An apology diminished

I hate the way that considerations of mental health and psychiatry have made their way into just about everything that Australian government agencies do. In Canberra today a historic apology to those affected by forced adoption has been made, and right in the middle of the speech there was talk about access to mental health services. It wasn't appropriate. The presence or absence of mental health issues and whether or not affected people seek the services or psychiatrists or psychologists is not a measure of what happened, nor are these things a measure of how serious the issue is. I am so fed up with hearing about mental health in discussions and speeches that are about other things. It's like listening to a tedious a religious person who can't help but bring God or Jesus into every discussion.

We live in a secular society, so we no longer have to put up with such nonsense, but what has happened is that psychiatry has replaced religion in the lives of many Australians, so everyone is now compelled to listen to frequent and inappropriate references to mental health issues and therapies seeping into every corner of public and private life. Mental health is the new religion, and we are made to feel obliged to strive for a new kind of perfection of the soul. A state of perfect mental health has replaced moral perfection as the ideal. It is an idea with some merits but I still believe morals are more important than health, even though I'm an atheist and thus don't hold a religious view of morality. I suspect that it might be the amorality of the new religion that is the reason why so many find it personally attractive. We no longer have to deal with old-style moralizing attitudes but the new flock are just as tedious as the Bible-bashers of old, because all religions have zealots, and zealots insert their views into life at every opportunity, regardless of appropriateness. Winston Churchill defined the fanatic as one who ".... can't change his mind and won't change the subject". This is why we have today had to listen to a description of mental health service provision by the government inserted into a historic apology, an annoying and probably in the eyes of some an insulting distraction. Enough already!

You thought the Gillard Govt had mental health all sorted?

WRONG!

Australia needs Better Access to psychological treatment
a petition to the Hon Julia Gillard MP initiated by
Dr Ben Mullings
Change.org
http://www.change.org/en-AU/petitions/australia-needs-better-access-to-psychological-treatment

Alliance for Better Access
http://betteraccess.net/

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.
http://www.abc.net.au/news/2012-06-11/expert-warns-against-child-mental-health-checks/4064474

Asia Pacific Conference on Mental Health. http://www.rfwa.org.au/aspac2012/news/?post=6

Roberts, Felicity (2012) Don't miss out on family payment. Web Child. Match 20th 2012. http://www.webchild.com.au/read/news/dont-miss-out-on-family-payment

Loner littlies to be labelled (in Australia)

See my post about this at my other blog:
http://incorrectpleasures.blogspot.com.au/2012/06/loner-littlies-to-be-labelled.html
Preschoolers to get mental health checks.
ABC News. June 10, 2012.http://www.abc.net.au/news/2012-06-10/preschoolers-to-get-voluntary-mental-health-checks/4062566

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. http://www.abc.net.au/radionational/programs/allinthemind/young-minds2c-the-highs-and-lows/4054982

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.
http://www.newscientist.com/article/mg21428653.600-trials-highlight-worrying-flaws-in-psychiatry-bible.html

Maxmen, Amy (2012) Psychosis risk syndrome excluded from DSM-5. Nature. May 9th 2012.
http://www.nature.com/news/psychosis-risk-syndrome-excluded-from-dsm-5-1.10610

Guardian reports that study finds drugs should not be first option

The Guardian newspaper yesterday published an article reporting the findings of a study which apparently found that drugs should not be the first option for treating young people thought to be at risk of developing a psychotic mental illness such as schizophrenia, because "only a tenth will go on to develop more serious conditions" and ""benign" psychological treatments, including Cognitive Therapy (CT), were effective in reducing the severity of psychotic experiences". So I've got to wonder why some Australian psychiatrists have been so enthused about trialling the pills. I guess this should be good news for psychologists and bad news for psychiatrists and drug companies. But didn't the Gillard Government bring in a program of mental health reforms that gave lots of funding for psychiatry at the expense of psychological treatment? Nice one, Julia! You're a one-woman-skill-shortage.

Drugs not best option for people at risk of psychosis, study warns. Guardian. April 6th 2012.
http://www.guardian.co.uk/society/2012/apr/06/drugs-psychosis-schizophrenia-counselling?CMP=twt_fd

Is there an elephanty smell in the room?

Is there an important matter which most high-profile federal members of the ALP have been constantly failing to acknowledge? Kevin Rudd is popular with the voters, while the same cannot be said of much of the rest of the federal ALP team. Rudd at one time was extraordinarily, unprecedentedly popular with the world outside of the ALP. Simon Crean and Julia Gillard as leaders were just about as popular with voters as pork chops at a bar mitzvah. Rudd knows the secret of voter popularity. So many of his critical colleagues don't. Surely the envy and damaged egos of the has-beens and the never-weres who have witnessed spectacular electoral success must be a factor in Rudd's much-discussed unpopularity within his own party.



