full report
The evidence behind this score 5 cited points
- 36 of 53 Malaysian hospitals offering ECT (67.9% coverage) with anaesthesia-supported protocols and geographic distribution across eight states
- 14-16 private facilities offering rTMS including Sunway Medical Centre (JCI Gold Seal accreditation), Gleneagles, Pantai Hospital, and Columbia Asia, with transparent pricing (RM 450 per session)
- 13 specialist neuropsychiatrists with ECT/TMS competency plus annual National Neuromodulation Course training psychiatrists nationally since 2012
- Sunway Medical Centre Velocity International Patient Centre providing language interpretation, medical visa support, appointment coordination, and airport transfers for international psychiatric patients
- Strong legal framework (Mental Health Act 2001) with explicit informed consent requirements and no nationality-based restrictions on ECT for foreign nationals
Read the full Malaysia report →
11 Singapore SG 4.0/5 Good Singapore demonstrates strong ECT/TMS clinical infrastructure with six modern ECT facilities and four TMS services, including JCI-accredited institutions and cutting-edge research programs. However, it falls short of ... Full report
The evidence behind this score 5 cited points
- Six ECT centers using modern Thymatron System IV equipment, representing 50% of psychiatric specialist centers (2015 survey)
- Four TMS facilities including IMH (MagVenture MagPro X100 since 2015), NUH with neuronavigation, and Promises Healthcare as dedicated private provider
- Multiple formally credentialed practitioners with ECT training at 5 of 6 centers; Section of Neurostimulation within College of Psychiatrists; internationally recognized experts in field leadership
- IMH JCI-accredited since 2005 (first mental health institution in Asia); formal College of Psychiatrists ECT practice guidelines established 2018
- English-language healthcare system throughout; private hospital routes (Promises, Mount Elizabeth Novena, Gleneagles) accessible to international patients; however, dedicated bundled packages explicitly limited and non-residents ineligible for Ministry of Health subsidies
Read the full Singapore report →
12 Thailand TH 4.0/5 Good Thailand demonstrates good ECT/TMS availability meeting Score 4 criteria with 34 ECT hospitals using modern equipment and 3-4 TMS facilities at major international hospitals. Extensive medical tourism infrastructure w... Full report
The evidence behind this score 5 cited points
- All 34 hospitals offering ECT services nationwide use brief pulse devices; 73.5% use modified ECT with anesthesia (thiopentone 60.7% or propofol 39.3%)
- FDA-approved TMS available at 3-4 major facilities: Vejthani (with deep TMS/H-shaped helmet coil), Bangkok Hospital Mental Health Centers, Bumrungrad, and The Dawn Rehabilitation Center
- Approximately 400 psychiatrists nationally with all 34 ECT hospitals having trained staff; comprehensive anesthesia support available at international facilities
- 62 JCI-accredited medical facilities as of July 2024; Bumrungrad was first Asian hospital with JCI accreditation (2002); Samitivej JCI-accredited since 2007
- TMS costs $2,500-4,000 (63% less than US average $9,000); psychiatry consultations $75-150; services concentrated in Bangkok and major urban centers with limited rural coverage
Read the full Thailand report →
13 Turkey TR 4.0/5 Good Turkey demonstrates robust ECT/TMS infrastructure with 14+ documented ECT facilities, multiple modern TMS centers with advanced equipment (MagVenture, NeuroStar, neuronavigated systems), and exceptional JCI accreditat... Full report
The evidence behind this score 5 cited points
- MediGlobus lists 14 clinics for Electroconvulsive Therapy in Turkey, with major hospital networks (Acibadem, Memorial, Liv, Medical Park, Moodist) providing ECT services
- NP Istanbul Brain Hospital is the first private hospital in Turkey with neuronavigated rTMS systems; Turkish clinics use modern MagVenture and NeuroStar TMS devices
- Turkey has 46-50 JCI-accredited health institutions (more than Israel's 20 or Germany's 10), with 29 in Istanbul and JCI standards ensuring state-of-the-art equipment and safety protocols
