ABSTRACT In recent years, legislators in many states have proposed laws governing the use of psychiatric electroceutical interventions (PEIs), which use electrical or magnetic stimulation to

treat mental disorders. To examine how the PEI views of relevant stakeholder groups (e.g., psychiatrists, patients, caregivers, and general public) relate to preferences for proposed

policies governing PEI use, we analyze data from a survey on using one of four PEIs to treat major depressive disorder administered to national samples of the stakeholder groups above. We

find that the three non-clinician groups’ similar PEI policy preferences differ significantly from those of psychiatrists—with the greatest divide on policies governing the use of

VIEWED BY OTHERS THE INFLUENCE OF PRIOR AWARENESS ON VIEWS ABOUT PSYCHIATRIC ELECTROCEUTICAL INTERVENTIONS AMONG NON-CLINICIAN STAKEHOLDERS Article Open access 03 May 2023 ETHICAL

CONSIDERATIONS IN RAPID AND NOVEL TREATMENTS IN PSYCHIATRY Article Open access 30 June 2023 A RAPID NARRATIVE REVIEW OF THE CLINICAL EVOLUTION OF PSYCHEDELIC TREATMENT IN CLINICAL TRIALS

Article Open access 02 July 2024 INTRODUCTION Psychiatric electroceutical interventions (PEIs) treat psychiatric disorders using electrical or magnetic stimulation to alter brain activity.

PEIs include both Food and Drug Administration (FDA) approved modalities, such as electroconvulsive therapy (ECT) and repetitive transcranial magnetic stimulation (rTMS), and also

interventions that remain largely experimental for psychiatric conditions, such as deep brain stimulation (DBS) and adaptive brain implants (ABIs). These interventions are notable for their

potential to treat major depressive disorder (MDD). Although the recommended front-line treatments for MDD are psychotherapy and antidepressant medications, only 70% of patients achieve

remission after treatment with four antidepressants1. Evidence demonstrates that ECT and rTMS are effective for patients with treatment-resistant depression (TRD)2,3. However, widespread

adoption of these therapies is constrained by practical barriers affecting their availability4,5, negative public perceptions of ECT6,7, and state regulations restricting the use of ECT

(e.g., specifying rules about patients’ informed consent and age, providers’ professional qualifications and required reporting, etc.)8. Over the last five years, legislators in a number of

states have proposed laws governing the use of PEIs. Most proposed policies aim to reduce rather than expand the use of ECT. They range from age-based restrictions9,10,11,12,13 to outright

bans14. At the same time, proposed legislation in at least one state supports greater access to ECT15, and bills in a few other states aim to increase the availability of rTMS16,17,18. While

many studies analyze how relevant stakeholder groups (e.g., psychiatrists, patients, caregivers, and the general public more broadly) view PEIs, we are unaware of any that examine how such

views relate to support for or opposition to existing laws or proposed policies governing their use. This gap in the literature is consequential for three reasons. At the most basic level,

better understanding how various interested parties’ knowledge and values influence their policy preferences is a fundamental aspect of effective, responsible, and evidence-based

policymaking19. Second, different stakeholders bring expertise, insights, and valuable knowledge from their respective domains that could help improve the design and implementation of public

health policies. Third, characterizing stakeholders’ policy preferences can help scholars and policy analysts more accurately estimate the likely effectiveness (and identify potential

unintended consequences) of such health policies. Policies with broad-based support from a range of stakeholders are more likely to be implemented effectively and produce their intended

outcomes than are those facing substantial opposition or confusion from at least one relevant stakeholder group. Our study aims to fill this gap while also contributing to the wider

literature on different stakeholders’ views of PEIs. Recent research finds that important views about PEIs vary by stakeholder group (i.e., psychiatrists, patients, caregivers, and the

general public), PEI modality (i.e., ECT, rTMS, DBS, and ABIs), and depression severity (i.e., moderate or severe).7 Further, there is some evidence that PEI modality moderates the influence

of stakeholder group membership on key PEI views. We extend this recent work by examining how such factors—as well as key PEI views themselves—influence preferences on proposed state

policies that either expand or reduce availability and use of PEIs for treating depression. METHODS STUDY DESIGN We administered a standardized survey with an embedded video vignette

experiment to four large US samples of the general public, caregivers, depressed patients, and board-certified psychiatrists, respectively. After securing a human subjects exemption from

