Posts Tagged ‘Patrick McGorry’

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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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Australian Psychiatrist Patrick McGorry Aborts Controversial Antipsychotic Drug Trial on Kids Amid Protests

Saturday, August 20th, 2011

Drug Trial Scrapped Amid Outcry

The Age
By Jill Stark
August 21, 2011

FORMER Australian of the Year Patrick McGorry has aborted a controversial trial of antipsychotic drugs on children as young as 15 who are “at risk” of psychosis, amid complaints the study was unethical.

The Sunday Age can reveal 13 local and international experts lodged a formal complaint calling for the trial not to go ahead due to concerns children who had not yet been diagnosed with a psychotic illness would be unnecessarily given drugs with potentially dangerous side effects.

Quetiapine, sold as Seroquel, has been linked to weight gain and its manufacturer AstraZeneca, which was to fund the trial, last month paid $US647 million ($A623 million) to settle a lawsuit in the US, alleging there was insufficient warning the drug may cause diabetes.

Professor McGorry, one of the Prime Minister’s key mental health advisers, planned to conduct the trial at Orygen Youth Health in Parkville, listing it on the Australian New Zealand Clinical Trials Registry last March. It was to investigate whether the drug would decrease or delay the risk of people aged between 15 and 40 with early signs of mental illness developing a psychotic disorder such as schizophrenia.

Last month, psychiatrists, psychologists and researchers from Australia, Britain and the US lodged a complaint with the ethics committee of Melbourne Health, the umbrella health service that includes Orygen.

They argued there was little evidence onset of psychosis can be prevented and it was potentially dangerous to use antipsychotics on people who merely have risk factors for a psychotic illness. They said there was evidence that up to 80 per cent would never develop a disorder.

Professor McGorry insists the decision to scrap the trial was made in June and is unrelated to the complaint, which he said he was only alerted to just over a week ago.

He maintained the trial received ethics approval in July last year but was abandoned due to “feasibility issues” with recruiting participants in European and American sites, which were to form the international arm of the study. He said Orygen had to choose between investing in the drug trial or pursuing another trial using fish oil, which had proven to be useful as an early intervention treatment for schizophrenia in a smaller study. He opted for fish oil because it had less potential for side effects than antipsychotics.

Melbourne Health confirmed the complaint will still be considered by its research ethics committee in September. Yesterday the trial was listed as “prospective” on the clinical trials registry but Professor McGorry said it was being removed.

Earlier this month The Sunday Age revealed a growing backlash against the government’s mental health reforms, with Professor McGorry’s peers claiming his youth early intervention model had been “massively oversold”.

Associate Professor Geoff Stuart of La Trobe University’s school of psychological sciences, who signed the complaint, said questions remained about the trial.

“If these feasibility obstacles can be overcome in future [would] Professor McGorry embark on such a trial again? He was willing to endorse a trial which was exploring the use of antipsychotic medication in an at-risk group. There’s a major ethical issue about medicating four people to supposedly save the fifth when you’re not saving them anyway, you’re just masking their symptoms. We’re talking about kids as young as 15 who could get a full dose of antipsychotics and they’re not psychotic.”

Professor McGorry acknowledged the evidence suggested antipsychotics were not effective as a first-line treatment for the at-risk group. But he said the risks had been exaggerated and he would consider a similar trial on patients for whom other treatments had failed. “I wrote the guidelines which said do not use antipsychotics in ultra-high risk patients, so I’ve never been supportive of it in clinical practice … [but] we should have the freedom to research all available options for this population,” he said.

The controversy over the aborted trial largely centres on “psychosis risk syndrome”, a condition that some mental health advocates want formally recognised. But critics say that could lead to young people being wrongly labelled, stigmatised and medicated for symptoms that may be temporary. They also fear that while Professor McGorry says his Early Psychosis Prevention and Intervention Centres prescribe drugs only to those who have experienced a psychotic episode, his willingness to medicate an at-risk group could mean the criteria will broaden. Professor McGorry insists this will not happen.

Early intervention What is it?

EARLY intervention is based on identifying and treating psychosis in its early stages to prevent patients developing full-blown psychotic illnesses such as schizophrenia.

Patrick McGorry’s Early Psychosis Prevention and Intervention Centres (EPPIC) treat young people who have experienced a psychotic episode with treatments such as psychotherapy, family therapy, medication or a combination. He says early treatment significantly improves the chance of recovery and reduces long-term impairment. But diagnosing psychotic disorders is difficult and McGorry’s critics say there is no reliable diagnostic tool to predict if someone will develop a psychotic illness and there is insufficient evidence intervention can prevent it.

Critics say up to 80 per cent of those with ”psychosis risk syndrome” – which refers to people who only have risk factors such as a family history or a deterioration in mental health – never develop an illness. They fear early intervention will lead to many patients being wrongly labelled as psychotic and medicated unnecessarily.