- Hospitals across Istanbul, Ankara, and Antalya operate dedicated international patient departments with translation in English, Arabic, Russian, German, and French, plus visa support, airport transfers, and concierge care
- ECT is mandated to be performed with anesthesia since 2006 as a regulatory requirement, and services include both inpatient and outpatient treatment models
Read the full Turkey report →
14 Colombia CO 3.5/5 Moderate Colombia demonstrates a moderately-developed ECT/TMS infrastructure with 8-9 ECT facilities and 5 TMS providers across 6+ cities, supported by a 19-member ACP specialist subcommittee and documented use of modern equip... Full report
The evidence behind this score 5 cited points
- 8-9 ECT facilities identified across Medellín, Bogotá, Bucaramanga, Manizales, Pereira; 19-member ACP ECT/TMS subcommittee (Subcomité TEC y Neuromodulación - ACP - 2024)
- 5 TMS providers confirmed: EMT Neurociencias (Medellín), Estimulación Magnética Bogotá, CETNI (Medellín), EMT Colombia (Bucaramanga), FCV (Bucaramanga) with INVIMA/FDA approvals (Estimulación Magnética Bogotá - 2024)
- Modern ECT equipment: Thymatron System IV at Clínica La Sabana (1,322 sessions 2009–2017 with 3.8% complication rate); HOMO acquired new TECAR equipment (Hospital Mental de Antioquia - 2023)
- Geographic distribution across 6+ cities with university-affiliated and public psychiatric institutions; published peer-reviewed clinical series in Revista Colombiana de Psiquiatría demonstrating established programs (Characteristics of 276 ECT Patients - PubMed - 2015)
- Zero ECT/TMS facilities hold JCI accreditation; no comprehensive ECT international programs identified; TMS clinics offer some English support but geographic concentration in Medellín/Bogotá; only conventional rTMS available, no deep TMS or theta burst (Clinical Practice Guideline Project - Universidad de La Sabana - 2024)
Read the full Colombia report →
15 Japan JP 3.5/5 Moderate Japan has a robust domestic ECT/TMS infrastructure—54 JSGHP-certified ECT facilities and 64 institutions offering rTMS with modern PMDA-approved equipment, comprehensive regulatory oversight, and strong clinical outco... Full report
The evidence behind this score 5 cited points
- 54 JSGHP-certified ECT facilities with PMDA-approved Thymatron brief-pulse devices as of March 2023; Yokohama City University Medical Center alone conducted 164 m-ECT procedures in FY2024
- 64 institutions offering insurance-covered NeuroStar rTMS as of 2024; private clinics offer theta burst and deep TMS on self-pay basis
- Mandatory JSGHP training for ECT practitioners; JSPN/Teijin Pharma joint training required for TMS operators; multidisciplinary team approval required before ECT
- Japan lacks dedicated ECT/TMS medical tourism programs; English-speaking psychiatric specialists are scarce; services described as one of the most underserved areas of international healthcare
- International patients face insurance eligibility barriers and predominantly inpatient ECT model (85%); out-of-pocket costs not publicly disclosed
Read the full Japan report →
16 Poland PL 3.5/5 Moderate Poland presents a bifurcated profile: ECT services are adequate on paper (19 facilities with modern equipment) but severely constrained in practice (62% of volume at 4 centers, inpatient-only, public system only, no i... Full report
The evidence behind this score 5 cited points
- 19 ECT facilities using modern Thymatron IV (68.7%) and MECTA Spectrum 5000Q (31.2%) equipment; however, four centers in central Poland account for 62.3% of annual ECT volume, effectively concentrating services in Warsaw and 2–3 other cities
- 6–8+ dedicated TMS clinics across Poland including Warsaw (Magwise Medical Center, TMS Clinic), Łódź (MedArt), Wrocław (NEUROMED), and Poznań; MindHealth operates 9 locations; multiple technology types available (rTMS, iTBS, SAINT, Neurolith TPS)
- Approximately 50 psychiatrists certified in ECT procedures (1.2% of 4,274 total psychiatric specialists); TMS practitioners hold UEMS/EACCME® recognized clinical certifications; Magwise reports 1,000+ patient treatments
