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Drugged Up Behind the Wheel: Older Drivers on Psych Drugs 5 Times More Likely to Crash

Tuesday, February 7th, 2012

The Australian – Feb 7, 2012
level of impairment caused by benzodiazepines and some anti-depressants could be compared to that of drinking alcohol.Older drivers who use prescription psychoactive drugs such as benzodiazepines may be five times more likely to be involved in a motor vehicle accident, a new Curtin University study has found.

The study, Psychoactive Medications and Crash Involvement Requiring Hospitalization for Older Drivers: A Population-Based Study, concluded that the use of psychoactive medications, particularly benzodiazepines and anti-depressants, increased the likelihood of involvement in motor vehicle crashes for older drivers.

Head of the Curtin Monash Accident Research Centre (C-MARC) study, Associate Professor Lynn Meuleners, said the level of impairment caused by benzodiazepines and some anti-depressants could be compared to that of drinking alcohol.

“The role of alcohol in traffic crashes has been established, but for prescribed medications there is limited current, evidence-based information,” A/Prof Meuleners said.

“The usage of medications, particularly benzodiazepines and anti-depressants, may contribute to a longer reaction time when faced with the unexpected while driving.

“In this study, older drivers exposed to benzodiazepines were five times as likely to be involved in a hospitalisation crash, and almost twice as likely for drivers exposed to anti-depressants.”

Given that benzodiazepines and anti-depressants are frequently used by people over 60, and polypharmacy (using several drugs at the same time) is also more common among this group, the study’s results bear great implications.

A/Prof Meuleners has therefore called for licensing authorities and policy makers to take note of the study’s results and consider the implications of the findings when creating rules and policy measures for older drivers.

“Inclusion of such medications on medical reporting forms for older drivers to licensing authorities would enable ongoing surveillance that would provide a more comprehensive evidence base of the need for stricter regulatory policies.”

The research, recently published in the Journal of the American Geriatrics Society, involved more than 600 individuals aged 60 and older who were hospitalised as the result of a motor vehicle crash between 2002 and 2008 in Western Australia.

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Prozac is now a defense for murder, writes Australian Member of Parliament Martin Whitely

Wednesday, December 21st, 2011

For the first time in criminal history, a murder was attributed to an anti-depressant drug. (Photo Credit -The Daily Telegraph)

Perth Now – December 21, 2011

FIRST it was ADHD drugs, then organ donation, now WA Labor MP Martin Whitely is hoping to get some action on the fatal risks of antidepressant drugs, such as Prozac, to children.

Anti-depressant manufacturers warn that products such as Prozac should not be given to children, because of the potentially tragic consequences, but they are prescribed every day to Australian kids.

Some anti-depressants, prescribed to help lift people out of a depressive state, actually have the opposite effect and make things worse.

This is what happened, with fatal results, in the case of a 16-year-old boy in Canada who stabbed a friend to death.

For the first time in criminal history, a murder was attributed to an anti-depressant drug.

In the finding, handed down on the 16th of September 2011, a Canadian Judge said a 16-year-old boy, who stabbed his brother’s friend in the stomach, would not have committed the offence had he not been treated with the drug Prozac (a brand of Fluoxetine).

The judge accepted the evidence of psychiatrist, Dr Peter Breggin, who told the court the boy’s symptoms were consistent with a Prozac-Induced Mood Disorder with Manic Features.

In delivering his decision the judge stated, “his basic normalcy now further confirms he no longer poses a risk of violence to anyone and that his mental deterioration and resulting violence would not have taken place without exposure to Prozac”.

The boy, who had no history of violence, had been taking Prozac for three months, during which his parents observed a marked deterioration in his behaviour and mood, which included acts of violence and self-harm where previously no such signs existed.

His alarmed parents returned to his doctor for advice, but instead of taking him off Prozac or reducing his dosage, his doctor increased the dose, obviously believing more of what appeared to be causing these dangerous behaviours, would solve the problem.

Fluoxetine is a selective serotonin reuptake inhibitor (SSRI) and is approved for use in Australia for the treatment of depression, obsessive compulsive disorder and premenstrual dysphoric disorder.

However, it is routinely prescribed ‘off label’ for a range of other conditions including panic and eating disorders.

Australian Government Department of Health and Ageing figures revealed that in the 2008 financial year, 110,848 Australians received Fluoxetine scripts that were subsidised via the Pharmaceutical Benefits Scheme.

Concerns about possible aggression and manic side effects of Prozac were first raised in Australia in the New South Wales parliament in 1995, just five years after the release of the drug in Australia.

Since 2007, the US Food and Drug Administration has labelled SSRI antidepressants including Prozac with the highest possible ‘black box’ warning stating:

“All patients being treated with antidepressants for any indication should be monitored appropriately and observed closely for clinical worsening, suicidality, and unusual changes in behavior, especially during the initial few months of a course of drug therapy, or at times of dose changes, either increases or decreases. The following symptoms, anxiety, agitation, panic attacks, insomnia, irritability, hostility, aggressiveness, impulsivity, akathisia (psychomotor restlessness), hypomania, and mania, have been reported in adult and pediatric patients being treated with antidepressants for major depressive disorder as well as for other indications, both psychiatric and non-psychiatric.”