A recently released literature review by The Cochrane Collaboration found there was insufficient evidence that early intervention could prevent psychosis and that any benefits were not long term. Professor McGorry said it used flawed methodology.

http://www.theage.com.au/national/drug-trial-scrapped-amid-outcry-20110820-1j3vy.html?from=age_sb

August 21, 2011

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DSM 5 in Distress—Seven Questions For Professor Patrick McGorry

Friday, August 19th, 2011

Psychology Today – August 18, 2011

by Allen Frances, M.D.

Psychiatry cannot promise more than it can deliver.

Whenever contradicted, Professor McGorry attacks the motives of the messenger rather than providing any reasoned rebuttal to the message.

The great news is that Professor McGorry has recently renounced the relevance of psychosis risk syndrome in the current practice of clinical psychiatry. He has done so in two separate and dramatic ways: 1) by withdrawing his support for the inclusion of psychosis risk in DSM 5; and 2) by promising not to include it as a target in Australia’s massive new experiment in early intervention. Psychosis risk syndrome is an extremely promising topic for ongoing research, but it is not nearly ready for current clinical application and if introduced prematurely could cause disastrous unintended consequences.

Professor McGorry’s sharp about face on both fronts could well be a wonderful double game changer. He is by far the most powerful psychiatrist in the world and an absolutely brilliant politician. Leveraging his unique stature as 2010 ‘Australian Of The Year,’ McGorry has succeeded in gaining the support of all the major Australian parties in the funding of a large and much needed investment in the country’s mental health. His new caution on psychosis risk will influence others to be less venturesome in prematurely promoting this potentially dangerous diagnostic proposal.

But a dark cloud surrounds the silver lining of having one psychiatrist in a position of almost unopposed influence. Professor McGorry has developed the messianic blind spot that is so common in visionary prophets. His zeal has made him an unreliable evaluator of scientific evidence, allowing him to defend absolutely indefensible positions with the convincing, but inaccurate, force of a true believer. A review of Professor McGorry’s public statements shows his willingness to ignore any evidence contrary to his belief, to change stated views back and forth when he regards this to be necessary or convenient, and to unfairly attack those who point out the fallacies and inconsistencies in his comments. His are the skills of a prophet and rainmaker, not those of a policy maker or a program developer or a sober reviewer of scientific evidence.

The most telling example of the McGorry blind spot was his ready dismissal of a recent Cochrane review that has discredited his extravagant claims for early intervention. This independent, systematic, comprehensive, and rigorous review of the scientific literature concluded there was insufficient scientific evidence to support McGorry’s grand assertions that early intervention programs promote enduring change and can reduce the lifelong burden and cost of illness. Early intervention does seem to be helpful temporarily while it is being provided, but does not seem to have any lasting impact on the course or cost of illness once it is stopped.

So, the Cochrane group lines up on one side and McGorry lines up on the other. Who to believe? The Cochrane group is widely credited for its impartiality and esteemed for its expertise in all aspects of scientific review. Its reports are considered a gold standard, exerting great influence on state of the art, evidence based medical practice throughout the world, particularly in Great Britain. One might expect that Cochrane’s stainless reputation would daunt a person even of Professor McGorry’s extraordinary power and blind conviction. But no. When the Cochrane report disappoints his expectations and fails to nourish his prejudices, McGorry feels no hesitation in attacking it, criticizing its methodology, and dismissing its discouraging conclusions. His rebuttal of the Cochrane group consists only of his personal endorsement of early intervention accompanied by the blithe (but empty) claim that it has strong supporting evidence. As far as McGorry is concerned, Cochrane be damned. Such idiosyncratic evaluation of scientific evidence cannot be trusted as a sensible foundation for mental health policy.

This is part of a pattern, not one isolated and exceptional instance of blind spot. Whenever contradicted, Professor McGorry attacks the motives of the messenger rather than providing any reasoned rebuttal to the message. His skill in the parry/thrust of the political sound bite is matched by an unwillingness to subject his views to anything resembling fact based discussion. When I expressed doubts about Dr McGorry’s excessive claims for his prevention model, he twisted my concerns to suggest that somehow I was defending the traditional US model of care against his innovative Australian model. This silly and totally incorrect attempt at diversion had not the slightest relevance to my two real motivations. Primary is the fear that by ambitiously overselling itself, psychiatry does a disservice to its patients and harm to its core mission and credibility. I believe strongly that scarce mental health resources must be judiciously spent to provide care for those who clearly need them- with continuity that starts with the first episode and lasts until they have either become well enough to do without or are dead. I therefore object to squandering vast resources upfront on those who may not need them using what are premature and still unproven methods. My secondary motivation (now somewhat assuaged by McGorry’s recanting, if he sticks to it) is the fear that the recognition of psychosis risk syndrome as an official diagnosis in DSM 5 and/or as a target in EPPIC programs will result in unnecessary stigma for the misidentified and dangerous off label overprescription of antipsychotic drugs.