Source of this image:
http://www.flickr.com/photos/seriykotik/5458307408/in/set-72157625756142997

I'd like to think that this lovely picture depicts Rudd's onging love affair with Australian voters, the big ugly animal in the room being the resentment of his ALP colleagues.

Rudd resigns from job as foreign minister unrepentant, commentators set to chatter themselves hoarse

Rudd's resignation speech as foreign minister.
Sydney Morning Herald.
February 22, 2012.
http://www.smh.com.au/opinion/political-news/rudds-resignation-speech-as-foreign-minister-20120222-1tnue.html#ixzz1n5s37keV

Serco Ruins Christmas for Children in Detention

What kind of miserable f***s would prevent children from being given gifts at Christmas-time? What kind of power-crazed c*** would forbid children from having coloured crayons or coloured pencils outside of formal classes?

DASSAN Press Release: Serco Ruins Christmas for Children in Detention
Refugee Rights Action Network
5 January 2012.
http://rran.org/blog/2012/01/dassan-press-release-serco-ruins-christmas-for-children-in-detention/

Serco drops ban on coloured pencils and crayons for asylum-seeker children
by Kirsty Needham
Sydney Morning Herald.
January 7, 2012.
http://www.smh.com.au/national/serco-drops-ban-on-coloured-pencils-and-crayons-for-asylumseeker-children-20120106-1pogh.html#ixzz1ilC5Sacc

Serco drops ban on coloured pencils and crayons for asylum-seeker children
Refugee Rights Action Network
7 January 2012.
http://rran.org/blog/2012/01/serco-drops-ban-on-coloured-pencils-and-crayons-for-asylum-seeker-children/

Words of wisdom about mental health from Jon Jureidini on the radio

I so much love the concept of the "unexplanation" in relation to mental illness labels which child psychiatrist Prof. Jon Jureidini has created and used in his talk which was recently broadcast on ABC radio, on the radio show All in the Mind on Radio National 810am. Prof. Jureidini cites depression and most mental health labels as "unexplanations", and I'd certainly agree with him on that point. We should never be satisfied with "unexplanations" from doctors or psychiatrists or psychologists or counsellors. We deserve so much more from highly paid and highly educated professionals who wield a lot of power in our society.

Prof. Jureidini is one of many critics (including myself) of Prof. Patrick McGorry who has had a great level of influence on federal government mental health policy, particularly under the Gillard Government, and this has concerned many people. Many thanks to Natasha Mitchell and the ABC's Radio National for giving airtime in two different radio shows to rational and science-based critics of "big pharma" such as Prof. Jureidini and the multi-award-winning Australian health journalist and author Ray Moynihan.

Juredini, Jon (2011) Sick, Screwed Up or Just Lazy? - 2011 Adelaide Festival of Ideas. All in the Mind. ABC Radio National. 22 October 2011.
http://www.abc.net.au/rn/allinthemind/stories/2011/3340004.htm

Moynihan, Ray (2011) A noble cause. Background Briefing. October 16th 2011.
http://www.abc.net.au/rn/backgroundbriefing/stories/2011/3337618.htm

Healthy Skepticism.
http://www.healthyskepticism.org/global

Could things possibly get any worse for the ALP?

Today, as Australia is coming to terms with the apparent collapse of the Gillard Government's "Malaysian solution" to the issue of refugees coming to Australia by sea, I'm wondering if the public image of this government could possibly look any worse. Even if the Malaysian deal can be resurrected, as an ANU professor has suggested, this policy still looks like a mistake and a prolonged drama. I think Australians have seen enough of long and draw-out stuff-ups in federal politics already. And now the Gillard Government's cooperation with psychiatry (not mental health) advocates such as Professors Ian Hickie and Patrick McGorry, which has won political popularity for the government is now starting to look more like a liability, as opposition to the recent mental health reforms grows organizes. Does anyone really believe, at this point in time, that Gillard was a better choice of PM than Rudd?

Patrick McGorry on ABC radio

A discussion between Prof. Patrick McGorry and the Dalai Lama from the June 2011 Happiness and Its Causes Conference in Sydney has been broadcast on the radio show All in the Mind hosted by Natasha Mitchell. It should be repeated on Monday at 1.00pm.