The US Black Box warning was followed by similar warnings in Australia. The evidence that led to these warnings came from, ‘pooled analyses of short-term placebo-controlled trials of anti-depressant drugs (SSRIs and others)’ which ‘showed that these drugs increase the risk of suicidal thinking and behavior (suicidality) in children, adolescents [by 100%], and young adults ages 18-24 (by 50 per cent) with major depressive disorder (MDD) and other psychiatric disorders.’ The fact that SSRI antidepressants like Prozac are supposed to manage severe depression in young people but increase the risk of suicidality poses obvious questions.

Over a 10 year period, up until 30 June 2011, more than 40 adverse events of self-harm and violence, including suicides, homicides and suicidal or homicidal ideation, for Fluoxetine were reported to the Australian Therapeutic Drugs Administration (examples are listed below).

Hundreds of reports were recorded by the TGA for other antidepressants however, it is impossible to know the true number of actual events, as the voluntary nature of the reporting system means only a fraction of actual incidents gets reported.

Despite the fact that the manufacturers advise that Prozac and other SSRI antidepressants are ‘not recommended for use in children and adolescents under 18 years of age’ they are frequently prescribed ‘off label’ to even very young children.

Data provided by the Commonwealth Department of Health revealed that in the 2007-8 financial year 3,752 Australian children 15-years-old or younger (863 were 10 or younger, 117 were six or younger) were prescribed Pharmaceutical Benefits Scheme-funded Fluoxetine.

Furthermore all the expense and risks of adverse side effects may be for little or no benefit. The efficacy of antidepressants are being questioned – with some high profile, mainstream critics, arguing that placebos are just as effective and much safer in treating moderate depression.

One such critic, Marcia Angell, MD, Senior Lecturer on Social Medicine at Harvard Medical School and former Editor-in-Chief of The New England Journal of Medicine, contends; ‘that clinical trials have failed to find antidepressants effective at all in mild to moderate depression; that many psychiatric drugs have devastating adverse effects, especially in children and when used long-term; and that despite the risks and uncertain benefits, use of psychiatric drugs is soaring and the heavy reliance on drugs diverts resources better spent on improving treatment’.

In summary, taxpayers are subsidising the ‘off label’ use by children and adolescents of antidepressants, with questionable efficacy, that double their risk of suicidality. This invites some obvious questions: Is this the best way to spend our taxes? And more importantly, is this the best way to help troubled young people?

* A sample from the Adverse Drug Reactions Committee (ADRAC) adverse event reports for Fluoxetine Hydrochloride:

  • A 54 year old woman attempted suicide. She was also suffering from mania and a confusional state.
  • A 36 year old woman “attempted suicide”.
  • A 36 year old woman was admitted to intensive care in a coma following a suicide attempt.
  • A 51 year old woman “had sudden urge to murder someone”.
  • A 37 year old woman was admitted to a psychiatric hospital suffering from “suicidal ideation, nausea, trembling, feelings of despair, anxiety, paranoia and fear”.
  • A 16 year old boy suffering from agitation and auditory hallucinations heard voices “telling him to kill his mother, father, sister and himself”.
  • A 45 year old man “became obsessively suicidal and cut his throat” 3/7 days after Prozac was stopped.
  • A 17 year old girl “became manic half an hour after commencing antidepressant.”
  • A 40 year old patient “experienced trembling, cramps, heard voices and had suicidal ideation.”
  • A patient of unrecorded gender and age experienced “homicidal and suicidal ideation.”
  • A patient of unrecorded gender and age attempted suicide after experiencing suicidal ideation.
  • A 44 year old patient “experienced akathisia, suicidal ideation and suicide attempt.”
  • A patient of unrecorded gender and age experienced “suicidal violence” and “aggression.”
  • A patient of unrecorded gender and age experienced “suicidal ideation.”
  • A patient of unrecorded gender and age experienced “suicidal ideation and “suicide attempt.”
  • A 50 year old patient experienced “suicidal ideation, suicide attempt and akathisia.”
  • A 37 year old patient attempted suicide.
  • A patient of unrecorded gender and age experienced “suicidal ideation and suicide attempt.”
  • A patient of unrecorded gender and age made a suicide attempt and was violent.
  • A 16 year old girl “attempted to hang herself with television cord from curtain rail in hospital bedroom. Nurse said she found her at the last moment.”
  • A 16year old girl “ingested 40 Panadol tablets. Also frequent self-harming.”
  • A 16 year old girl “attempted suicide by ingestion of 80 Panadol, 20 Panadeine, 7 Olanzapine.”
  • A 29 year old patient “developed acute suicidal akathisia” and made a suicide attempt.
  • A 73 year old patient “experienced homicidal ideation and made a suicide attempt.”
  • A 60 year old woman “experienced suicidal ideation, suicide attempt and homicidal ideation – she attempted to kill her parents.”
  • A 69 year old patient “experienced suicidal ideation and was very anxious.”
  • A 16 year old girl attempted to “strangle herself with and IPod cord in the bathroom of the hospital. Agitation. She ran around crying and banging her fists of the walls and windows begging to be let out. … it lasted about 10 minutes before I could settle her.”
  • A patient of unrecorded gender and age “took a fistful of sleeping pills.”
  • A 35 year old patient “murdered his wife whilst on Prozac. He had also experienced suicidal thoughts.”
  • A female patient of unrecorded age “became seriously depressed, complained of headaches, and clenching jaw, was unable to sleep and started to self-harm. She began to have suicidal thoughts, was hyperventilating, agoraphobic, had five suicide attempts, was confused, tearful, phobic, aggressive, experienced akathisia and suspected serotonin syndrome. She experienced weird dreams, was impulsive, light headed, had numbness and tingling limbs and committed suicide by hanging on 11 September 2000 on the second attempt.”
  • A 50 year old woman “became more depressed whilst taking Prozac. She wanted to throw herself off a train or bus, had difficulty sleeping, was pacing and restless, had voice hallucinations, would look in the mirror and see a different person, had murderous thoughts, stiff legs, was hot a lot, felt she was in a delirium, could not concentrate, was angry, had numbness in her hands and pins and needles a lot in her body.”
  • A 19 year old male “had thoughts about killing himself which made him violent, tried to hit someone else, tried to hit a security guard with feelings of killing and tried to do physical damage. Tried to hurt himself and had thoughts of hurting other people. He was walking faster than normal. Experienced aggression, insomnia and was feeling high on Prozac. Also felt anxious and put on more than 20kg.”
  • A male of unreported age “experienced severe depression, cognitive impairment and was acutely suicidal.”
  • A 16 year old girl was “cutting herself, throwing herself against the walls while an inpatient”. She “intentionally overdosed on Fluroxetine” and “developed severe levels of aggression and violence.”
  • A 14 year old boy experienced “suicidal ideation.”
  • A female of unreported age “experienced suicidal ideation”.
  • A 16 year old girl experienced “excessive bleeding, psychosis, high blood pressure, severe diarrhea, sweating, tremors, violent, aggressive and suicidal behavior, serotonin syndrome.”
  • A 14 year old male experienced “severely increased suicidal ideation in two days with high level of intent and plan to jump in front of train. Previously no suicidal ideation and settled spontaneously within four days of ceasing Fluoxetine”.
  • A female patient experienced a “sudden and marked increase in hostility and verbal abuse of others and describes intrusive suicidal ideation. Seems agitated and restless”.
  • A 32 year old woman experienced “audio hallucinations, bright and blurred vision, made everything sound louder, constipation, increased suicidal thoughts and increased anxiety”

