Sunday, June 17, 2012

Former Liberal Prime Minister rips into current Liberal Party leader on asylum-seeker policy

“The most effective way to restore integrity and public confidence in  asylum  seeker policy  is through strong leadership, myth busting and accurate  information. Not to present a policy that is the closest thing to evil you can get. A policy that is full of misinformation."

“In 2010-11, 4730 asylum seekers  arrived by boat. During the same period, more  than  13 million people crossed our borders and arrived in Australia; 4730 out  of 13.9 million is not a ''system vulnerable to abuse''."

“This is the opposite of integrity. It is inhumane and demeans Australia. Is this the basis on which Abbott will operate if he, as he believes he will, becomes prime minister?"

Abbott's evil policy work.
by Malcolm Fraser
Sydney Morning Herald.
June 18, 2012

Monday, June 11, 2012

It's like watching tennis - Prof. Allen Frances criticizes new govt child mental illness screening program

Like night follows day, American Emeritus Professor Allen Frances, a psychiatrist and also a veteran of a past DSM revision, has volunteered his two-bob worth on the subject of the Gillard Government's upcoming program of mental health screening of three-year-olds, "The Healthy Kids Check", and true to form, he isn't being kind. According to Prof. Frances "There's absolutely no evidence at all that we can predict accurately who will go on to have a mental disorder", so it would appear that a program that aims to identify mental illness in little ones who aren't even old enough to go to big school would be a foolish enterprise indeed. Add to that the probability that the screening will do harm: "A label like 'autism' can be obviously devastating, but even less severe labels can have a dramatic effect on expectations, on the way the child feels about himself, his role in the family. I would be very cautious about labels, especially in young children, especially because they're so likely to be wrong."

The ABC are claiming that the Healthy Kids Check will be voluntary, but I have my doubts that parents will not be financially coerced by the federal government into submitting their young children to examination. In March 2012 the Australian parenting magazine Web Child reported that parents risk losing a Centrelink payment if they omit to "take their four year old for a mandatory health assessment." Is this the same assessment as the Healthy Kids Check?

All of the media stories that I have read about the planned program indicate that it is not limited at all to identifying mental illness, but is in fact very much geared to identifying supposed signs of autism, which is considered to be an incurable developmental disability or alternately a form of neurodiversity. In Australia mental health and early intervention are some of the biggest fads of the decade, so apparently to give this intrusive program appeal it is being sold as a form of mental health early intervention leading to recovery, a spin on the subject that is sure to offend many people who identify themselves as autistic but not mentally disordered.

Prof Frances is currently appearing in Perth, along with the Irish-Australian psychiatrist professor whom he has often spoken out against, Prof Patrick McGorry, at the Asia Pacific Conference on Mental Health. Clinical Professor Jon Jureidini and the federal Minister for Mental Health and Ageing Mark Butler will also be speaking at this conference.

Hall, Eleanor (2012) Expert warns against child mental health checks. PM. ABC Radio National. June 11th 2012.

Asia Pacific Conference on Mental Health.

Roberts, Felicity (2012) Don't miss out on family payment. Web Child. Match 20th 2012.

Loner littlies to be labelled (in Australia)

See my post about this at my other blog:
Preschoolers to get mental health checks.
ABC News. June 10, 2012.

McGorry and co get a run on Radio National

I didn't hear ABC radio presenter Lynn Malcolm ask any tough questions in this program, but perhaps they were edited out, as McGorry did address many of the issues that people have with his plans for psychiatry geared to young people in Australia, funded by the Gillard Government. He also acknowledged that there are areas of active controversy. I think the most interesting thing about this show is how readily McGorry and another professional interviewed admit that some of the most important modes of treatment delivered at their various networks of mental health clinics are not fully researched and are not supported by a complete or even firm evidence base. They are happy to admit that much more research is needed, and the big issue that I have with McGorry and co is that I believe that an evidence base should precede the offering of any medical treatment (outside of the context of a clinical trial), and not follow after the treatments are offered to vulnerable young people, and after huge sums of funding from the federal government have been aggressively solicited for and received. Demonstrating that a medical service does more good than harm should not be just an afterthought to placate the critics. 
Malcolm, Lynne (2012) Young minds, the highs and the lows. All in the Mind. ABC Radio National. June 10th 2012.

Thursday, June 7, 2012

Need to see a head specialist?

Does one really need to visit a mental health clinic for butterflies in the stomach? A fluttering in the abdomen is anxiety as in a psychiatric disorder? It seems like a bit of an exaggeration to me.