The beginning of the discussion consists of McGorry giving a monologue about stuff that he is interested in - psychosis in youth and his psychiatric practice. I found McGorry's account to be cause for concern, but not in the way that McGorry probably intended. McGorry used the self-contradictory phrase "severe spectrum" to describe psychotic illness. I can only guess why McGorry might have chosen to use such nonsensical terminology - either he is himself confused in his thinking, or he aims to confuse the listener. Then McGorry went on to paint the false picture that schizophrenia was a disease that was never cured nor ever spontaneously remitted before the (McGorry's) concept of early intervention in psychosis came along. Perhaps this gloomy prognosis was an opinion held by many practitioners of modern psychiatry, but I don't think it was a reflection of the best scientific evidence. According to what I've read schizophrenia is a disorder that is characterized by waxing an waning of symptoms, and is apparently more likely to go into remission in patients in third-world countries where state-of-the-art psychiatric drugs are unavailable. McGorry kept on testing the limits of my credulity. At one point McGorry appeared to be asserting that psychosis or mental illness is the main health problem affecting young people in Australia - a claim that I find hard to believe. There are more mentally ill Aussie teens than obese teens, or teens with acne, or teens with asthma? Really?

Between McGorry, the Dalai Lama and the host Natasha Mitchell, the Dalai Lama's unfortunately difficult-to-understand words conveyed by far the most sensible idea of the whole discussion - that a new intervention with young people needs to be trialled at one location in a long-term study over a number of years with a "concrete sort of research" and then it can be tried out at multiple sites, and then the government should take up the intervention. It's a great pity Prof. McGorry and the Gillard Government have ignored this type of advice. McGorry's interventions aren't supported by solid research findings, despite whatever he might say. McGorry did not respond to the Dalai Lama's cautioning message, he took off on another rather autistic monologue, this one about positive psychology. And then the hostess laughably declared that a consensus had been reached!

The broadcast continued with discussion between McGorry, host Mitchell and mirror-neuron researcher Marco Iacoboni, who has an Italian accent that is even more soporific than the Dalai Lama's Tibetan accent. McGorry spoke out against the way asylum-seekers are treated in Australia - a statement that won him even more popularity with the Sydney audience.

My respect for His Holiness the Dalai Lama grows, while my respect for the other speakers at this forum shrinks to a size that can no longer be detected by the naked eye.

Dialogue with the Dalai Lama - Part 3 - Australian of the Year Patrick McGorry.
9 July 2011
All in the Mind.
ABC Radio National 810am
http://www.abc.net.au/rn/allinthemind/stories/2011/3249471.htm#transcript

http://www.happinessanditscauses.com.au/conference-day-two-friday-17-june-2011.stm

I really shouldn't laugh.....

Julia Gillard vows to plough ahead despite polls.
From: AAP
Herald Sun.
June 28, 2011.
http://www.heraldsun.com.au/news/breaking-news/julia-gillard-vows-to-plough-ahead-despite-polls/story-e6frf7jx-1226083234667

"She is now the most unpopular modern prime minister since Paul Keating at his worst."

Julia Gillard now leads 'most unpopular Australian government in past 40 years'.
Alison Rourke
Guardian.
18 June 2011
http://www.guardian.co.uk/world/2011/jun/18/julia-gillard-most-unpopular-leader-australia

"With her personal approval rating collapsing (nearly 60% of those polled disapprove of her), Kevin Rudd is now the preferred Labor leader by a margin of two to one."

Labor would win election under Rudd: poll
By Jeremy Thompson
Updated Mon Jun 27, 2011.
ABC News.
http://www.abc.net.au/news/stories/2011/06/27/3254766.htm?section=justin

"Fifty-one per cent of those polled believe Australia has become a "worse place" since Ms Gillard became Prime Minister."

Secret behind Blanche d'Alpuget and Sue Pieters-Hawke airport scuffle.
Annette Sharp and Clementine Cuneo
The Daily Telegraph
June 28, 2011.
http://www.dailytelegraph.com.au/news/sydney-nsw/bob-hawkes-wife-blanche-dalpuget-and-daughter-sue-pieters-hawke-in-catfight-involving-afp/story-e6freuzi-1226083064129

"Federal police were called after an altercation between the two women in the Qantas chairman's lounge at Brisbane Airport on Thursday. Witnesses said one of the women slapped the other four times."

Another quote to ponder

(this post has been edited a number of times for clarification)

"We're trying to say that some who have failed psycho-social therapy but are severely unwell in a pre-psychosis stage, maybe some of them do need anti-psychotics and that needs to be studied before it's ever advocated for of course," he says."

This is what I believe is a revealing quote attributed to Professor Patrick McGorry from an article in The Australian newspaper from only ten days ago. I believe this quote is revealing for a couple of reasons. Firstly, it shows that the professor is indeed prepared to consider prescribing highly problematic anti-psychotic drugs to a patient who does not meet the full diagnostic criteria for a psychotic mental illness, a situation which is just the type of scenario that professor emeritus Allen J.Frances MD from the US has repeatedly expressed much concern about.