http://www.perthnow.com.au/news/western-australia/prozac-is-now-a-defence-for-murder/story-e6frg13u-1226227796937

Note from CCHR International:  CCHR is the only organization to have decrypted the US FDAs Medwatch reports on adverse reactions to psychiatric drugs and compiled them in an easy to search database.    This database is provided here http://www.cchrint.org/psychdrugdangers/medwatch_psych_drug_adverse_reactions.php

CCHR has also compiled all international drug warnings and studies on psychiatric drugs here http://www.cchrint.org/psychdrugdangers/drug_warnings.php

 

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Medical mafia in Australia to force parents to drug children diagnosed ‘ADHD’

Tuesday, November 29th, 2011

Natural News – 11/20/2011

Australian government is actually considering mandating parents of diagnosed children accept the prescribed drug treatments or else face the wrath of child protective services.

The typical treatment recommendation for children diagnosed with psychiatric or mental health conditions such as bipolar disorder or attention deficit hyperactivity disorder (ADHD) includes a combination of behavior and drug therapies. Such treatments are legally optional, but the Australian government’s National Health and Medical Research Council (NHMRC) is actually considering mandating that parents of diagnosed children accept the prescribed drug treatments or else face the wrath of child protective services.

Australia’s Sky News reports that authorities originally crafted the proposed measure as a guidance for doctors in how to treat children with such conditions, writing in a draft paper that “combined behavoural-pharmacological treatment is most effective” for normalizing child behavior. In the process, these authorities are essentially pushing a draconian form of medical tyranny that will eliminate health freedom of choice, and force parents to take the drug route with their children.

The entire field of psychiatry and its mental health screening process is questionable to begin with, as ADHD, bipolar disorder, and depression are not verifiable medical conditions like heart disease or cancer. There are no legitimate scientific tests to determine without a doubt the presence of these ambiguous “conditions” — and yet the entire psychiatric industry is built on pushing $84 billion worth of pharmaceutical drugs every year as treatment for them (http://www.cchrint.org/psychiatric-…).

Psychiatric drugs cause drastic changes in the cognitive and behavioral profiles of children. Drugs are not necessarily for the better. Most of these drugs also cause severe side effects, including mind-altering hallucinations, and they are typically far more addictive than illicit drugs like marijuana, cocaine, and heroin, all of which are illegal.

But certain government officials, likely influenced by Big Pharma, are continuing to propagate the lie that psychiatric drugs are the only option for these often-fictitious mental disorders. West Australian Labor MP, author, and anti-ADHD medication campaigner Martin Whitely is quoted in News Tonight as saying that ADHD drugs are “the only possible medical interventions” and that parents who refuse to use them “may see their child put in care.”

Earlier this year, a SWAT team raided the Detroit home of Maryanne Godboldo for refusing to medicate her daughter with dangerous psychiatric drugs. These thugs actually kidnapped the young girl, who was eventually released after it was determined that Maryanne had every right to choose her own daughter’s medical care (http://www.naturalnews.com/032089_a…).

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Instead of drugs, children need a good dose of parenting

Friday, November 25th, 2011

The Australian – 11/26/2011

by Frank Furedi

As far as the American Academy of Pediatrics is concerned you can never drug children early enough.