McGorry has also tried to stifle his Australian critics- consistently evading their well reasoned and empirically supported arguments with the false innuendo that their motivation is simply to protect turf. His distraction technique employs catchy phrases (“Merchants of doubt do no favours for people with mental illnesses”) and dismissive insults (critics are a ‘cadre’). This so called ‘cadre’ of ‘merchants of doubt’ happen to be highly respected colleagues who are doing precisely what needs to be done- challenging McGorry in an open discussion of his excessive claims and of his idiosyncratic take on the literature. They are trying to protect Australia from blindly making a risky public health bet promoted by a stubborn ‘true believer’ who refuses to engage in meaningful dialog and cannot be unconvinced even by clearest evidence contradicting his personal belief system. It is crucial that scientists and policy makers always be honest and skeptical ‘merchants of doubt’ -not joiners in a parade of the credulous marching blindly off a cliff. McGorry needs to meet opposition with facts and rational debate, not innuendo and insult.

This brings me to my immediate purpose here. Let’s all get off the personal and focus instead on the issues. Below are seven questions that beg for Dr McGorry’s immediate public response. No evasion or questioning of my motivation is called for- just straight answers to simple questions. It will be useful for Professor McGorry to respond for the record now, before Australia’s makes final the terms of its much needed and awaited investment in mental health.

Question 1) Please spell out on what scientific basis you have dismissed the findings of the Cochrane report and indicate why Australia should base policy decisions on your personal interpretation of these data rather than on Cochrane’s more objective and systematic approach?

Question 2) What will be your role in establishing the goals and in directing the implementation of Australia’s early intervention programs and what protections are in place to ensure that opposing voices and interpretations get a fair hearing? Who else will be involved in the governance of these programs and how will they be selected?’

Question 3) Can you now state with certainty that the newly
funded early psychosis intervention programs will be restricted exclusively to those who are already diagnosed with definite psychosis and will definitely not include individuals deemed to be only at some increased risk for future psychosis?

Question 4) Do you now agree that it is inappropriate to prescribe antipsychotic medication for psychosis risk except under the close supervision of an approved research protocol?

Question 5) What protections will be in place to avoid the premature and incorrect differential diagnosis of psychosis? The distinction between prepsychotic and psychotic is much clearer on paper than in practice and psychotic symptoms in teenagers are often transient, caused by substance abuse or mood disorder. Will strict diagnostic requirements, careful differential diagnosis, and quality control guard against incorrect, premature, and stigmatizing diagnoses and also against unnecessary and potentially harmful treatments?

Question 6) Why not roll out the EPPIC programs in gradual steps? This would ensure that the model translates well from the research environment to day to day practice and would provide an opportunity to demonstrate its efficacy and cost effectiveness before disproportionate investments are made in it.

Question 7) How do you justify the funding shortfalls for other necessary continuity of care programs that will likely be caused by the front ending of expenditures for EPPIC (especially given lack of convincing evidence that EPPIC confers enduring benefits or any reduction in future need for, or cost of, services)? Is it worth staking such a large proportion of the mental health budget on such an uncertain roll of the dice?

His track record makes clear that Professor McGorry can not be relied upon as a neutral reviewer of scientific evidence or a neutral advisor on the question of which mental health investments will bring to Australians the highest and safest returns. His countrymen should be very grateful to Professor McGorry for having obtained desperately needed funding for mental health, but should also be cautious in following his lead in determining how to best to allocate it. The mental health situation in Australia is without historic precedent. Never before has the future direction of an entire country’s mental health program depended almost solely on the unopposed opinions and actions of one charismatic psychiatrist and his band of loyal followers. His inordinate power places a huge responsibility on Professor McGorry to exercise responsible and responsive leadership. Direct answers to the questions raised above are needed to ensure that public policy will follow the scientific evidence and not be unduly influenced by the blinkered zeal of one man, however well meaning and highly respected he may be.

http://www.psychologytoday.com/blog/dsm5-in-distress/201108/seven-questions-professor-patrick-mcgorry

 

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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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Australia’s Outrageous Mental Health Agenda Under Attack from Leading U.S. Psychiatrist