The second thing that I find interesting about this quote is the apparently confused thinking that it betrays. If a patient is in "a pre-psychosis stage" then presumably they are not fully psychotic. Commentators have claimed that McGorry's new diagnosis of "pre-psychosis" has a huge false-positive rate, with most of the youth that it identifies as potential cases of psychosis or schizophrenia not being genuine early cases at all. So I've got to wonder how these patients can be "severely unwell". If they are "severely unwell", why don't they qualify for a full diagnosis of a psychotic mental illness?

According to what Prof. McGorry himself has said about the new psychiatric disease category of "Psychosis Risk Syndrome", which Prof. McGorry has strongly advocated for, a huge 70% of the patients who meet the criteria for this proposed new "pre-psychotic" mental illness and are given only non-drug intervention will NOT proceed to becoming genuinely psychotic:

"Six studies around the world now show 30 per cent of patients given supportive care only went on to develop psychosis but 10 per cent of those given drugs and cognitive behavioural therapy went on to psychosis, McGorry says."

If this is true, the intervention does help some people, but it also needlessly labels a large proportion of patients. Given what I've read about the large false-positive rate and the apparent lack of need for drug therapy of the majority of the people who have been given this "pre-psychosis" label, I frankly find it hard to believe that so-called "pre-psychotic" patients can be "severely unwell" due to psychosis, as Prof. McGorry claims they could be in the quote from The Australian. I'm very much tempted to consider whether, if these patients do indeed have severe problems, are their problems due to some issue or illness other than psychosis? This raises the spectre of psychiatric misdiagnosis, an issue that one can find throughout the entire history of psychiatry as a medical specialty, and a problem that has ruined many lives. The more that I read about the expensive federal government funded plans of the former Australian of the year Professor Patrick McGorry, the more concerned I feel.

Just to put into perspective the issue of incorrectly prescribing antipsychotic drugs to young people who don't really need them, I'd like to point out that these drugs, also known as neuroleptic drugs, have many serious problems as acknowledged side effects, including obesity, diabetes and a number of different forms of permanent brain damage that cause disturbing-looking facial tics. Tardive dyskinesia is one of these drug-induced tic syndromes. It is a tragic fact that the drugs themselves can mask the underlying brain damage and tics that can be caused by the use of these drugs, so that the patient and the prescribing doctor may be unaware of the damage being done by these drugs until the patient is taken off the drugs, and then the hideous tics become obvious. The patient can then look forward to a life blighted with bizarre involuntary tics that make then look crazier than they ever were before.

It appears that Professor McGorry is so obsessed about the supposedly 20% of patients who might be saved from developing full psychosis by being given drugs and therapy early that he has overlooked the majority of patients who would be identified with the proposed new diagnosis, the false-positives, who would be falsely diagnosed and permanently stigmatized as having a pre-psychosis mental illness, and who risk being given drugs that can ruin lives. It also appears that McGorry is so over-focused on potential benefits of his new vision of adolescent mental health that he doesn't realise that at least some people are going to notice the definite hazard of causing harm, and might identify this as a bigger thing than the potential pluses. I believe that I see a clinician who has no proper perspective on the issue.

Dunleavy, Sue (2011) Schism opens over ills of the mind. Australian. June 16th 2011.
http://www.theaustralian.com.au/news/features/schism-opens-over-ills-of-the-mind/story-e6frg6z6-1226075910650

Gutless

I’d like to dedicate this lovely tune, by the legendary and not-gutless Courtney Love, to the Australian Labor Party,

the party who have never had the guts to challenge or to educate voters who misguidedly view refugees as a threat to our nation

the party who swiftly respond to popular outrage over animal cruelty while not swerving from policies which cause cruelty to human refugees

the party that has leaders who stuffed up the live cattle trade with Indonesia and endangered the relationship between Australia and Indonesia, leaving the great big mess for their outcast Foreign Minister to sort out

the party who can’t bring themselves to catch up with the twentieth century and end the embarrassment of our backwards nation still not allowing same-sex marriage

the party who has caved in to the expensive and questionable demands of a professor psychiatrist who has a flair for self-promotion, who lacks scientific credibility, has many conflicting interests and has routinely broken the rules of professional conduct by failing to declare conflicting interests in published journal papers

the party that has a long history of political dynasties (the less polite term for this is nepotism)

the party who were happy to sit in opposition for many years under an internally popular but shockingly useless leader

the party who still revere a past leader who was a drunken womanizer who ruled during times of high unemployment and high interest rates, and has been a vocal advocate of the brutal regime of “Myanmar”

the party who still revere a past leader who was a smug smartarse despite the shockingly high rates of unemployment and interest rates during the times when he was a treasurer and a Prime Minister, and who appointed an obese predatory paedophile as a federal government minister

the party who were happy to allow a hardworking individual to pull them out of the wilderness of opposition, and later pull the nation through the international global financial crisis using great judgement and decisiveness, while all the time reserving the right to knock him down and replace him should he become less useful