Michigan State University’s Institutional Review Board (STUDY00001247), we contracted with Qualtrics (an online survey platform and online panel provider) to host the survey, which was

completed by participants between April and June 2020. We employed a between-subjects 4 × 2 full factorial design for our embedded experiment. Crossing the two factors—intervention type (DBS

vs. rTMS vs. ECT vs. ABIs) and disease severity (moderate vs. severe depression)—produced eight total conditions into which participants were randomly assigned. All participants received

the same set of core questions, in addition to a few different questions unique to each stakeholder group. PARTICIPANTS To draw our three non-clinician samples, we contracted with Qualtrics,

which manages a large internet panel (i.e., sampling frame) designed to capture the demographic diversity of the US adult population. For our general public stakeholder group, Qualtrics

drew a quota sample of 1022 adults from this sampling frame that matched adult population estimates of age, sex, race, and income from the US Current Population Survey. For our caregiver

stakeholder group, Qualtrics applied a screening question in addition to the population estimate matching to select 1026 adults who were currently serving as the primary caregiver for

someone with depression. For our patient stakeholder group, Qualtrics drew a quota sample of 1050 adults with depression from a separate internet panel of adults who had previously reported

having a depression diagnosis. Our patient sample matched age, sex, and race estimates of the US adult population living with depression in 202020. Our research team managed the recruitment

and sampling of our psychiatrist stakeholder group. Our sampling frame contained the 49,431 board-certified psychiatrists listed in the American Board of Psychiatry and Neurology directory

in late 2019. We used stratified random sampling—stratifying by state—to contact 16,190 US psychiatrists across all 50 states. Employing the Tailored Design Method21, widely considered as

best practice in survey research, we contacted this group multiple times via postal mail and email—achieving a sample of 505 US psychiatrists who fully completed our survey. Supplementary

Table 1 displays key social and demographic characteristics for each of our four samples in this study. PROCEDURES After providing informed consent, participants answered a few initial

questions and viewed a randomly assigned video vignette22,23. We carefully crafted and filmed the video vignette—featuring professional actors playing a patient named “Mary” with (moderate

or severe) treatment-resistant depression (TRD) symptoms receiving information about a PEI from her psychiatrist named “Dr. Wilson”24,25. Supplementary Table 2 contains links to each of the

eight video vignettes. After completing a few questions assessing their understanding of the experimental message26, participants then answered several questions measuring their views about

the intervention featured in their video as well as their demographic, social, and political characteristics. VARIABLES The research team created several novel instruments to measure key PEI

views through a multi-stage process involving insights from and revisions after: (a) a review of the relevant literature; (b) 48 semi-structured interviews with psychiatrists, patients, and

members of the general public27,28; (c) four rounds of pilot testing; (d) feedback from our Scientific Advisory Board comprised of scholars with expertise in psychiatry, neuroethics, and

ethics; and (e) a round of (talk-aloud) cognitive testing with two patients and a psychiatrist. This process—with the results of a principal components analysis and a reliability

analysis—informed our creation of eight composite scales. Within each of these instruments, we randomized the item order to eliminate question order effects.21 Supplementary Table 3 displays

the survey question wording and response category coding for each of the scales we used in this study. OUTCOME VARIABLES Our two outcome variables are composite scales that measure

participants’ preferences on six proposed state-level policies that either would expand or restrict PEI access and use for treating clinical depression. For ease of interpretation, we coded

both scales so that lower values represent more negative sentiment toward PEI access and use and higher values represent more positive sentiment toward PEI access and use. The 3-item