Thursday, June 16th, 2011

The 'Pre Psychosis Risk' Scam

While the United States unfortunately leads the world in labeling its children with mental ‘disorders’ which cannot be scientifically proven to exist as medical conditions,  Australia seems determined to take over  the [dishonorable] title.  And they just might do it.   For poised to carry them into the winners circle is none other than psychiatrist and former “Australian of the Year”  Patrick McGorry.   The scam is called “pre-psychosis risk syndrome” which simply translates as this:  Despite the fact there is not one proven scientific or medical test to prove any child has a mental “disorder,”  Patrick McGorry maintains he can determine who will develop one.  That’s right.   He can determine who will develop a mental disorder before they develop a mental disorder that cannot be medically proven to exist.   If that sounds a little crazy to you,  rest assured, you’re not alone.    In fact,  the logic is so backwards that McGorry’s plan has come under fire from U.S. psychiatrist Allen Frances, who chaired the committee that produced the psychiatric diagnostic bible of “mental disorders” used the world over, ‘The Diagnostic and Statistical Manual of Mental Disorders (DSM) IV.    If you’re in the mental health “business,” like McGorry is,  then that is called being attacked from altitude.

Frances calls McGorry a “false prophet” and says “Australia, led astray by his impractical hopes, is about to embark on a vast and untried public health experiment that will almost surely cause more harm to its children than it prevents.”

We agree.  And it looks like Australians are starting to catch on….

from The Australian—June 16th, 2011

Schism opens over ills of the mind

PATRICK McGorry is the face of mental health in Australia. He put the subject on the public agenda through his GetUp! ads at last year’s federal election and was instrumental in securing $2.2 billion in government funding for his cause in last month’s budget.

But now he and his early psychosis prevention and intervention centres are under attack from members of his own psychiatric profession.

At stake is the credibility of the centres that treat people aged 15-24. A $222 million program to establish 16 EPPICs is an important plank in Julia Gillard’s mental health reforms. Tony Abbott also wants to expand the centres as part of his mental health policy.

McGorry is no stranger to controversy. In 2006 Time magazine in an article headlined “Drugs before diagnosis?” was critical of his work testing the use of anti-psychosis drugs on pre-psychosis patients in the late 1990s.

West Australian Labor MP Martin Whitely has been conducting a campaign against McGorry on his blog Speed Up and Sit Still.

Many of McGorry’s mental health colleagues have questioned whether his centres got the bulk of extra money in the budget’s mental health reforms because the government wanted to silence its biggest critic. There are other models and other priorities for mental health funding, they say.

This week McGorry came under fire from US psychiatrist Allen Frances, the man who chaired the committee that produced the psychiatric diagnostic bible Diagnostic and Statistical Manual of Mental Disorders IV.

Underlying the attack on McGorry is a dispute dividing psychiatry worldwide: is there a danger that attempts to define mental illnesses are making a disease out of everyday suffering resulting in the unnecessary medication of patients?

Frances says he was very conservative when he produced DSM IV, including only two out of 84 suggested new mental illness diagnoses. After its publication, diagnoses of autism, attention deficit hyperactivity disorder and bipolar disorder skyrocketed.

“Once the genie was out of the bottle and heavy drug marketing followed and the internet and ADHD and school services [began] being tied to a diagnosis, the manual gets used differently to the way you thought it should and you have no control over it,” he says.

Frances says anti-psychotic drugs are now the leading revenue producing drugs in the US.

“It’s an astounding fact that 5 per cent of all scripts in the US are written for anti-psychotics. The industry in America is $US15bn and it is the No 1 seller of all drugs and anti-depressants are the fourth biggest sellers,” he says.

“What we’re talking about is a massive worldwide experiment in the use of anti-psychotics.”

Frances fears a similar outbreak of over-diagnosis of mental illness and unnecessary medication of patients could follow the new DSM 5, due out in 2013.

The root of Frances’s dispute with McGorry is the Melbourne psychiatrist’s work in trying to develop a tool that can diagnose patients before they develop full-blown psychosis and finding ways to treat them to prevent the illness.

This tool has various names: psychosis risk syndrome, attenuated psychotic syndrome or ultra high-risk syndrome.

This new diagnosis is a candidate for inclusion in DSM 5. But it is a highly controversial issue in the psychiatric profession and its listing is opposed by one of McGorry’s research partners, Melbourne University psychiatrist Alison Yung.

Yung and Frances fear listing the disorder will lead to teenagers being labelled and stigmatised and given powerful anti-psychotic drugs that have side effects including substantial weight gain.

Read the rest of the article here:

http://www.theaustralian.com.au/news/features/schism-opens-over-ills-of-the-mind/story-e6frg6z6-1226075910650

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US expert slams Patrick McGorry’s psychosis model

Monday, June 13th, 2011

Note from CCHR:   CCHR International was the first organization  to expose  the complete insanity of psychiatrist and “Australian of the Year” Patrick McGorry’s campaign to “pre-diagnose” children before they ‘develop” mental disorders.  But we’re no longer the only ones.   Even his fellow psychiatrists are attacking it.  Let’s just break it down; psychiatrists admit there are no medical tests in existence to prove any child suffers from a mental ‘illness.”  Diagnoses is based solely on opinion, yet more than 20 million children worldwide have been ‘diagnosed’ and prescribed dangerous and potentially lethal drugs based on nothing more than psychiatry’s junk science.     Yet this doesn’t seem to be a problem to McGorry, or Australia for that matter, considering they just allocated $400 million to McGorry’s  crystal ball theory of “pre-diagnoses,”  for ‘psychosis’ adding even  more lunacy to the child labeling and drugging epidemic that is literally killing kids.   Now that, is psychotic – and it’s psychiatrist Patrick McGorry that’s leading the way.