the party who failed to support their leader when he took on the might of Australia’s mining companies with a new tax

the party who failed to confront that leader when all that power went to his head, preferring instead to simply wipe him out and start with someone else

the party who allowed an unelected union leader to publicly announce the outcome of the most controversial leadership coup in Australian political history

the party who caved in to the demands of mining company billionaires who don’t like to pay tax

the party who kiss-up to and obey the US government, and who have prominent members who inform on other members to the US embassy, and who trot along to the Australian-American Leadership Dialogue every year, and munch hot dogs at baseball matches like the aspiring yankee doodle dandy suckholes that they are

the party who has a leader who will soon be going to Western Australia for a conference, perhaps in the hope that the mining state will be the least hostile place to be a year after the political assassination of their former leader, and months after the party caved in to the threats and demands of mining billionaires who like to avoid paying tax

you’re gutless!

Review by The Cochrane Collaboration cautions about vested interests as possible source of bias in McGorry studies

"However, as with the Australian studies, many of the trials were undertaken by leading figures in the world of early intervention who could have a vested interest in the findings - just as industry has in the outcomes for the drugs they manufacture."

All but one of the many "Australian studies" referred to here have Professor Patrick McGorry as a co-author. It seems clear that former Australian of the Year Prof. McGorry is one of the "leading figures" referred to here as having a potential conflict of interest. I'd say that is an understatement.

If you are going to click on one of the links and have a look at the review, you might wish to check the summary of the main results in the abstract of the systematic review. You'll see that there is very little to get excited about among the results of trials of various early or preemptive interventions for psychosis. The whole idea of preventively treating people who appear to be at risk of developing schizophrenia/psychosis, people with "prodromal symptoms", is not supported by this systematic review:

"At the moment it is not clear whether treating people presenting with prodromal symptoms of schizophrenia provides benefits. There is inconclusive evidence on the personal and social consequences of providing treatment to people who will not necessarily become unwell. Further evidence is needed before recommendations can be given."

This is one type of mental health service that has been most assertively advocated by Professor McGorry. It appears that there is no reason to believe that it is effective, or more beneficial than harmful, but the Gillard Government has committed to spending hundreds of millions of dollars on McGorry's new EPPIC centres that have been promoted as having psychosis prevention and treatment of "prodromal" youth as a major element of their services.

Perhaps you are not familiar with the Cochrane Collaboration, the organization that is behind these systematic reviews. It is probably the world's most respected source of information in medicine. It is my understanding that it doesn't do medical research, but it judges the worth of medical research trials (published or not) and compiles systematic reviews of studies of various medical interventions and drugs, based on only studies that meet certain standards, and if this evidence is searched for but simply doesn't exist, the Cochrane Collaboration makes it clear that no conclusions can be made. The Cochrane Collaboration are like the great big rubbish filter of medical science, and my oh my, there is so much rubbish research published in medical journals.

Sources:

Marshall, M. and Rathbone, J. Early intervention for psychosis. The Cochrane Library. Cochrane Database of Systematic Reviews. 2011 Issue 6. page 24.
Art. No.: CD004718. DOI: 10.1002/14651858.CD004718.pub3.

http://onlinelibrary.wiley.com/o/cochrane/clsysrev/articles/CD004718/pdf_fs.html

http://onlinelibrary.wiley.com/o/cochrane/clsysrev/articles/CD004718/frame.html

Schism opens over ills of the mind.
Sue Dunlevy
The Australian.
June 16, 2011.
http://www.theaustralian.com.au/news/features/schism-opens-over-ills-of-the-mind/story-e6frg6z6-1226075910650

June 24th 2011?

So, is anything planned to commemorate that day? Not that I'm advocating or suggesting in any way that anything of an illegal nature should happen on that day, but surely someone should do or say something? I guess some print journos will write pieces arguing that Gillard has been a pathetic disappointment as a leader and as Australia's first female Prime Minister, and that the Gillard Government has been pragmatic but gutless and uninspired, but wouldn't that just be stating the obvious?

I used to date this boy who had an absolute gift for thinking up practical jokes. The things that you can do with a dead kangaroo, or a set of "Detour" signs!

Professor Patrick McGorry - too influential and too much influenced?

Are the ideas of early intervention in general and the idea of proactive and interventionist treatment of mental illness two incredibly popular intellectual fads in Australia? Yes.

Has the former Australian of the Year Professor Patrick McGorry received support from pharmaceutical companies that produce drugs used for mental illnessess for which Prof. McGorry advocates a greater level of diagnosis? Yes, he has.

Does Prof. Patrick McGorry have many conflicting interests? Yes.

Has Prof. Patrick McGorry many times failed to declare conflicting interests in journal papers in which he is a co-author? It appears that the answer is yes.

Is that shonky? Well, what do you think? There are very good reasons why medical journals ask their authors to declare conflicting interests.