Headspace - Dreaded Butterflies.
by Simon Bronson

Sunday, June 3, 2012

Big news on the psychiatry front when I wasn't looking

I've not had much time for blogging in the last few weeks and I've missed some important developments in the last couple of months regarding the upcoming edition of the "bible of psychiatry", the Diagnostic and Statistical Manual of Mental Disorders (DSM-5). An early-intervention mental health diagnosis that has been championed by Prof Patrick McGorry, who has great influence on the Gillard Government and a high-profile in Australia, has been rejected by the American Psychiatric Association (APA). This supposed disorder which is thought to be a milder early sign of the onset of a psychotic mental illness, typically in teens and young adults, will not be included inthe fifth edition of the world-famous manual of psychiatric diagnosis, but will be relegated to the appendix where disorders requiring more research are placed and forgotten. This controversial condition went by a bewildering range of names: "psychosis risk syndrome" "prodromal symptoms" "prodrome" "high-risk syndrome" "ultra-high-risk syndrome" "at-risk mental state" etc. The ad hoc nomenclature gives the impression that the professor was just making it up as he went along. 

Don't be overly distracted by the rejection of one proposed new mental illness by the APA. The crashing and burning of the prodrome is not really the big news from last month on the subject of modern psychiatry's revision of it's great big guidebook. The big news was that two diagnostic categories in some of the most supposedly common and also some of the most aggressively promoted types of mental illness in Australia, major depressive disorder and generalised anxiety disorder, have been found by psychiatry researchers to be diagnostic categories which cannot be reliably identified, in that there was found to be a major lack of consensus from one doctor to another about who did or did not meet some diagnostic criteria for these types of disorders. What kind of diagnoses are these, which cannot be identified with any certainty or reliability? If modern psychiatry was an emperor, he'd be looking very bare and very embarrassed right now.

Why are these recent developments important to Australians? The Gillard Government has committed a huge sum of money to reforms in mental health services, guided by controversial figures such as Pat McGorry, Ian Hickie and John Mendoza. We don't only have the government spending big on psychiatry and shoving the message down our throats that we all need more of it, we also have some very powerful and influential charities and organizations inflicting very pervasive and long-standing public awareness campaigns about mental illness onto the general public. Two that come to mind are Beyondblue and the Brain and Mind Research Institute, but there is a mental health message promoter lurking around every corner in Australia. Awareness campaigns actively recruit ordinary unqualified, uneducated members of the public as peer-support spreaders of the word that mental illness is everywhere and needs to be treated yesterday. Psychiatry propaganda seeps into ordinary social exchanges and is impossible to avoid. TV news stories hammer the message that we should be uncertain and concerned about the minds of others and our own. Journalists have swung from one extreme to another regarding the reporting of suicide (which is universally assumed to be the result of mental illness). I remember the days when it was a subject banned from news reports based on the belief that reporting might trigger copy-cats. These days suicide is the flavour of the month on current affairs reporting, and journalists jump to label crimes and deaths as suicide, sometimes mistakenly. Because of this tasteless and horrible focus on the morbid and the sordid it is now impossible to sit through the news hour on TV in the company of young children. For many years now Australians who watch late-night commercial television have been assailed by TV commercials for the network of Headspace psychiatric clinics aimed at young people, often with scant or no indication that this is what these clinics actually are. Now I find that there is absolutely no place except home where I can go to escape messages about mental derangement. Even in a public toilet I have psychiatry propaganda about depression and anxiety (the two disorders that can't apparently be reliably diagnosed) shoved in front of my face. We now have full-page illustrated advertisements advocating the identification of mental illness and the use of the services of professional mental health services on the back of dunny doors! They are found in toilets in shopping centres, universities, you name it. ENOUGH!

What's wrong with spreading awareness, you might ask. If the message is a misrepresentation, then it is all bad, and the message is indeed mostly lies. We are told that the treatments work. In fact, there is a load of good evidence that many of the drugs prescribed for depression and other mental illnesses do not act as chemical treaments and have troublesome or dangerous side effects. If they were just sugar pills, that would only be a con, but it's worse than that. An active placebo works because the person taking the drug can feel definite and troublesome side effects, and he/she unconsciously takes this as evidence of the potency of the drug, and this gives rise to a powerful placebo effect (which is a real effect, but not the result of any drug action). These drugs cost patients and the taxpayer dearly, many have serious side effects and many of them basically don't work, and in the process the patient is often unjustifiably convinced that she/he has a defective brain which needs ongoing chemical assistance to work adequately. We are told that modern psychiatry is based on a solid foundation of decades of research evidence that meets the highest scientific standards, but in fact one of the trials which was part of the evidence foundation of the recent DSM revisions had a grand total of nine (9) ill patients as subjects. And they are trying to make you and I feel guilty for not going along with this debacle? Pull the other one, mate!
Aldhous, Peter (2012) Trials highlight worrying flaws in psychiatry 'bible'. New Scientist. 17 May 2012 issue 2865. p.6-7.
Maxmen, Amy (2012) Psychosis risk syndrome excluded from DSM-5. Nature. May 9th 2012.