The Australian – June 14, 2011

by Sue Dunlevy

PATRICK McGorry’s model of early diagnosis of psychosis, favoured by the federal government and the Coalition in their mental-health policies, has come under attack from a leading US psychiatrist, who warns that predicting psychosis is unreliable and could lead to patients being wrongly medicated.

Allen Frances, who chaired the committee that produced the current diagnostic bible for psychiatry, the DSM-IV, has warned that Professor McGorry’s Early Psychosis Intervention Centres do not have a reliable early diagnosis tool.

Professor Frances, an emeritus professor at Duke University in North Carolina, fears early diagnosis could lead to people without psychosis being put on medications that have serious side-effects, including massive weight gain.

He has also attacked the Gillard government’s plans to spend $222 million expanding Professor McGorry’s EPIC program by another 16 centres as a “vast untried public-health experiment”.

“The Australian experiment will be flying blind on an airplane that is not at all ready to leave the ground,” he said in a blog posted on Psychology Today in the US.

His concerns are shared by Adelaide University psychiatry professor Jon Juredini, who says the Gillard government should have shared mental-health funding around many different early intervention projects to see what worked best. “A lot of the evaluation of EPIC shows any advantages it has disappear over time, so that tends to suggest that in terms of intervention they are good while they are happening, but they don’t necessarily give long-term protection,” Professor Juredini told The Australian.

Their criticism came as the past president of the Royal Australian College of Psychiatrists, Louise Newman, attacked the $197 million the government will spend on expanding the number of Headspace youth mental health centres from 60 to 90.

“There have been certain statements about the efficacy of  the Headspace approach that have been overstated,” she told Australian Doctor magazine.

Early intervention to prevent mental illness needed to happen at a much earlier stage of development than adolescence, Dr Newman said.

A spokeswoman for Mental Health Minister Mark Butler said the government was making substantial investments in youth mental health and early psychosis prevention services. “We are confident these evidence-based models will be of benefit to young Australians,” she said.

Professor Frances’s arguments have been seized on by Scientologists, who argue against the notion of mental illness.

Although Professor Frances chaired the committee that produced the fourth version of the Diagnostic and Statistical Manual of Mental Disorders in 1994, he has been left off the panel developing the fifth version.

He has written extensively of his concerns about how strict medical definitions of mental illness can lead to misdiagnosis by non-experts.

Professor McGorry dismissed Professor Frances’s attack as a “beat-up”, and said no one received anti-psychotic drugs at his centres unless they had had a psychotic episode.

While Professor Frances agreed that Professor McGorry did not recommend anti-psychotic medication as a preventive measure, he feared general practitioners might overuse the drugs if they started using Professor McGorry’s diagnostic tool for early psychosis.

Professor Frances said in his Psychology Today blog that early intervention to prevent psychosis required first that there be an accurate tool to identify who would become psychotic.

“The false positive rate in selecting pre-psychosis is at least 60-70 per cent in the very best hands and may be as high as 90 per cent in general practice . . . these are totally unacceptable odds,” he said.

Professor McGorry agreed that false positive rates of diagnosing prepsychosis were high, but said the first line of treatment for people who had sub-threshold psychosis was supportive care.

http://www.theaustralian.com.au/national-affairs/us-expert-slams-patrick-mcgorrys-psychosis-model/story-fn59niix-1226074544901

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Australia’s Reckless Experiment In Early Intervention

Wednesday, June 8th, 2011

Note from CCHR: The article below was written by Allen Frances, a psychiatrist, and former Chairman of the DSM IV task force.  The subject of the article is Australian psychiatrist Patrick McGorry and his agenda to pre- diagnose kids with mental ‘illness’ before they develop it, which  Frances calls  a dangerous and risky proposition.    It is.  Yet Frances seems to be making excuses for the fact that McGorry’s plan is not only dangerous – its criminal.    He calls McGorry a charismatic psychiatrist, which may be true, but this is exactly what makes him so dangerous.  Because the Australian government has just funded a program so controversial and dangerous to children that even other psychiatrists, leaders in the field, are speaking out against it.  And why did they fund it?   Because “charistmatic” Patrick McGorry sold them  a $400 million bill of goods.