Has there been serious criticism of the idea of early or preemptive identification of psychosis/schizophrenia in youth from psychiatric professionals from around the world, an idea advocated emphatically and repeatedly by Prof. McGorry? YES.

Was the Rudd Government right to refuse some of the funding sought by Prof. McGorry for his empire of clinics for the preemptive and early identification of psychosis in youth? Yes.

Was the Gillard Government wrong to cave-in to pressure to meet Prof. McGorry's well-publicised and emotive demands? Yes.

Why is a suburban housewife writing about this? Because Australian journalists aren't.

Why aren't Australian journalists covering this issue? You tell me! Maybe Australian journalists are clueless or useless.

A list of drug companies from which Prof. Patrick McGorry has received a research grant

Janssen - Cilag - producer of the drugs:

Concerta which is prescribed for ADHD

Haldol which is prescribed for Schizophrenia

Invega Sustenna which is prescribed for Schizophrenia

Invega which is prescribed for Schizophrenia

Risperdal Costa which is prescribed for Schizophrenia

Risperdal & Quicklet which is prescribed for Schizophrenia

Eli Lilly - producer of the drugs:

Cymbalta which is prescribed for Depression and Anxiety

Prozac which is prescribed for Depression, OCD and "premenstrual dysphoric disorder"

Strattera which is prescribed for ADHD

Zyprexa which is prescribed for Schizophrenia and Bipolar

Zyprexa Relprevv which is prescribed for Schizophrenia

Zyprexa IM which is prescribed for Schizophrenia and Bipolar

Bristol-Myers Squibb - producer of the drug:

Abilify which is prescribed for Schizophrenia, Bipolar, Depression and bothersome behaviour in autistic people

AstraZeneca - producer of the drugs:

Seroquel which is prescribed for Schizophrenia, Bipolar and Depression

Seroquel XR which is prescribed for Schizophrenia and Bipolar

Pfizer - producer of the drugs:

Geodon which is prescribed for Schizophrenia and Bipolar

Zoloft which is prescribed for Depression

Novartis - producer of the drugs:

Ritalin which is prescribed for ADHD

Ritalin LA which is prescribed for ADHD

Tofranil which is prescribed for Depression

"He has acted as a paid consultant for, and has received speaker’s fees and travel reimbursement from, all or most of these companies."

Sources:
McGorry, Patrick (2008) Is early intervention in the major psychiatric disorders justified? Yes. British Medical Journal. August 4th 2008. 337:a695. http://www.bmj.com/content/337/bmj.a695.full

I have also taken information about the products from the websites of the pharmaceutical companies and from the Wikipedia.


An incomplete list of medical journal papers in which Prof. Patrick D McGorry was an author and failed to disclose competing interests
(check it yourself - papers available to read free in full text)

Alexandra G Parker, Sarah E Hetrick, Anthony F Jorm, Alison R Yung, Patrick D McGorry, Andrew Mackinnon, Bridget Moller, and Rosemary Purcell (2011) The effectiveness of simple psychological and exercise interventions for high prevalence mental health problems in young people: a factorial randomised controlled trial. Trials. 2011; 12: 76. Published online 2011 March 13.
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3061928/?tool=pmcentrez#__sec22

Amresh Shrivastava, P. D. McGorry, Ming Tsuang, Scott W. Woods, Barbara A. Cornblatt, Cheryl Corcoran and William Carpenter (2011) “Attenuated psychotic symptoms syndrome” as a risk syndrome of psychosis, diagnosis in DSM-V: The debate. Indian Journal of Psychiatry. 2011 Jan-Mar; 53(1): 57–65. doi: 10.4103/0019-5545.75560.
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3056191/

Takahashi T, Wood SJ, Yung AR, Walterfang M, Phillips LJ, Soulsby B, Kawasaki Y, McGorry PD, Suzuki M, Velakoulis D, Pantelis C. (2010) Superior temporal gyrus volume in antipsychotic-naive people at risk of psychosis. British Journal of Psychiatry. March 2010 196: 206-211. doi: 10.1192/bjp.bp.109.069732
http://bjp.rcpsych.org/cgi/content/full/196/3/206

Jo Robinson, Sarah Hetrick, Sara Gook, Elizabeth Cosgrave, Hok Pan Yuen, Patrick McGorry and Alison Yung (2009) Study protocol: the development of a randomised controlled trial testing a postcard intervention designed to reduce suicide risk among young help-seekers. BMC Psychiatry. 2009; 9: 59. Published online 2009 September 23. doi: 10.1186/1471-244X-9-59.
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2759913/