It is important to realise that what drives the steady expansion of the diagnosis of ADHD among children is not the discovery of a hitherto unknown medical condition, but the cultural redefinition of some of the normal existential problems of childhood

In their recently published guidelines they recommend that children as young as four can be treated with the psycho-stimulant drug Ritalin.

These new guidelines issued by the academy at its annual conference in Boston proposed that preschool children who show symptoms of inattention and hyperactivity should be evaluated for pharmacological intervention. “Treating children at a young age is important, because when we can identify them earlier and provide appropriate treatment, we can increase their chances of succeeding in school,” was how Mark Wolraich, one of the authors of the guidelines, justified this proposal.

The targeting of preschoolers by the academy is an integral part of a disturbing tendency to advocate medical and pharmaceutical intervention as a legitimate option for the management of childhood behaviour. The campaign, which has as its premise the conviction that children’s behavioural problems represent a marker for mental illness, implicitly assumed a coercive and intrusive form. In Australia, draft guidelines being considered by the National Health and Medical Research Council threaten parents who refuse to medicate children diagnosed with ADHD with being referred to child protection authorities. The proposed guidelines assert that “as with any medical intervention” the “inability of parents to implement strategies may raise child protection issues”.

Regardless of whether these authoritarian draft guidelines will be accepted by the NHMRC, they demonstrate a dangerous tendency to transform child-rearing into a form of professionally dominated behaviour management. The guidelines should not be seen as simply the work of a handful of insensitive and zealous Ritalin promoters. Parents throughout the Anglo-American world face considerable pressure to medicate their children. In the US and Britain, numerous parents have been given an ultimatum by their children’s school either to start giving their child Ritalin or leave. Consequently the number of children diagnosed as suffering from ADHD is continually on the increase. According to the academy, one in 12 children suffer from this condition.

It is important to realise that what drives the steady expansion of the diagnosis of ADHD among children is not the discovery of a hitherto unknown medical condition, but the cultural redefinition of some of the normal existential problems of childhood. In the eyes of the supporters of early-years medicalisation, virtually every manifestation of a child’s behaviour can be diagnosed as a medical issue. That is why they argue that doctors should evaluate children from four onwards for signs such as fidgeting, excessive talking, reluctance to concentrate and abandoning homework or chores. Apparently such normal forms of misbehaviour are symptoms of ADHD. So according to these experts, ADHD is characterised by many of the traits that would, in the absence of a medical definition, be frowned on as bad behaviour: inability to concentrate, lack of application, unruliness.

Although most sensible people are likely to be appalled by the proposal to drug preschool children, it is likely that the medicalisation of childhood will continue to gain institutional support. The main reason why children’s behaviour has become a target for pharmacological intervention is because of the difficulty that adults have in exercising authority over the life of young people. Parents have always found it difficult to deal with their toddler’s defiance and with adolescent discipline. Today, however, this age-old problem has become far more difficult to manage because of the tendency to devalue adult and parental authority.

Read the rest of the article here

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Australia—New Guidelines Threaten Parents Who Refuse to Drug Their Kids

Monday, November 21st, 2011

Note from CCHR: The group that fought for, and won, state legislation in the United States prohibiting schools from being able to force a parent to drug their child as a condition of attending school, was CCHR.     The article does not mention that in the U.S. this bill was also passed on a federal level, the Prohibition on Mandatory Medication Amendment (also due to CCHR’s efforts).   Now it appears Australia is in desperate need of similar legislation.

The Australian – November 21, 2011

EXPERTS have warned that parents who don’t medicate children with ADHD could be referred to child protection authorities under controversial draft guidelines being considered by the National Health and Medical Research Council.

The practice points, to guide doctors who treat the disorder, were drawn up by an NHMRC expert working group to address community concern over the use of stimulant medication to treat attention deficit hyperactivity disorder. They state: “Consideration should be given to the ability of the child/adolescent and their caregivers to implement strategies. As with any medical intervention, the inability of parents to implement strategies may raise child protection concerns.”

West Australian Labor MP, author and anti-ADHD medication campaigner Martin Whitely says “the only possible medical interventions are ADHD drugs and the implied threat that a parent’s refusal to allow their child to be ‘medicated’ with amphetamines may see their child put in care”.

The clinical practice points are open for public comment until the end of the week and he is calling for the statement to be removed because he fears it may lead to a situation similar to that in the US.

Some US states have had to legislate to prevent schools and child protection authorities from telling parents they must put their children on drugs, he said.

However, child psychiatrist and Monash University lecturer George Halasz says the situation should not be seen as unique to ADHD and parents who fail to manage serious conditions such as their child’s asthma or diabetes could also be considered to be failing their duty as a parent.

Dr Halasz said the new guidelines were a step in the right direction because they asked doctors to first try to find other explanations for a child’s behaviour before they diagnosed ADHD.

And he says it will not be humanly possible to diagnose ADHD in a single 50-minute consultation under the new clinical practice points.

“If any child is given medication after one consultation, then that child should be reviewed,” he said.

The practice points state that “a child who meets diagnostic criteria for ADHD may not be best served by making that diagnosis” and says their behaviour may be better understood as a reaction to more specific cognitive difficulties or family/environmental services.

The document says “not all people with ADHD will require, or benefit from, pharmacological management”.

It says children using medication should receive a three- to six-monthly review and that the long-term effects of ADHD drugs are unknown.

However, the document also says “for children and adolescents diagnosed with ADHD, stimulant medications like Ritalin can reduce core ADHD symptoms and improve social skills and peer relations in the short term”.