- Magwise Medical Center and MedArt Centrum Psychiatrii explicitly market to European patients, price services in euros, maintain English websites, and report short TMS waiting times (1–2 weeks); no structured ECT packages for international patients
- Institute of Psychiatry and Neurology holds ISO 9001:2015 and WHO Collaborating Centre status; no Polish psychiatric facility holds JCI accreditation; Polish Psychiatric Association published rTMS safety standards (2022) but no comprehensive ECT national guidelines exist as of 2025
Read the full Poland report →
17 Hungary HU 2.5/5 Moderate Hungary possesses basic ECT and TMS infrastructure — Semmelweis University operates a Thymatron-System IV device and 3–4 private clinics offer rTMS — but lacks the international patient infrastructure required for med... Full report
The evidence behind this score 6 cited points
- Only 3 of ~22 ECT centers sustained services through all 4 COVID-19 pandemic waves; 47% suspended entirely, indicating severe structural fragility
- 3–4 private rTMS clinics exist in Budapest but operate exclusively in Hungarian with no documented English-language support or international patient coordination
- No medical tourism packages or dedicated international patient programs documented at any ECT or rTMS facility
- No Hungarian psychiatric hospital holds JCI or equivalent international accreditation; only EU regulatory (CE marking) compliance confirmed
- Anesthesiologist shortages explicitly identified as a major barrier to ECT delivery; inpatient ECT only (no outpatient model)
- Semmelweis University operates modern Thymatron-System IV device and conducts active research (theta-burst rTMS trial for treatment-resistant depression)
Read the full Hungary report →
18 Jordan JO 2.5/5 Moderate Jordan has documented but limited ECT infrastructure (2–4 facilities, with Arab Medical Center and Jordan University Hospital actively serving international patients) and meaningful JCI accreditation at two sites, pla... Full report
The evidence behind this score 5 cited points
- ECT available at 2–4 facilities (Arab Medical Center JCI-accredited with international patient coordination; Jordan University Hospital JCI-accredited teaching hospital; National Centre for Mental Health and Al-Rashid unconfirmed)
- No TMS/rTMS/deep TMS services documented; 2025 regional review confirms absent clinical rTMS infrastructure across entire Levant region
- 87–108 licensed psychiatrists in country; ECT referenced only as last-resort option in 2025 practice survey; no documented national ECT credentialing system
- Arab Medical Center explicitly markets ECT to internationals with bilingual staff and coordination; no bundled ECT packages at any facility
- JFDA regulatory pathway permits modern FDA/CE-cleared equipment; JCI accreditation at two facilities; but equipment transparency and NCMH condition concerns noted
Read the full Jordan report →
19 Mexico MX 2.5/5 Moderate Mexico presents a bifurcated landscape: TMS services are well-developed with 5 documented private facilities offering modern, FDA/COFEPRIS-approved equipment, exceeding the Score 3 threshold. However, ECT infrastructu... Full report
The evidence behind this score 5 cited points
- 5 identified TMS facilities with modern equipment (Grupo Punto de Partida, NeuroSpa, BrainStim, ABC Medical Center, National Institute of Psychiatry), exceeding Score 3 minimum
- ECT facilities documented but with critical concerns: hospitals lacking running water, basic sanitation, and documented ethical misuse for behavioral control
- Only 2.8 psychiatrists per 100,000 inhabitants with 41% concentrated in Mexico City—severe practitioner shortage
- No documented medical tourism integration, package programs, or international patient coordinators for psychiatric neuromodulation services
- TMS equipment approved by both COFEPRIS and FDA, demonstrating regulatory compliance and modern standards
Read the full Mexico report →

See the full ranking, the 1–5 rubric and the reports →