Jo Robinson, Sara Gook, Hok Pan Yuen, Patrick D McGorry and Alison R Yung (2008) Managing deliberate self-harm in young people: An evaluation of a training program developed for school welfare staff using a longitudinal research design. BMC Psychiatry. 2008; 8: 75. Published online 2008 September 15. doi: 10.1186/1471-244X-8-75.
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2564929/

Patrick D McGorry, Eóin Killackey and Alison R Yung (2007) Early intervention in psychotic disorders: detection and treatment of the first episode and the critical early stages. Medical Journal of Australia. 2007; 187 (7 Suppl): S8-S10.
http://www.mja.com.au/public/issues/187_07_011007/mcg10314_fm.html

Michael Berk, Karen Hallam, Nellie Lucas, Melissa Hasty, Craig A McNeil, Philippe Conus, Linda Kader and Patrick D McGorry (2007) Early intervention in bipolar disorders: opportunities and pitfalls. Medical Journal of Australia. 2007; 187 (7 Suppl): S11-S14.
http://www.mja.com.au/public/issues/187_07_011007/ber10341_fm.html#0_elementId-1094133

Andrew M Chanen, Louise K McCutcheon, Martina Jovev, Henry J Jackson and Patrick D McGorry (2007) Prevention and early intervention for borderline personality disorder. Medical Journal of Australia. 2007; 187 (7 Suppl): S18-S21.
http://www.mja.com.au/public/issues/187_07_011007/cha10304_fm.html

Patrick D McGorry, Rosemary Purcell, Ian B Hickie, Alison R Yung, Christos Pantelis and Henry J Jackson (2007) Clinical staging: a heuristic model for psychiatry and youth mental health. Medical Journal of Australia. 2007; 187 (7 Suppl): S40-S42.
http://www.mja.com.au/public/issues/187_07_011007/mcg10315_fm.html#0_elementId-1093800

Alison R Yung, Patrick D McGorry, Shona M Francey, Barnaby Nelson, Kathryn Baker, Lisa J Phillips, Gregor Berger and G Paul Amminger (2007) PACE: a specialised service for young people at risk of psychotic disorders. Medical Journal of Australia. 2007; 187 (7 Suppl): S43-S46. http://www.mja.com.au/public/issues/187_07_011007/yun10343_fm.html#0_elementId-1093889

Patrick D McGorry (2007) The specialist youth mental health model: strengthening the weakest link in the public mental health system. Medical Journal of Australia. 2007; 187 (7 Suppl): S53-S56.
http://www.mja.com.au/public/issues/187_07_011007/mcg10311_fm.html

Patrick D McGorry, Chris Tanti, Ryan Stokes, Ian B Hickie, Kate Carnell, Lyndel K Littlefield and John Moran (2007) Headspace: Australia’s National Youth Mental Health Foundation — where young minds come first. Medical Journal of Australia. 2007; 187 (7 Suppl): S68-S70.
http://www.mja.com.au/public/issues/187_07_011007/mcg10346_fm.html

Annemarie Wright, Patrick D McGorry, Meredith G Harris, Anthony F Jorm and Kerryn Pennell (2006) Development and evaluation of a youth mental health community awareness campaign – The Compass Strategy. BMC Public Health. 2006; 6: 215.
Published online 2006 August 22. doi: 10.1186/1471-2458-6-215.
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1564138/

Berger, Gregor, Fraser, Richard, Carbone, Stephen & McGorry, Patrick (2006) Emerging psychosis in young people - part 1. Australian Family Physician. Vol. 35, No. 5, May 2006. p. 315-321.
http://www.racgp.org.au/afp/200605/200605berger.pdf


And some journal papers in which Prof. McGorry did disclose conflicting interests

Patrick D McGorry, Sherilyn Goldstone (2011) Is this normal? Assessing mental health in young people. Australian Family Physician. March 2011 Vol 40, (3) 94-97.
http://www.racgp.org.au/afp/201103/41499

McGorry, Patrick (2008) Is early intervention in the major psychiatric disorders justified? Yes. British Medical Journal. August 4th 2008. 337:a695.
http://www.bmj.com/content/337/bmj.a695.full

Patrick D McGorry (2005) Evidence based reform of mental health care
Early, intensive, and home based treatments are the answer. British Medical Journal. 2005 September 17; 331(7517): 586–587.
doi: 10.1136/bmj.331.7517.586.
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1215539/

Yucel, Murat et al (2003) Morphology of the anterior cingulate cortex in young men at ultra-high risk of developing a psychotic illness. British Journal of Psychiatry. (2003) 182: 518-524.
http://bjp.rcpsych.org/cgi/content/full/182/6/518


Further Reading

Ahmed, Tanveer (2010) Mental health claims overblown. Sydney Morning Herald. smh.com.au August 12, 2010.
http://www.smh.com.au/opinion/politics/mental-health-claims-overblown-20100811-11zoj.html