In the short term, the paper says, “combined behavioural-pharmacological treatment is most effective” in normalising child behaviour.

Controversy has dogged the NHMRC’s ADHD guidelines since Daryl Effron, the original chairman of the committee, resigned because of his association with drug companies that produce ADHD medications.

http://www.theaustralian.com.au/national-affairs/medicate-adhd-kids-or-else-parents-told/story-fn59niix-1226200652633

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Mental health services have become increasingly dominated by psychiatry’s ”medical model”

Friday, September 16th, 2011

The Sydney Morning Herald, Australia – “With More Talk in Mind” – Sep 15, 2011

by Dr. John Reed, Professor of Clinical Psychology

SERIOUS problems in Victoria’s mental health system have been revealed recently in The Age. The important thing now is to find solutions. In doing so we should remember that although Victoria is in the spotlight, similar ”crises” occur regularly all over the world. Perhaps this is because Victoria is not alone in having a system based on fundamentally flawed principles.

Mental health services have become increasingly dominated by psychiatry’s ”medical model”, which claims that feeling depressed, anxious or paranoid is primarily caused by genetic predispositions and chemical imbalances.

This has led to alarming rises in chemical solutions to distress. In New Zealand, one in nine adults (and one in five women) is prescribed antidepressants every year.

The public, however, in every country studied, including Australia, believes that mental health problems are caused by issues such as stress, poverty and isolation. The public also prefers talking therapies to drugs and electroconvulsive therapy (ECT).

Research suggests the public is right. For example, the single best predictor of just about every mental health problem is poverty, followed by other social factors such as abuse, neglect and early loss of parents in childhood, and – once in adulthood – loneliness and a range of adverse events including losses and defeats of various kinds.

Meanwhile, reviews of studies on anti-depressants (which only recently have been able to include those previously kept secret by drug companies) conclude that they are superior to placebos only for those at the extreme end of the ”most severe” group of depressed people. This represents less than 10 per cent of the people who are receiving these drugs.

A recent Cochrane review (the type most highly regarded in the scientific community) for risperidone, a leading anti-psychotic drug, ”suggests that there is no clear difference between risperidone and [a] placebo”.

A placebo (from the Latin meaning ”I please”) is not necessarily a bad thing. Indeed the talking therapies are effective partly because, if done well, they too instil hope and expectations of recovery.

The problem is that psychiatric drugs often have serious adverse effects. Anti-psychotics, for instance, can cause rapid weight gain, loss of sexual function, diabetes, heart disease, neurodegeneration and reduced life span.

As previously reported, my review of ECT studies (with Professor Richard Bentall of Liverpool University) found that this treatment is ineffective for most recipients and frequently causes permanent memory loss. This in itself can be depressing.

ECT also has a slight but significant risk of death, most frequently from cardiovascular failure.

Inpatient units are equally ineffective and can also be damaging. When will we learn that putting large numbers of extremely distressed people in the same building is not a good idea?

What I conclude from all this is that any review of mental health services in Victoria, or anywhere else for that matter, should probably be led by anyone other than a psychiatrist – and certainly not in Victoria’s case the state’s Chief Psychiatrist, whose job, according to Dr Ruth Vine herself, is “to watch over how the system is functioning”.

It is unfair to expect Dr Vine to take an objective view on the failure of the system for which she is responsible. That lack of objectivity is amply demonstrated by her claims that ECT is “safe and effective” and that the problem is the public’s “negative” views.

Perhaps a lawyer from the Mental Health Legal Centre might be a good choice.

Read the rest of the article here: http://www.smh.com.au/opinion/society-and-culture/with-more-talk-in-mind-20110914-1k9m2.html#ixzz1Y8tVJQlv

 

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Politics and mental health a poor mix

Wednesday, September 14th, 2011

The Sydney Morning Herald – September 13, 2011
by Tanveer Ahmed

"Mental health possesses a built-in capacity for abuse that is greater than in other areas of medicine."

Imagine a tribunal where the public could challenge clinical decisions by neurosurgeons or cardiologists. It would be ridiculous. But mental health is different. Unlike other medical specialties, it resembles law or politics: fields where subtle variations in the interpretation of a word can alter the entire trajectory of a patient’s treatment.

That’s why the right to appeal clinical decisions by mental health professionals through a tribunal, announced recently by the NSW government, met with public approval. Mental health possesses a built-in capacity for abuse that is greater than in other areas of medicine. A patient’s psychiatric diagnosis has enormous cultural power in many other fields, from the marketing of antidepressant medications, to general practice, disability claims and legal proceedings.

The contestable nature of mental health is also why there is a constant battle to keep it free from politics. Some of the 20th century’s most despotic regimes used mental health to oppress opponents, coining disorders such as ”delusions of capitalism” in the Soviet Union or ”politically paranoid” in China. But psychiatry has a way of becoming a political football in public discourse regardless of how authoritarian or democratic the society.

Today it is increasingly a tool of progressive politics, used to highlight the human pain apparently caused by harsh policies. In the case of asylum seekers, for example, any emotional distress is automatically viewed through the lens of mental health. Resilient individuals who have escaped harsh circumstances and coped with far-reaching travel are suddenly classified as fragile, undone by bureaucratic delay and limited incarceration. There is no doubt mental illness exists among asylum seekers, but its prevalence is vastly overstated.