_Support for Expanded PEI Use Scale_ (Cronbach’s α = 0.74), ranging from “strongly oppose” = 1 to “strongly support” = 7, measures participants’ views toward using state tax revenue to fund

more research on their assigned PEI, to help pay the costs of the assigned PEI for indigent patients, and for requiring access to the assigned PEI in at least one medical facility in each

county in the state. The 3-item _Opposition to Reduced PEI Use Scale_ (Cronbach’s α = 0.65), ranging from “strongly support” = 1 to “strongly oppose” = 7, measures participants’ views toward

prohibiting the use of the assigned PEI until there is more evidence of its safety and efficacy, prohibiting the use of the assigned PEI with minors, and banning the use of the assigned PEI

outright. STAKEHOLDER GROUP AND EXPERIMENTAL VARIABLES We modeled the main effects of stakeholder group membership (i.e., psychiatrists, patients, caregivers, and members of the public) and

the experimental factors (i.e., PEI modality and depression severity) with dummy variables. For the former, we used three dummy variables of _public_, _caregivers_, and _patients_, with

psychiatrists as the reference category. For PEI modality, we used three dummy variables of _rTMS_, _DBS_, and _ABI_, with ECT as the reference category. _Severe TRD_ distinguishes those

participants in the severe depression category from those in the moderate depression category. COVARIATES We employed five composite scales to measure important beliefs and attitudes that

participants have about their assigned PEI. These include: * a 8-item _General Affect Scale_ (Cronbach’s α = 0.93), ranging from “negative” (1) to “positive” (7); * a 7-item _Perceived

Influence on Self Scale_ (Cronbach’s α = 0.94), ranging from “strong negative influence” (1) to “strong positive influence” (7); * a 6-item _Perceived Benefits Scale_ (Cronbach’s α = 0.87),

ranging from “no benefit at all” (1) to “great benefit” (6); * a 5-item _Perceived Riskiness Scale_ (Cronbach’s α = 0.87), ranging from “no risk at all” (1) to “great risk” (5); and * a

6-item _Perceived Invasiveness Scale_ (Cronbach’s α = 0.90), ranging from “not interfere at all” (1) to “greatly interfere” (6). We also measured participants’ perception of how bad it would

be to live with TRD every day with a single-item (_bad daily life with TRD_) ranging from “moderately bad” (1) to “extremely bad” (10). As noted earlier, we asked each stakeholder group a

few additional questions beyond those posed to every participant. Non-clinicians reported their prior awareness of a range of psychiatric interventions. The dichotomous _prior PEI awareness_

indicates whether or not (“no” = 0; “yes” = 1) non-clinicians were aware of their assigned PEI prior to the survey. Non-clinicians also reported their level of distrust or trust in mental

health information provided by a range of sources. A 5-item _Trust in Medico-Scientific Establishment Scale_ (Cronbach’s α = 0.81), ranging from “strongly distrust” = 1 to “strongly trust” =

 7, measures the extent to which participants trust their primary care physician, psychiatrists, the scientific community, the U.S. Centers for Disease Control and Prevention (CDC), and the

U.S. Food and Drug Administration (FDA). Psychiatrists reported their experience referring or administering to patients either ECT, rTMS, DBS, or vagus nerve stimulation (VNS). The

dichotomous _PEI referral or administration_ indicates whether or not (“no” = 0, “yes” = 1) a psychiatrist had referred or administered to patients either for treatment or in clinical trials

any of the following PEIs: ECT, rTMS, DBS, or VNS. DEMOGRAPHIC, SOCIAL, AND POLITICAL CHARACTERISTICS Finally, we measured six demographic, social, and political characteristics that we

employed as controls in our statistical analyses. We measured sex (“male” = 0; “_female_” = 1) and race (“non-white” = 0; “_white_” = 1) with dummy variables. _Age_ varied from “18–24” (1)

to “65 or over” (6), and _educational attainment_ varied from “high school diploma or GED” (1) to “graduate degree” (4). We measured _political ideology_ along a unidimensional scale from

“very conservative” (1) to “very liberal” (7), and we measured _religiosity_ as the frequency of religious service attendance, ranging from “never” (1) to “at least once every week” (6).