APANA Autistic People Against Neuroleptic Abuse
http://www.dinahm.pwp.blueyonder.co.uk/

Attard, Monica (2010) Professor Patrick McGorry, 2010 Australian of the Year. Sunday Profile. ABC Radio National. January 31st 2010.
http://www.abc.net.au/rn/sundayprofile/stories/2010/2806382.htm

Dunleavy, Sue (2011) Schism opens over ills of the mind. Australian. June 16th 2011.
http://www.theaustralian.com.au/news/features/schism-opens-over-ills-of-the-mind/story-e6frg6z6-1226075910650

Dunleavy, Sue (2011) US expert slams Patrick McGorry's psychosis model. Australian. June 14, 2011.
http://www.theaustralian.com.au/national-affairs/us-expert-slams-patrick-mcgorrys-psychosis-model/story-fn59niix-1226074544901

Fitzsimmons, Hamish (2011) Mental health experts disagree on future of care. Lateline. ABCTV. August 18th 2011.
http://www.abc.net.au/lateline/content/2011/s3297038.htm

Francis, Allen J. (2011) Continuing Controversy On Australia's Mental Health Experiment: Seven questions for Dr McGorry. Psychology Today Blogs. June 13th 2011.
http://www.psychologytoday.com/blog/dsm5-in-distress/201106/continuing-controversy-australias-mental-health-experiment

Francis, Allen J. (2011) Australia's Reckless Experiment In Early Intervention: prevention that will do more harm than good. Psychology Today Blogs. May 31st 2011.
http://www.psychologytoday.com/blog/dsm5-in-distress/201105/australias-reckless-experiment-in-early-intervention

Frances, Allen J. (2010) DSM5 'Psychosis Risk Syndrome'--Far Too Risky. Psychology Today. March 18, 2010.
http://www.psychologytoday.com/blog/dsm5-in-distress/201003/dsm5-psychosis-risk-syndrome-far-too-risky

McGorry's early intervention model slammed. Australian Doctor. June 14th 2011.
http://www.australiandoctor.com.au/thisWeek.asp

Marshall, M. and Rathbone, J. Early intervention for psychosis. The Cochrane Library. Cochrane Database of Systematic Reviews. 2011 Issue 6. page 24.
Art. No.: CD004718. DOI: 10.1002/14651858.CD004718.pub3.
http://onlinelibrary.wiley.com/o/cochrane/clsysrev/articles/CD004718/pdf_fs.html
http://onlinelibrary.wiley.com/o/cochrane/clsysrev/articles/CD004718/frame.html
[see "Other potential sources of bias" in the summary of findings]

Raven, Melissa and Jureidini, Jon (2010) Misleading claims in the mental health reform debate. On Line Opinion. August 9th 2010.
http://www.onlineopinion.com.au/view.asp?article=10793

Speed Up & Sit Still (blog of Martin Whitely MLA)
http://speedupsitstill.com/

Stark, Jill (2011) Drug trial scrapped amid outcry. The Age. theage.com.au August 21, 2011.
http://www.theage.com.au/national/drug-trial-scrapped-amid-outcry-20110820-1j3vy.html#ixzz1VduAfoTT

Stark, Jill (2011) McGorry accused of conflict of interest. Sydney Morning Herald.August 7th 2011
http://www.smh.com.au/national/mcgorry-accused-of-conflict-of-interest-20110806-1igxd.html
http://m.theage.com.au/national/mcgorry-accused-of-conflict-of-interest-20110806-1igxd.html

Stark, Jill (2011) Doctors in different headspace on suicide. Sydney Morning Herald. August 7th 2011
http://www.smh.com.au/nsw/doctors-in-different-headspace-on-suicide-20110806-1igk0.html

Webb, David and Raven, Melissa (2010) McGorry's 'early intervention' in mental health: a prescription for disaster. On Line Opinion. April 6th 2010.
http://www.onlineopinion.com.au/view.asp?article=10267

Weber, David (2011) Mental health centres under attack. ABC News. May 12, 2011.
http://www.abc.net.au/news/stories/2011/05/12/3215323.htm

Weber, David (2011) Professor McGorry hits back at critics. The World Today. ABC Radio National. May 20 2011.
Audio:
http://www.abc.net.au/news/audio/2011/05/20/3222359.htm
Transcript:
http://www.abc.net.au/worldtoday/content/2011/s3222359.htm

Whitaker, Robert (2010) Anatomy of an Epidemic: Magic Bullets, Psychiatric Drugs, and the Astonishing Rise of Mental Illness in America. Crown, 2010.
http://www.madinamerica.com/madinamerica.com/Anatomy%20of%20an%20Epidemic.html

Williams, Daniel (2006) Drugs before diagnosis? Time. June 18th 2006.
http://www.time.com/time/magazine/article/0,9171,1205408,00.html