In one of the more farcical applications of psychiatry to political debates, a report this month linked inaction on climate change to the possibility of worsening mental health. Released by the Climate Institute, it suggested that increasing natural disasters might be linked to climate change, which might lead to increased costs in mental healthcare. The evidence for every link was slight at best, yet the novelty of the report ensured widespread attention.

It was launched by Professor Ian Hickie, who has been rightly recognised for giving mental health a greater profile, but who has also played politics to do so.

Hickie has done more than any other clinician to promote tick-a-box diagnosis, particularly among general practitioners, who now regularly prescribe antidepressants through questionnaires alone.

"It is disingenuous to suggest, as McGorry has done, that there is no conflict of interest because their organisations are non-profit."

With former Australian of the Year Professor Patrick McGorry, Hickie has made overblown claims about the prevalence of mental health. It is disingenuous to suggest, as McGorry has done, that there is no conflict of interest because their organisations are non-profit. Their bodies shared in $2.2 billion of funding in the federal budget. Their exorbitant claims – such as one in four people will suffer mental illness – are indicative of a blurring of the lines between illness and normal, human responses to adversity.

Another good example of the uneasy relationship between politics and mental health – and how one can colour the other – is the former Victorian premier Jeff Kennett, a tireless campaigner in raising awareness for depression who openly admits he uses the term not in its medical context, but as a synonym for emotional distress.

The fiercest critics of this modern therapeutic culture in Western societies have argued that the decline of the political left is at the heart of the trend – in particular, the collapse of any ambition for social change.

Having given up on the notion that human beings could collectively change the world, the argument goes, the left has instead focused on people adapting to their circumstances.

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Australia—Deaths in mental health facilities: unexpected, unnatural and violent

Friday, September 2nd, 2011

 

Click Image to Read CCHR's Mental Health Declaration of Human Rights

 

The Sydney Morning Herald— September 3, 2011

by Richard Baker and Nick McKenzie

 

THIRTY-SIX people died unexpected, unnatural or violent deaths in Victorian mental health facilities between 2008 and 2010, Coroners Court files reveal.

Data released to The Saturday Age by the Coroner’s Prevention Unit reveals 119 of the 502 coronial inquests held in Victoria between 2008 and 2010 involved people with diagnosed mental illnesses.

Of those 119 mental health coronial cases, almost a third related to the deaths of patients while they were being treated at state-run and private mental health facilities.Other figures from the Department of Health show 975 people under the care of Victoria’s mental health system have died unnatural, unexpected or violent deaths between 2006 and 2010.

These include mental health patients under the care of the state who committed suicide outside psychiatric facilities, as well as those who died in car accidents and house fires or drowned. But they also include dozens of patients who died in Victorian psychiatric wards.

The Saturday Age today publishes an investigation into the deaths of three men who died in state-run psychiatric wards across Melbourne between 2007 and 2009: Adam White, 31, Anthony Travaglini, 40, and Jeffery Hartwig, 43.

Each case involves allegations that serious failings by senior mental health staff may have contributed towards their unexpected deaths. Evidence also suggests that the health services involved allegedly covered up or failed to collect important information about the deaths, possibly preventing a proper examination of their cause.

Mr White’s death was the subject of a coronial inquest this year but a finding has yet to be made. The deaths of Mr Travaglini and Mr Hartwig are to be investigated by a coroner at a later date.

Southern Health, the health service responsible for the care of Mr Hartwig and Mr White care, this week complained to the Coroner’s Court after receiving questions from The Saturday Age about their deaths. A suppression order was made by coroner John Olle preventing the newspaper from publishing important information about Mr Hartwig’s death. Despite this, the paper is determined to report as much as it can about these deaths.

Our investigation found:

■ Mr Travaglini, who died in September 2008 at Eastern Health’s Upton House psychiatric hospital in Box Hill, was killed by a combination of powerful anti-psychotic medications given to him by staff, according to a Victorian government pathologist. Staff and patients aware of the circumstances of his death say the 40-year-old was pleading not to be given more drugs on the night he died. Staff and patients also allege there was an attempt to conceal information about the circumstances of his death from his family.

■ Mr Hartwig died at the Monash Medical Centre in December 2009 after he went into a coma following a suspected overdose of illicit drugs supplied by unknown visitors. His family says the hospital’s psychiatric ward kept no visitor log nor did it supervise visits to patients. Police sources say the hospital’s legal department interfered with their investigation and ordered staff not to speak about the circumstances of Mr Hartwig’s death.

■ Mr White’s 2007 death at Dandenong Hospital’s psychiatric ward during a struggle with security guards was the subject of a recent inquest. A finding has yet to be made, but evidence to the inquest suggests Mr White was asphyxiated while being held face down by security staff. A witness told the inquest that Mr White apparently yelled ”I give up”, but security did not ease off. He died soon after.

The circumstances of the men’s deaths and the treatment of their families raise questions about whether there is a culture of cover-up in the Victorian mental health system. The families have complained of a lack of answers from health services responsible for the care of their loved ones.

Eastern Health declined to comment, citing the coming inquest into Mr Travaglini’s death.

In addition to asking that details of Mr Hartwig and Mr White’s deaths be suppressed, Southern Health said it was ”committed to patient-centred care and constant improvement in regards to the quality of service we provide to our patients”.

Health Department statistics show that 239 people, 162 of them men, under the care of Victoria’s mental health system died unexpected, unnatural or violent deaths in 2009-10.