ANALYTICAL TECHNIQUES We managed the survey data and conducted three stages of analyses using IBM SPSS 24.0-28.0. First, we performed a series of one-way ANOVA tests to examine the

differences in means on our six policy preference items across stakeholder groups and assigned PEI modality. Second, we ran a series of multiple ordinary least squares (OLS) regression

models on data from our pooled sample to examine variation in our two PEI policy preferences scales by stakeholder group, PEI modality, and depression severity, while accounting for

participants’ PEI views and their demographic, social, and political characteristics. We included in these multiple OLS regression models interaction terms to examine whether the influence

of stakeholder group membership on PEI policy preferences is statistically moderated by PEI modality or depression severity. To reduce the likelihood of multicollinearity problems associated

with using higher-order (e.g., interaction) terms in regression models, we created our interaction terms using centered scores (mean – value)29. Supplementary Table 4 contains a set of

nested models for each PEI policy preference scale. The page after Supplementary Table 4 offers a brief summary of the results of these models. Also, given the increasing scholarly interest

in investigating how views of and experiences with PEIs vary across racial groups, Supplementary Table 7 presents the results of one-way ANOVAs examining how values on each of the five PEI

views scales and two PEI policy preferences scales vary by race. Third, given the patterns found in the first two stages of analyses, we ran separate sets of multiple OLS regression models

containing the experimental, covariate, and control variables for non-clinicians and psychiatrists, respectively—allowing us to examine the effects of group-specific variables. Supplementary

Tables 5 and 6 contain a set of nested models for each outcome variable for non-clinicians and psychiatrists, respectively. In each, the _base model_ contains four experimental condition

dummy variables; participants’ perception of daily life with TRD; and five demographic, social, and political characteristics as controls. The base model in Supplementary Table 5 also

includes two stakeholder dummy variables and educational attainment. The _PEI views model_ in each table adds five PEI views scales to the base model. The _full model_ in Supplementary Table

5 adds the Trust in Medico-Scientific Establishment Scale and participants’ prior awareness of their assigned PEI to the PEI views model. The _full model_ in Supplementary Table 6 adds the

psychiatrists’ prior experience referring or administering any PEI. RESULTS DESCRIPTIVE RESULTS Approximately 45.5% of all respondents supported (but 36.1% opposed) a proposed policy

authorizing state tax revenue be used to cover the costs of administering their assigned PEI to indigent patients with depression. Around 47.2% of respondents supported (but 32.4% opposed) a

proposed policy directing state tax revenue to fund more research on using their assigned PEI for treating depression. Roughly 38.6% supported (but 44.6% opposed) a proposed policy

requiring each county to have at least one medical facility that offers their assigned PEI for treating depression. Further, approximately 37.4% of all respondents opposed (but 45.5%

supported) a proposed policy prohibiting the use of their assigned PEI for treating depression until we have more evidence of its safety and efficacy. Around 37.1% of respondents opposed

(but 49.5% supported) a proposed policy prohibiting the use of their assigned PEI for treating depressing in legal minors. Finally, roughly 69.1% opposed (but 23.6% supported) a proposed

policy banning all use of their assigned PEI for treating depression. Yet, these aggregate percentages conceal substantial variation by stakeholder group and PEI modality. Figures 1 and 2

below display, by PEI modality, the percentages of each stakeholder group that supported three potential policies to expand PEI use and that opposed three potential policies to restrict PEI

use, respectively. Four robust patterns in these two figures are noteworthy. First, across each PEI modality, the three non-clinician stakeholder groups reported similar PEI policy

preferences. Further, the similarity in preferences was greater for their levels of opposition to access-reducing policies than for their levels of support for access-expanding policies.