“Charisma is a tricky thing.  Jack Kennedy oozed it–but so did Hitler and Charles Manson. Con artists, charlatans, and megalomaniacs can make it their instrument as effectively as the best CEOs, entertainers, and presidents.” Patricia Sellers, FORTUNE Magazine


prevention that will do more harm than good

Psychology Today
By Allen Frances
May 31, 2011

Patrick McGorry is a charismatic psychiatrist who has recently gained heroic status. First he was chosen to be Australia’s Man Of The Year. Now, he has convinced the Australian government to spend more than $400 million over five years to fund his plan for a nationwide system of Early Psychosis Prevention and Intervention Centres. McGorry is the visionary prophet and pied piper of preventive psychiatry. His goal is to diagnose mental disorders early and treat them expectantly- before they can do their worst damage.

McGorry’s goal is certainly great. But its current achievement is simply impossible and Australia’s plans are patently premature. Early intervention to prevent psychosis requires first that there be an accurate tool to identify who will later become psychotic and who will not. Unfortunately, no such accurate tool exists. The false positive rate in selecting prepsychosis is at least about 60-70% in the very best of hands and may be as high as 90% in general practice. That’s right, folks, nine misidentified non patients for one accurately identified truly prepsychotic patient. Those are totally unacceptable odds.

What are the costs? McGorry does not recommend antipsychotic medications as a routine part of his prevention regimen. But experience teaches us that they will be overused despite having no proven efficacy and posing the risk of massive weight gain (and its consequent array of serious complications). The false positives will also suffer unnecessary stigma and worry and will undergo unnecessary and misdirected treatment. And surely there are many more productive ways to spend $400 million doing a better job of managing the mental health needs of those who have real and treatable psychiatric disorders.

Unfortunately, Mcgorry is a false prophet who’s visions are offered at least a few decades before their time. Australia, led astray by his impractical hopes, is about to embark on a vast and untried public health experiment that will almost surely cause more harm to its children than it prevents. Before embarking on this headlong and reckless rush, the following research steps need to be accomplished:

1)Developing a proven and reliable definition of “Psychosis Risk”

2)Learning how to use it in a way that reduces current outrageously high false positive rates to levels that are tolerable.

3)Demonstrating that the interventions chosen are indeed effective in preventing psychosis.

4)Determining the likely rate of antipsychotic use and how this influences the overall risk/benefit balance sheet of early intervention.

5)Studying the beneficial and harmful impacts of early diagnosis on stigma and self perception.

6)Comparing the marginal utility of a dollar spent trying to prevent an alleged future disorder vs a dollar spent treating an already clearly established one.

This is a research enterprise that will take many groups around the world many decades to complete. But it is an absolutely necessary precondition before spending $400 million on what is likely to be a failure. The Australian experiment will be flying blind on an airplane that is not at all ready to leave the ground. Doing prevention prematurely and poorly will give a good idea an unnecessary bad name.

McGorry’s intentions are clearly noble, but so were Don Quixote’s. The kindly knight’s delusional good intentions and misguided interventions wreaked havoc and confusion at every turn. Sad to say, Australia’s well intended impulse to protect its children will paradoxically put them at greater risk. Let’s applaud McGorry’s vision but not blindly follow him down an unknown path fraught with dangers.

Read article here:  http://www.psychologytoday.com/blog/dsm5-in-distress/201105/australias-reckless-experiment-in-early-intervention

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Australian Psychiatrist Patrick McGorry’s Pre Diagnosing Kids Agenda: Voodoo Science & Snake Oil

Friday, June 3rd, 2011

Seroxat Sufferers Please Stand Up
By Bob Fiddaman
June 2, 2011

Two great articles by Kat McCormick from May 2011. It seems McGorry has a growing army of critics, pity the Aussie government can’t see through his crystal ball gazing as many others can – it’s akin to taking a losing lottery ticket up to a paypoint and…well, being paid the jackpot prize.

McCormick’s first article poses many questions, the most pertinent of which are: Are our children really AT RISK or is Patrick McGorry selling us Voodoo Science & Snake Oil?

Her article is concise as well as thought-provoking.

McCormick’s second article, ‘Mental Health and the Budget’ focuses on McGorry’s research methods and she writes, “There are several disturbing elements in Patrick McGorry’s research and I’m not the only one to question his motives or methodologies.”

Nope, you sure ain’t sister!

Read article here:  http://fiddaman.blogspot.com/2011/06/is-patrick-mcgorry-selling-us-voodoo.html

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Hickierie Dickory Doc – McGorry Turns Back the Clock

Monday, May 30th, 2011

Seroxat Sufferers – Stand Up and Be Counted
By Bob Fiddaman
May 30, 2011

Patrick McGorry

McGorry’s Delorean continues on it’s trip back to the future in Australia, it’s new passenger, Prof Ian Hickie.

I say new, Hickie has been around for years.