Melbourne Health and Eastern Health had the highest rates of unexpected, unnatural or violent deaths, with 44 and 31 respectively.

In 2008-09, there were 302 such deaths. In 2007-08 there were 205 and in 2006-07 there were 229.

Victoria’s chief psychiatrist, Ruth Vine, admitted the performance of Victoria’s mental health system could improve.

Dr Vine said she could not comment on the specific issues identified in the three deaths.

But she said the mental health area was one of the most difficult for health professionals.

”I don’t wish to be defensive or an apologist because I’d be the first to admit that our care provided is not perfect all the time,” Dr Vine said.

”But it is difficult to manage fairly large, fairly aggressive men and I think it is the case in some of these [deaths] that there was a degree of physical unwellness underlying.”

Dr Vine said Victoria had taken steps in recent years to improve care given to mental health patients.

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‘Former Australian of the Year’ Psychiatrist Patrick McGorry Accused of Conflict of Interest

Saturday, August 6th, 2011

Sydney Morning Herald – August 7, 2011

by Jill Stark

”It’s extremely worrying that the government is listening to professional lobbyists who have a massive personal investment in the programs they’re recommending – and they are undoubtedly overstating the evidence. There’s a massive conflict of interest there,” Professor Castle said.

 

Patrick McGorry Photo: Pat Scala

PSYCHIATRISTS, psychologists and patients’ groups say there is a growing backlash against the federal government’s mental health reforms and have accused its expert adviser, former Australian of the Year Patrick McGorry, of a conflict of interest.

Several mental health specialists have told The Sunday Age the focus on early intervention for adolescents and young adults has been ”massively oversold” by the ”McGorry lobbying machine”.

They claim he used his position on the government’s mental health expert working group to recommend funding for programs he founded.

David Castle, head of psychiatry at Melbourne’s St Vincent’s Hospital, said Professor McGorry, – who founded headspace (Australia’s national youth mental health foundation) and the early psychosis prevention and intervention centres – and Professor Ian Hickie, a headspace board member, had overstated the evidence for early intervention for young people at risk of psychosis.

Headspace is a service for 12 to 25-year-olds with mild to moderate problems such as bullying, stress and relationship difficulties. Patients do not require a GP-referral. The early psychosis prevention and intervention centres provide integrated psychiatric, psychological and social support for 15 to 24-year-olds.

Between them, the two services received almost a quarter of the $2.2 billion mental health package in the May federal budget. Both professors McGorry and Hickie were on the government’s mental health expert working group that advised the Prime Minister.

”It’s extremely worrying that the government is listening to professional lobbyists who have a massive personal investment in the programs they’re recommending – and they are undoubtedly overstating the evidence. There’s a massive conflict of interest there,” Professor Castle said.

The row comes after US psychiatrist Allen Frances – chairman of the committee that produced the Diagnostic and Statistical Manual of Mental Disorders IV, the key psychiatric diagnostic source – described Australia’s investment in early intervention as a ”vast untried public-health experiment”, claiming there was little evidence it had long-term benefits.

The dispute is in part a turf war about where limited funding should go. Some argue traditional GP and psychiatrist-led care has failed teenagers and youths who fall between paediatric and adult services, leading to delays in treatment.

About 14 per cent of children aged four to 17 have mental health problems, with depression and anxiety disorders the most common. About 2 per cent suffer from a psychotic illness.

George Patton, professor of adolescent health research at Melbourne’s Royal Children’s Hospital, praised Professor McGorry’s work but said his faith in early intervention was not shared by everyone. ”There’s a real groundswell of concern amongst the senior psychiatric community that we are running ahead of the evidence,” he said.

Professor McGorry rejected the claims, accusing critics of being a small minority who are ”disaffected, destructive and irresponsible”, and who are misusing scientific evidence to protect their turf and the ailing traditional mental health model.

”The reforms around early psychosis and headspace advantage patients and families, and have 20 years of solid evidence behind them, with successful upscaling in hundreds of communities worldwide,” Professor McGorry said.

He said there was no conflict of interest as he and Professor Hickie headed non-profit organisations, and while ideally all services would have received more funding, young people had the most acute needs.

Peter Birleson, former director of mental health services at Melbourne’s Royal Children’s Hospital, disagreed. ”The McGorry machine is distorting things in Australia. There’s people in the UK who look at what’s happening in adolescent and youth psychiatry here and think that it’s completely mad. While McGorry champions the cause of youth and young adults, actually 50 per cent of lifelong mental disorders appear before the age of 14, so there should be a massive shift towards strengthening services to children,” Dr Birleson said.

Professor Hickie said he and Professor McGorry had long advocated for services outside the youth area, and had no more influence than anyone else on the government’s working group.

”People taking cheap shots is disappointing but it’s characteristic of the mental health area. When there’s been very little investment, people end up fighting over the crumbs,” he said.

Louise Newman, past president of the Royal Australian and New Zealand College of Psychiatrists, said the focus on early intervention was too narrow and could lead to young people being overmedicated, prematurely diagnosed and stigmatised.

However, David Crosbie, chief executive of the Community Council for Australia and former head of the Mental Health Council of Australia, said professors McGorry and Hickie were being targeted for challenging current practice. ”I have nothing but admiration for Pat and for Ian, who are prepared to go well beyond what their roles are to try and make a difference – and it’s a pity that other people in the sector couldn’t support improvements for the greater good of mental health.”