Second, when considering PEI modality, we see the greatest divide between the policy preferences of psychiatrists and non-clinicians with ECT than with the other modalities. Third, the

divide between the policy preferences of psychiatrists and non-clinicians was greater with opposition to access-reducing policies than with support for access-expanding policies. Fourth,

there are only three instances where psychiatrists’ policy preferences were less favorable toward PEIs than were those of any non-clinician group. Compared to patients and caregivers,

psychiatrists reported lesser support for a policy requiring each county to have at least one medical facility that offers rTMS, DBS, or ABIs. RESULTS OF OLS REGRESSION MODELS Table 1 below

displays the full models for both policy preferences scales for non-clinicians and psychiatrists. We first discuss the results for non-clinicians before discussing the results for

psychiatrists. The variables in the non-clinicians’ full models explain between 20% and 33% of the variation in these policy preferences scales, and the variables in the psychiatrists’ full

models explain between 38% and 46% of the variation in these same scales. Compared to the general public, caregivers and patients reported greater support for expanded use—and patients

reported less opposition to reduced use—of their assigned PEI. Non-clinicians’ PEI-related policy preferences do not vary across PEI modality or TRD severity experimental conditions. Their

perceived badness of daily life with TRD is positively associated with support for expanded PEI use but is unrelated to opposition to reduced PEI use. Non-clinicians views of their assigned

PEIs accounted for nearly all of the explained variance in the Support for Expanded PEI Use Scale (81%) and the Opposition to Reduced PEI Use Scale (95%). Generally, more favorable views of

their assigned PEI resulted in more favorable PEI-related policy preferences. While greater trust in the medico-scientific establishment is associated with stronger support for expanded PEI

use, it nevertheless has a weak negative influence on opposition to reduced PEI use. Finally, non-clinicians’ prior awareness of their assigned PEI has a weak positive influence on support

for the expanded use of the same PEI, but has no influence on opposition to reduced use. While non-clinicians’ PEI-related policy preferences do not vary by PEI modality, psychiatrists’

policy preferences do. Compared to their peers in ECT condition, psychiatrists in the rTMS, DBS, and ABI conditions reported lesser support for expanding PEI use and also lesser opposition

to reducing PEI use. As with non-clinicians, psychiatrists’ PEI-related policy preferences do not vary across TRD severity experimental conditions. Also like with non-clinicians,

psychiatrists’ perceived badness of daily life with TRD is positively associated with support for expanded PEI use but is unrelated to opposition to reduced PEI use. Compared to the patterns

seen among non-clinicians, the influence of PEI views on psychiatrists’ PEI-related policy preferences were weaker and less consistent—though in the same substantive direction.

Psychiatrists’ views of their assigned PEIs accounted for only a small percentage of the explained variance in the Support for Expanded PEI Use Scale (29%) and the Opposition to Reduced PEI

Use Scale (22%). Generally, more favorable views of their assigned PEI resulted in more favorable PEI-related policy preferences. Finally, while psychiatrists’ prior experience referring or

administering any PEIs had no influence on their support for expanded PEI use, it nevertheless did have a small positive influence on their opposition to reduced PEI use. DISCUSSION

Approximately 8.3% of adults and 20.1% of adolescents (12-17 years old) in the USA experienced a major depressive episode in the past year, and approximately 61.0% and 40.6% of these groups,

respectively, received some kind of treatment for their MDD.20 Over the last two decades, public stigma toward MDD has declined30. In recent years, especially with the rise of

telepsychiatry and mental health apps for smartphones, front-line treatments are increasingly available. Yet, as noted earlier, at least one-third of those diagnosed with MDD see no

substantial improvement in their symptoms through therapy and multiple rounds of antidepressants alone.1 For those with TRD, FDA-approved PEIs have proven effective, and experimental PEIs in

development hold considerable promise. State-level mental health legislation facilitates or constrains the availability and use of such PEIs—as shown already with ECT.8 Indeed, elected

officials in a number of states have introduced policies regulating the use of certain PEIs in recent years. Our study extends recent work on PEI views by examining the extent to which

relevant stakeholder groups oppose or support PEI-related policies and the influence that their PEI views have on these policy preferences. Our results above and those from similar studies

provide insights that may aid the integration of a responsible research and innovation approach31,32 (which can support the ethical development and use of PEIs) and an analytic-deliberative

process33,34 (which can guide effective PEI governance by ensuring that public discussion and decision-making on these emerging technologies are informed by the best available science).