Judging by an article in today’s Australian Telegraph, there seems to be questions being asked regarding the number of Australian children being prescribed antidepressant medication.

Elissa Doherty and Marianne Betts write:

The number of children aged six and under being prescribed anti-depressants has soared by almost 50 per cent since the federal government pledged to investigate the issue, new figures show.

Thing is, just two meetings have been held since Australian Health Minister, Nicola Roxon, ordered an investigation over three years ago!

In the meantime, McGorry’s Delorean [early intervention program] continues to pick up speed…with government backing!

Ian Hickie

Ian Hickie was the inaugural CEO (2000-2003) of ‘beyondblue: the national depression initiative’, which has very successfully sold depression in Australia, with many millions of dollars of government money. This has worked brilliantly for the drug companies, and beyondblue does not accept pharma funding, so the drug companies get the promotion for free. I’ve previously wrote about beyondblue back in November 2008.

Graham “Biff Tannen” Burrows, whom I wrote about here, is now retired but has played a huge role in promoting psychiatric diagnoses and psychotropic drugs in Australia, particularly in the 1990′s.

It would appear that Burrows has been totally in bed with the pharmaceutical companies. More importantly, he influenced government policy in the 1990′s to focus on depression. Without him, it could be suggested that beyondblue would not have come about nor would McGorry’s meteoric rise a decade or so later.

Beyondblue and Hickie paved the way for EPPIC, a psychiatric service aimed at addressing the needs of older adolescents and young adults with emerging psychotic disorders.

Hickie, it would appear, is the Burrows of the 21st century.

McGorry shot to fame last year when he was appointed Australian of the Year. Hickie and McGorry had already been working together for several years, in fact Hickie is a key player in McGorry’s ‘Headspace’).

Anything they say to the Aussie government seems to be taken at face value, this is something that baffles me. We can all make claims about “fixing” mental disorders because they simply cannot be diagnosed. The way forward for Australians is nipping these disorders in the bud by ‘catching them early.’ I cannot believe the Aussie government could fall for this – what evidence has McGorry supplied to back up these claims?

Whatever they say is usually accepted as gospel, and it is very rare for either of them to be criticised, save for a handful of advocates, a few Australian MP’s and the Citizens Commission on Human Rights [CCHR]

SPHERE

The PDF above is a seemingly egregious example of the conflicts of interests that exist: a whole journal supplement based on the SPHERE project clinical audit. The audit was funded by Bristol-Myers Squibb (see p. S54), the manufacturer of Serzone. The publication of the supplement was funded by beyondblue with Commonwealth [Australian] Government money (see title page).

The audit, which used Hickie’s SPHERE questionnaire, found ridiculously high rates of mental disorders. This was reported in the supplement by Hickie, Davenport, Naismith, & Scott (2001, p. 52) as:

‘Sixty-three per cent of people attending general practice have some evidence of mental disorder (including alcohol or other substance misuse) by self-report or GP’s diagnosis of psychological difficulties.’

63%?

That’s some cash cow huh?

Not surprisingly, if you scroll to the bottom of the PDF you will find: Source: Hickie et al. Educational Health Solutions; 2000

McGorry claimed in a recent interview, “…we are trying to do is provide effective treatment for those young people for what they are presenting with and trying to reduce the risks. There are other effective ways of reducing the risk including cognitive behaviour therapy, the use of omega-3 fatty acids and so on.”

With previous involvement of Hickie and the pharmaceutical industry, I’d really love to believe that McGorry would use CBT and omega-3 fatty acids etc to help kids diagnosed with a mental disorder…before they actually get it!

I am left wondering if the Australian government have done their homework on McGorry & Co or if they just like to throw money into projects without first taking a look at the scientific proof – Has the current Australian Prime Minister, Julia Gillard, ever sought to seek evidence about the chemical imbalance myth? Has she taken a good look at the deaths associated with psychiatric drugs?

Here’s an idea for the Aussie PM, ask for scientific proof of McGorry & Co’s time-travelling prediction vehicle, don’t just take it as gospel that it works.

For the record, and so Patrick McGorry and his cronies totally understand, I was raised a Catholic. I denounced myself as one in later years. McGorry & Co can throw the Scientology tag at me if they wish, they have done it in the past when backed into a corner by CCHR. If that is all they have in their armour then I envisage a future of mind altering drugs being prescribed to Australian children on the basis that they may have an illness rather than they actually have an illness. If parents of those children dare question McGorry & co, prepare yourselves for some mud slinging – you may as well sign yourselves up to the Church of Scientology, you’ll be labelled one regardless…and we all know how psychiatrists, such as McGorry, just love to use labels.

How do I know this? Well, like McGorry & Co, I travelled forward in time…in my Tardis – my DeLorean is at the garage in need of a new flux capacitor.