Another supporter, SANE Australia’s executive director, Barbara Hocking, said Professor McGorry had championed services he wasn’t involved with and was instrumental in getting more funding for the sector overall.

Money for the early intervention programs came from cuts to the over-budget Better Access scheme, which provides psychological services through GPs, psychologists and social workers.

The cuts were opposed by the Australian Medical Association, the Royal Australian College of General Practitioners, and the Australian Psychological Society, which claim people with anxiety and depression now will be priced out of treatment.

Professor Hickie and Monsignor David Cappo, who is also on the government’s working group, opposed the Better Access scheme. Prior to the budget they, along with Professor McGorry, released a blueprint to transform mental health. It listed 30 ”best buys” in mental health – Better Access was not among them.

Ben Mullings, head of the Association of Counselling Psychology, said the government’s working group could not claim to be independent when panellists were direct beneficiaries of funds.

Victorian Mental Illness Awareness Council director Isabell Collins said she respected Professor McGorry’s commitment to youth but felt other age groups were being neglected.

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DSM 5 Will Further Inflate The ADD Bubble

Tuesday, August 2nd, 2011

Psychology Today
by Allen Frances, Former Chairman, DSM Task Force

Video: ADHD Labeling Normal Kids "Mentally Ill"

The Child Work Group Fails Again To Learn From Its Experience

Martin Whiteley is an MP who represents Perth in the Australian parliament. He has been actively involved in mental health issues and succeeded in a crusade to curb what had been Perth’s alarming overdiagnosis and overmedication of  Attention Deficit Disorder Disorder (ADD). Mr Whiteley has become expert in the intricacies of ADD and is alarmed that the changes suggested for DSM 5 will greatly exacerbate the ADD fad he worked so hard to tame. Read Mr Whiteley’s careful item by item review and you will be alarmed too:

http://speedupsitstill.com/dsm-5-proposal-adhd-%e2%80%93-making-l…

We are already in the midst of a false epidemic of ADD. Rates in kids that were 3-5% when DSM IV was published in 1994 have now jumped to 10%. In part this came from changes in DSM IV, but most of the inflation was caused by a marketing blitz to practitioners that accompanied new on-patent drugs amplified by new regulations that also allowed direct to consumer advertising to parents and teachers. In a sensible world, DSM 5 would now offer much tighter criteria for ADD and much clearer advice on the steps needed in its differential diagnosis. This would push back ,however feebly, against the skilled and well financed drug company sell. DSM 5 should work hard to improve its text, not play carelessly with the ADD criteria in a way that may unleash a whole set of dreadful unintended consequences- unneeded medication, stigma, lowered expectations, misallocation of resources, and contribution to the illegal secondary market peddling stimulants for recreation or performance enhancement.

The DSM 5 child and adolescent work group has perversely gone just the other way. It proposes to make an already far too easy diagnosis much looser.

How puzzling and troubling. Child mental health has already promoted no fewer than three false epidemics in just 15 years- ADD, childhood bipolar, and autism. Any reasonable group would now be learning from this past experience. For the future, it would be chastened, cautious, and eager to correct the damage it has done- rather than embarking on any reckless new adventures. A prudent DSM 5 would tighten its criteria for ADD and put in a black box warning against the blatant current off-the-DSM-label diagnosis of childhood bipolar. DSM 5 instead does everything wrong it possibly could with ADD and then remarkably takes the mischievous further step of adding yet another new candidate for diagnostic fad (Disruptive Mood Dysregulation Disorder) likely that will increase the already scandalous overprescription of dangerous antipsychotic medication to children. Go figure.

In many circles, the accepted wisdom is that DSM 5 workers are making such unaccountably bad decisions because they want to promote drug sales to kids. To support this accusation, cynics raise the Biederman affair and also APA’s previous excessive financial support from Pharma.

This is one time when the cynics are dead wrong. The DSM 5 work group is making simply disastrous decisions for the purist of reasons. These are not people with close industry ties and their conflict of interest is intellectual, not financial. Experts in child psychiatry are dangerously naïve about the likely misuses of their well meaning suggestions. They are blind, not corrupt.

What is needed is outside supervision to curb child psychiatry’s seemingly endless taste for diagnostic excess. And APA should also realize the grave harm done to its credibility by the appearance that DSM 5 is far too Pharma friendly even if this has not been the real motivation behind the bad DSM 5 proposals.

To make matters worse, the DSM 5 field trial will be completely worthless- providing no information at all about the magnitude of the rate increase in ADD that will occur once DSM 5 opens the floodgates even wider. We did careful field trials before DSM IV to compare the impact on rates of the different possible definitions and predicted a 15% increase for the one finally chosen. Instead, the rates more than doubled- courtesy of pressure from the drug companies. For obscure reasons, DSM 5 is conducting extraordinarily expensive field trials that (again perversely) avoid the only question that really counts- just how high will the rates skyrocket under the even easier to meet new DSM 5 definition.

DSM 5 will be flying completely blind into dangerous territory, unimpeded by adult supervision. The leaders of child psychiatry (who already have the unfortunate track record of producing fads) will now be given a free pass to further feed their blossoming ADD fad. Will they never learn from past mistakes?

http://www.psychologytoday.com/blog/dsm5-in-distress/201108/dsm-5-will-further-inflate-the-add-bubble

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