Neither framework favors any particular substantive outcome; rather, they both emphasize processes that are iterative, transparent, reflexive, and responsive. Above all, both frameworks

expect that optimal outcomes are dependent upon the full inclusion of a broad range of relevant stakeholders and affected groups into decision-making processes and the authentic

consideration of their values, perceived risks and benefits, and ethical concerns. To that end, we offer several insights below that may inform subsequent deliberations among relevant

stakeholders, even though these insights likely are constrained by three characteristics of our study. First, our national samples likely are insufficient for characterizing the particular

PEI views and policy preferences of stakeholder groups in any particular state—the political jurisdiction in which elected officials have introduced nearly all PEI governance policies. This

is especially case for our smaller sample of board-certified psychiatrists, which resulted from a low response rate. Second, given the three proposed state-level policies for expanding PEI

access and use either directly or indirectly require the expenditure of tax revenues, we cannot rule out that participants’ tax preferences may have influenced their responses. Third, our

experiment likely complicates the interpretation of our results, since participants responded only to their one assigned PEI. Subsequent state-level studies in which participants report

their views on multiple PEIs may be necessary to gain optimal information in this regard. With these caveats in mind, we recommend that those involved in creating or revising policies

governing the use of PEIs consider the following insights to guide inclusion of relevant stakeholders. Above all, it is important to consider how clinicians and non-clinicians alike perceive

these interventions, attending to the direction and magnitude of the association between key PEI views and preferences toward policies that maintain or increase PEI access. The differences

between clinicians’ and non-clinicians’ PEI policy preferences—and their PEI views7—are nontrivial. Further, both divides vary substantially by modality. That is, the differences between

clinicians’ and non-clinicians’ views and policy preferences on ECT are greater than they are on rTMS, DBS, and ABIs. Briefly, psychiatrists favor ECT, while non-clinicians fear it. This

suggests sizable opportunity gaps for (a) informing non-clinicians about the science of the efficacy and safety of ECT, (b) educating psychiatrists about the types of perceived risks and

ethical concerns that non-clinicians have about ECT, and (c) creating opportunities for psychiatrists to learn more about the lived experiences of those who have had PEI treatment. Among

psychiatrists, PEI modality is associated strongly with policy preferences. As noted above, they report preferences more favorable toward maintaining or increasing PEI access when

considering ECT than any other PEI. This pattern likely reflects their awareness of the ample evidence of ECT’s effectiveness treating TRD and the lesser amount of such evidence for the

other modalities. To a lesser extent, psychiatrists’ PEI views are related to their policy preferences; briefly, more favorable PEI views—independent of modality—are associated with slightly

stronger preferences for policies maintaining or increasing PEI access. At first glance, non-clinicians’ PEI-related policy preferences seem unrelated to their assigned PEI modality.

However, these policy preferences do vary substantially by their _views about_ their assigned PEI modality, which _are_ related to modality35. That PEI views at least partially mediate the

influence of modality on policy preferences highlights the need to fully acknowledge and discuss these views in deliberations. More strongly than seen with psychiatrists, non-clinicians’

more favorable PEI views—independent of modality—are associated with much stronger preferences for policies maintaining or increasing PEI access. It seems reasonable that these views—such as

affect toward their PEI, perceived benefits of their PEI, and perceived influence of their PEI on their sense of self—serve as heuristics to help them make decisions on PEIs in the absence

of technical understanding of how they work or scientific knowledge of their therapeutic efficacy. Further, non-clinicians’ trust in major medical and scientific occupations and

organizations has mixed effects on their PEI-related policy preferences: a positive association with support for expanding PEI use but a negative association with opposition to restricting

