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/

Prof McGorry's pet theory loses battle with reality

I've only just found out about the online publication in late November of last year of a study by former Australian of the Year and influential psychiatrist Prof. Patrick McGorry and his research team, which tested the prof's pet theory that elevated risk for developing psychosis can be identified in young people and treated in an early intervention to prevent a conversion to mental illness.The subjects of the trial were 115 young clients of a PACE clinic in Melbourne. Two supposedly effective forms of intervention were tested: the neuroleptic antipsychotic drug risperidone and cognitive therapy. McGorry's team had planned a couple of years ago to trial a different antipsychotic drug, but that trial was abandoned after complaints from other mental health experts. In this trial only a low dose of the drug risperidone was trialed. Three different combinations of drug or placebo and talking interventions were trialed (check the details for yourself), one being only placebo with "supportive therapy". No significant difference in results was found between the three groups. The supposedly effective interventions apparently weren't found to be any more effective than placebo and a nice chat, and as any true expert in the field of trying to predict risk for developing psychosis could have predicted, a large majority of the youths that had been labelled as being at "ultra-high risk for psychosis" did not become psychotic within the year that the trial was run. Call that ultra-high risk? I certainly don't! The sky isn't falling Henny Penny, and your interventions don't work!

Patrick D. McGorry, MD, PhD; Barnaby Nelson, PhD; Lisa J. Phillips, PhD; Hok Pan Yuen, MSc; Shona M. Francey, PhD; Annette Thampi, MRCPsych; Gregor E. Berger, MD; G. Paul Amminger, MD; Magenta B. Simmons, BA; Daniel Kelly, Grad Dip (Psych); Andrew D. Thompson, MD; and Alison R. Yung, MD (2012) Randomized Controlled Trial of Interventions for Young People at Ultra-High Risk of Psychosis: Twelve-Month Outcome. Journal of Clinical Psychiatry. Submitted: March 16, 2012; accepted September 13, 2012. Online ahead of print: November 27, 2012 (doi:10.4088/JCP.12m07785).
http://article.psychiatrist.com/dao_1-login.asp?ID=10008115&RSID=3876442436586

Thank you Neuroskeptic for the interesting blog post about the trial:

Neuroskeptic (2012) Neither Drugs Nor Therapy Prevent Psychosis. Neuroskeptic. December 15th 2012.
http://neuroskeptic.blogspot.co.uk/2012/12/neither-drugs-nor-therapy-prevent.html

The high price of Julia

According to demographer and former Labor senator John Black, by the middle of 2012, with most polls showing Labor's primary vote stuck at 30 per cent, Julia Gillard had cost her party two million votes.

- Maxine McKew, page three in her recent book Tales from the Political Trenches published by Melbourne University Press

This book is my pick as a summer read for Australian readers with an interest in politics. The book is part autobiography, blending with commentary and reporting on the events before, during and after the winter of 2010 when a highly popular Aussie PM in his first term was deposed by lesser beings, throwing the ALP into an abyss of voter unpopularity, pretty much the same abyss that Rudd had only two and a half years earlier pulled the ALP out of. In case you didn't know, McKew had a long and respected career in journalism at a public broadcaster before retiring and successfully later running for the ALP in the 2007 Rudd landslide federal election, and in doing so unseating the Liberal Prime Minister John Howard who till then had appeared to be unassailable. McKew was later unseated in the 2010 federal election which was a choice between political leaders that could be summed up as "dumb and dumber". So, Maxine has heaps and heaps to write about, and she's got the skill in spades to write in a clear and engaging manner. This is probably why this book drew me in, even to read stuff that I'd not otherwise find of interest. The main attraction for me in this book is McKew's debunking of many of the points in the official ALP/Gillard and Swan account of why Rudd had to be removed, and also McKew's general arguments against the integrity and competence of Gillard and Swan. Many anonymous but apparently very senior ALP sources are quoted by McKew regretting the coup of winter 2010. I can completely understand why such sources would insist on anonymity. There's also a quote from Rudd. Two and a half years later, many Australians are still feeling outrage at Gillard and Swan's disloyal grab for power. It must surely go down in Australian political history as the stupidest decision ever.

I've heard worse....