Fid

http://fiddaman.blogspot.com/2011/05/hickierie-dickory-doc-mcgorry-turns.html

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Psychiatrist Patrick McGorry Ticked Off CCHR’s Busted Him Over Bogus “Early Intervention” Claims

Thursday, April 21st, 2011

Psychiatrist Patrick McGorry promotes a highly dangerous and outrageous agenda of pre-diagnosing youth as mentally ill "before" they develop it...

Seroxat Sufferers – April 21, 2011

by Bobby Fiddaman

I had to laugh at the article from the Herald written last August.

It would appear that Australian psychiatrist Patrick McGorry [originally an Irish born lad] doesn’t like it when he is brought to task regarding his early intervention claims [He can predict if a child can get a mental disorder in later years you know]

The article,  written by Brigid O’Connell, lays claim that McGorry has become the target by the Church of Scientology after he and other psychiatrists spoke out against them.

I think you will find that it’s the other way around.

The Citizens Commission on Human Rights [CCHR] have, for a long time, been on McGorry’s back. Where McGorry gets confused [bless him] is that CCHR is not the Church of Scientology. Okay, CCHR was founded by the Church [and actually also a psychiatrist Thomas Szasz, who no doubt wouldn't agree with your "early intervention" drugging kids fad either] but they are funded by Tom, Dick and Harry…that is, by anyone concerned enough about human rights.

CCHR have requested documents under the Freedom of Information Act. Documents that may or may not show McGorry’s links to the pharmaceutical industry. We are not talking about a free dinner here, we are talking millions of Aussie dollars.

You see, McGorry has devised a program whereby it could be…um…guessed through early intervention if children would develop a mental disorder in later years. Your modern day DeLorean time machine if you will.

One would imagine that such a test would involve some sort of brain scanning machine or maybe a series of blood tests. Nope… just form filling or rather box-ticking. That’s all the info the early intervention program needs to diagnose [stigmatise] a child…or rather “predict” if a child will fall foul to a mental disorder. Hey, and McGorry and friends know exactly how to treat this invisible futuristic illness too.

I find it odd that McGorry would cry victim, even more so that he would claim to be the target of “harassment.” Would he do the same if Joe Bloggs requested information under the Freedom of Information Act or is he just pissed at CCHR? If the Catholic Church were to request such documents would McGorry & Co scream that they were being victimised?

For the record Paddy [McGorry], I’m not a great fan of yours either. I’d also like to see if you are funded by the industry and would ideally love to take a ride in your Delorean to predict now if I will get an ingrowing toenail when I’m 55. “Please Massa, show me the boxes to tick. I promise to be a gooooood patient”

Oh, I’m not a Scientologist either but have won two human rights awards from CCHR. Geez, they must have “brainwashed” me [which, by the way Paddy, only your drugs can do]…can your early intervention program undo what they have done to my brain? Can you give me some drugs please Paddy?

Come on Paddy, be a good little psychiatrist and show the world that you have nothing to hide…unless of course you have something to hide? Show the Aussie government the $3.5 billion “investment” plan for its kids you want to rip off the taxpayers isn’t gonna be used to put them on antipsychotics that those drug companies which probably fund you are going to benefit from. Is this really why you feel harassed – you may not get your booty?

The only way people can seek the truth is by going through proper channels, namely by using the Freedom of Information Act. That’s their given right, Paddy! Everyone has a right to use this tool be they Scientologists, a human rights movement, someone who claims to be from the planet Zog or someone who has delusions that Shania Twain will one day mattress dance with them.

Oh by the way, I walk under ladders as I’m not very superstitious – if I were to avoid walking under ladders I’m sure your profession would label me with some disorder, have me drugged to the eyeballs, restrained and injected with experimental drugs. Maybe you can tell me if I will walk under ladders in future years?

Face it, your crystal ball is no more effective than a fortune teller at the end of a seaside pier. At least she has the signs outside telling customers that she is paid for her crystal ball gazing.

It never ceases to amaze me that when psychiatrists are backed into a corner they scream victim. When their patients are backed into a corner, restrained, injected and/or force-fed psychiatric drugs they have no choice but to take it on the chin.

Your Delorean needs a new flux capacitator Paddy. CCHR are coming to getcha…and there are many who support their work.

Bob Fiddaman
Shania Twain fan.

http://fiddaman.blogspot.com/2011/04/psychiatrist-patrick-mcgorry-slams-his.html

Read more about Patrick McGorry here: Prison Planet -Pharma Backed Australian of the Year Psychiatrist Wants Millions in Government Funding for Brave New World of Pre-Drugging Kids

http://www.prisonplanet.com/pharma-backed-australian-of-the-year-psychiatrist-wants-millions-in-government-funding-for-brave-new-world-of-%E2%80%9Cpre-drugging%E2%80%9D-kids.html

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