PEI use. Given this, mental health advocates for greater PEI access should not assume that simply building non-clinicians’ institutional trust would necessarily strengthen their support for

policies maintaining or increasing PEI access. Finally, there is some evidence that familiarity with MDD and PEIs shapes stakeholders’ PEI-related policy preferences. For instance,

psychiatrists’ and non-clinicians’ perceived badness of living with TRD is inversely associated with their support for expanded PEI use. Further, non-clinicians’ prior awareness of their

assigned PEI and psychiatrists’ prior experience referring or administering any PEI are associated with support for expanding PEI use and opposition to reducing PEI use, respectively.

Processes that solicit the TRD perceptions of stakeholders with varied familiarity or experience with PEIs likely will yield rich deliberation on the details, costs, and benefits of

PEI-related policies. Such an inclusive participatory approach, while challenging to implement36, should help guide more effective PEI governance into the future. DATA AVAILABILITY The

dataset used and analyzed during the current study is available from the research team upon reasonable request ([email protected] or [email protected]). Once we have completed analysis of this

dataset from which this paper is based, we will post the direct links to the data repository at https://peiproject.com/. We expect to upload the data to the data repository by the end of

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635–645 (2019). Article  PubMed  Google Scholar  Download references ACKNOWLEDGEMENTS This study was supported by a BRAIN Initiative grant (#1RF1MH117802-01) from the National Institute of

Mental Health within the US National Institutes of Health. The funding source had no influence on the study design; the collection, analysis, and interpretation of data; the writing of the

report; or the decision to submit the manuscript for publication. We thank Emily Shank for her helpful assistance with this manuscript. AUTHOR INFORMATION AUTHORS AND AFFILIATIONS *

Department of Sociology, Michigan State University, East Lansing, MI, USA Aaron M. McCright * Department of Psychiatry, Western Michigan University Homer Stryker M.D. School of Medicine,

Kalamazoo, MI, USA Eric D. Achtyes * Department of Philosophy and Lyman Briggs College, Michigan State University, East Lansing, MI, USA Robyn Bluhm * Center for Neural Engineering,

Department of Engineering Science and Mechanics, and Rock Ethics Institute, Pennsylvania State University, University Park, PA, USA Laura Y. Cabrera Authors * Aaron M. McCright View author

publications You can also search for this author inPubMed Google Scholar * Eric D. Achtyes View author publications You can also search for this author inPubMed Google Scholar * Robyn Bluhm

View author publications You can also search for this author inPubMed Google Scholar * Laura Y. Cabrera View author publications You can also search for this author inPubMed Google Scholar

CONTRIBUTIONS A.M., E.A., R.B., and L.C. secured funding for the project and managed data collection. A.M. analyzed the data. A.M. and L.C. wrote the main manuscript text and prepared Figs.

1 and 2. A.M., E.A., R.B., and L.C. reviewed and revised the manuscript. CORRESPONDING AUTHOR Correspondence to Aaron M. McCright. ETHICS DECLARATIONS COMPETING INTERESTS A.M., R.B., and

L.C. have no conflicts of interest to declare. E.A. has received research support from the following entities in the preceding 12 months: Alkermes, Boehringer-Ingelheim, Janssen, Karuna,

Neurocrine Biosciences, Teva, and the Vanguard Research Group. E.A. also has served on advisory boards or consulted with Alkermes, Boehringer-Ingelheim, Clinical Care Options, CMEology, CME

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ABOUT THIS ARTICLE CITE THIS ARTICLE McCright, A.M., Achtyes, E.D., Bluhm, R. _et al._ Explaining key stakeholders’ preferences for potential policies governing psychiatric electroceutical

intervention use. _npj Mental Health Res_ 3, 52 (2024). https://doi.org/10.1038/s44184-024-00096-5 Download citation * Received: 08 April 2024 * Accepted: 15 October 2024 * Published: 06

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