That wasn't the rumour that I've heard about Tony Abbott, Mr Marr. Did you dig deep enough?

The two faces of Lateline

How ironic. Lateline on the ABC last night featured an interview with Professor Patrick McGorry. He has in the past expressed his concern, as a professional mental health doctor, for the welfare of asylum-seekers imprisoned in detention centres for long periods of time, and he was again expressing such concerns last night. A less likable aspect of the professor is his insistent advocacy of routine and widespread psychiatric intervention into the lives of young people who show what could controversially be interpreted as the first signs of psychosis, including the definite possibility use of controversial neuroleptic drugs such as Seroquel/Quetiapine. Prof McGorry has been the subject of widespread and effective opposition on this front from other mental health professionals. I thought last night's interview on Lateline gave the professor a sympathetic run, with an absence of questions about psychiatric drug interventions and their negative effects. In stark contrast, apparently tonight Lateline will be running an exclusive story about the serious misuse of this same class of stupefying and damaging psychiatric drugs in nursing homes. I really do wonder whether there is a wilful lack of attention going on a the ABC. It is politically easy to question the questionable use of questionable drugs, except when a charismatic public figure says they are completely necessary. 

http://www.abc.net.au/lateline/

I want an assurance from someone in the government that any asylum-seekers who develop mental illness or apparent mental illness while detained overseas will not be inappropriately or routinely prescribed questionable drugs, and will not be included in any trials of interventions of such a nature. 

Tonight's story on Lateline looks like it will be powerful stuff, but I doubt that it will be as big as the expose of the anti-anxiety psychiatric drug Xanax that was on Seven's Sunday Night last month:
http://au.news.yahoo.com/sunday-night/transcripts/article/-/14243425/xanax/

Wild speculation

I wonder, is there anything at all in the idea of a split in the ALP? Would that be a case of Doc Evatt deja vu? 

A political quote to ponder from a wise ALP elder

"I've even, Paul, fought more Greens and Liberals and Nationals than you've done media interviews."  (cheers, applause and smiles from the audience at a left-wing conference) "Why don't you just put a sock in it for once?" 

That was a highlight of ALP Senator John Falkner's reply to union leader and ALP faceless man Paul Howe's attack on the Greens over voting preferences. A short excerpt of Howes' and Falkner's speeches can be viewed on the ABC TV show Insiders. In my opinion, the idea of attacking the Greens has many risks for the ALP, and Paul Howes has demonstrated a level of zero expertise in courting the voter.

Aston, Heath (2012) Put a sock in it, Falkner tells Howes. Sydney Morning Herald. July 15th 2012. 

http://www.smh.com.au/opinion/political-news/put-a-sock-in-it-faulkner-tells-howes-20120714-222tr.html

It's a pity what they've done to Google Search

It's a pity they've buggered up Google search. In the good old days it would have been easy to look up this blog, just type in blond ambition, and maybe the term blog, and you probably would have seen a page from this blog in the first page of results, with no need for the use of quotation marks to bossily direct the search engine in how to do it's job. It would have stood out from all the stuff on the net with the title blonde ambition, all the girly blogs and Madonna paraphernalia, because I chose to spell this blog without the E at the end of blond, to denote the male meaning of the word blond.

But they had to screw up the perfect search engine in the quest of making it idiot-proof, and now Google search takes all manner of misspellings and also legitimate and distinctive spelling variations and makes the assumption that they all mean the same thing, and now the default search is an incredibly vague search which does allow for spelling errors, but also squashes and disregards useful and important information. I'm not sure if this is the same methodology that was used to stuff up PubMed many moons ago. I've given up trying to figure out how PubMed works, I just muddle on with it and throw as much relevant info at it as possible, and now look upon it as an unwilling servant to be beaten into submission.

So now, it appears that the best and possibly only way to quickly retrieve my political blog using Google search is to do a search that is part phrase search, part regular search, thus:

"blond ambition" blog

and there it is at numbers one to four of the first page of results. These days you've got to be a little bit smart to use the new, improved, idiot-proof Google search. That's progress!

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. smh.com.au

June 18, 2012
http://www.smh.com.au/opinion/politics/abbotts-evil-policy-work-20120617-20hzs.html#ixzz1y753sRAD

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

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


http://vimeo.com/41257447

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