Electroconvulsive therapy (ECT) is used in modern psychiatry worldwide, but is not fully understood by the general public, practitioners and researchers. Controversy continues to surround its application, the long-term consequences of its use and its legality in the management of the most serious mental illnesses, such as major depression, bipolar disorder and schizophrenia.

After describing the historical roots of ECT, the author provides a description of the main factors that divide opinion on its use today. This appreciation of the different perspectives, and comparison between attitudes in New South Wales, Australia, and in the UK, can inform the debate about this treatment.