Rife with Conflicts of Interest and Could Lead to More Children Being “Pre-Drugged”

Please take action and provide feedback to federal government via a survey or email

On the 16th January 2012 the Department of Health released the draft document which will be used by the federal and state governments to map the reform of Australia’s mental health system for the next 10 years. Despite it being January and many people still on breaks, ONLY 2 weeks have been given for the public to respond. As one Senator said about this extremely short consultation period: “Is this really just a gesture to try and let people think, ‘well we’ve had the opportunity to comment?'”

Of concern is that the drafting process indicates this could be a bonanza for pharmaceutical companies and psychiatrists with spending on psychotropic drugs on the Pharmaceutical Benefits Scheme already reaching more than $700 million.^[1] It appears they will be the ones to benefit, not our children or those within the mental health system. Early intervention is a key issue in the Roadmap. It even states that the proportion of three and four year olds screened for behavioural and other emotional health problems will indicate “How we will know we are doing better.” There is nothing stating that these early intervention programs must be based on scientific evidence.

Screening for mental illness involves the use of checklists which are so subjective that any child could be labelled mentally ill and potentially recommended for prescription of a psychiatric drug. Checklists are the tool used for “early intervention.” These checklists involve such questions as:

Does the child listen attentively? Do they cry a lot? Are they impulsive? Tense? High strung? Disobedient? Do they fidget or stare out the window?

These are symptoms which every parent knows are part of normal childhood behaviour. If a child does have a problem then there is a very real chance that the source of the problem will not be found and handled, instead the child could be labelled and drugged.

The Roadmap specifically recommends early intervention for psychosis services as being required.

Early intervention for psychosis includes the use of subjective checklists and in some cases pre-drugging a child to prevent them from becoming psychotic in the future. The disorder is known as psychosis risk syndrome (PRS).

Australian psychiatrist Prof.Patrick McGorry pioneered the Early Psychosis Intervention Centres (EPPIC) model which the Australia government has adopted to the tune of $222 million.^[2] He is also the self-proclaimed “father of PRS”, which has led to strident international criticism. Prof. McGorry was involved in developing this Roadmap as well as being specifically in charge of “youth” for the Roadmap.

With almost 10,000 Australian children under the age of 16 years prescribed an antipsychotic (759 of those aged 6 years and under), this Roadmap with its early intervention recommendations for psychosis can only lead to more children being put on potentially dangerous antipsychotics. There have already been 15 deaths linked to antipsychotics in Australian children under 19 years of age.

The Minutes of Meetings held to plan Australia’s 10 year mental health reform between 11 experts -including psychiatrists Prof. Ian Hickie (from the Brian and Mind Research Institute) and Prof. McGorry with the Minister for Mental Health in 2011 show that both Prof. Ian Hickie and Prof. McGorry were instrumental with two other people and the Minister for Mental Health for the “vision and strategy” of the 10 year plan.

Prof. McGorry: Has received unrestricted research grants from Janssen-Cilag, Eli Lilly, Bristol Myer Squibb, Astra-Zeneca, Pfizer and Novartis. He has acted as a paid consultant for, and has received speaker’s fees and travel reimbursement from all or most of these companies.^[3] He is the Executive Director of the youth mental health organisation, Orygen (of which EPPIC is part of) who receive funding from Eli Lilly, Bristol Myer Squibb, Janssen-Cilag and Astra Zenica.^[4]

Prof. Hickie: Received $70,000 from Bristol-Myers Squibb to develop the depression checklist for the GP training program called SPHERE which he founded. Pfizer also fund SPHERE and it was boasted that SPHERE assisted Pfizer to restore their antidepressant Zoloft to the number one antidepressant in Australia.5 Prof. Hickie has also served on professional advisory boards convened by Bristol-Myers Squibb & Eli Lilly, Wyeth, and AstraZenica have also funded Prof. Hickie.^[5] In 2011 he declared he was receiving support from Servier for a study involving the antidepressant agomelatin for which he is currently under fire for in Australian Doctor magazine.^[6]

Both Prof. McGorry and Prof. Hickie declared in the minutes of each of the meetings to develop the 10 year plan that they had no conflicts of interest.

The Mental Health Council of Australia (MHCA) produced the report from the one day 10 Year Roadmap Workshop held in September 2011. The MHCA in 2004, signed a Memorandum of Understanding with 5 drug companies. This agreement has continued every year. Their 2009/10 Annual Report lists out Eli Lilly, Pfizer, Wyeth and AstraZeneca as the drug companies currently on this Memorandum of Understanding.

Profs. McGorry and Hickie and the former CEO of the Mental Health Council of Australia Sebastian Rosenberg , also made the startling admission in a report they authored with others in 2011: Connecting, Contributing: a blueprint to transform mental health and social participation in Australia, that concerned the issue that psychiatrists and health authorities cannot produce any outcome reports for the $5.5 billion already spent annually from past mental health budgets. The Roadmap does not tackle this issue of this lack of accountability except to say the Mental Health Commission will be responsible for accountability.

This 10 year Roadmap is vague, with no specific targets or accountability which would show that children are being genuinely helped and will very obviously cost billions to implement. Prof. McGorry is already pushing for more funding to ensure the Roadmap is successful. This begs the obvious question – where are the results from the money already spent on mental health? Surely, this record spending should be causing decreasing mental illness rates rather than the incessant message that it is in a “crisis situation” requiring specialised services, and increasing budgets, etc.

Please take action and provide feedback via the survey or separate email to ensure that the Roadmap really will improve the well being and health of our children. Real reform should be based on evidence based interventions and proven and scientific methods. There must be real accountably before more money is spent.

To read the 10 Year Roadmap: http://health.gov.au/internet/main/publishing.nsf/Content/mental-pubs-t-roadmap

To complete the survey: You can state your objections and suggestions concerning what should be contained in Australia’s plan to reform mental health for the next 10 years. The survey is faulty as you can be locked into giving an answer when you actually disagree with all options. But please still answer it as it allows you to give comment under those selections. http://www.surveymonkey.com/roadmapsurvey2012

To email your objections/suggestions/submission: roadmap@health.gov.au

To see the minutes of the meetings to develop the 10 year Roadmap: These are available on the Department of Health and Ageing website, see 23rd September 2012 entry: http://www.health.gov.au/internet/main/publishing.nsf/Content/foi-disc-log

Submissions close on the 1st February at 7pm AEDST.

[1] National Mental Health Report 2010: Summary of 15 Years of reform in Australia’s Mental Health Services under the National Mental Health Strategy 1993-2008,” Commonwealth of Australia 2010, page 26.

[2] Sue Dunlevy, “US expert slams Patrick McGorry Psychosis Model, The Australian, 14th June 2012. http://www.theaustralian.com.au/national-affairs/us-expert-slams-patrick-mcgorrys-psychosis-model/story-fn59niix-1226074544901

[3] Patrick D McGorry, “Is Early Intervention in the Major Psychiatric Disorders Justified?: Yes.” BMJ2008;337:a695. http://www.bmj.com/cgi/content/full/337/aug04_1/a695

[4] http://rc.oyh.org.au/ResearchCentreStructure/otherfunding

[5] Prof. Gordon Parker and Prof. Ian Hickie ,”Is Depression Over Diagnosed? No,” BMJ, 18 Nov. 2007. And:
http://www.mja.com.au/public/issues/191_07_051009/hic109639_fm.html

[6] “Tackling depression and poor sleep with one drug, The Conversation, May 17th 2011. And “Hickie criticised over drug claims, “Australian Doctor, 20th January 2012. http://www.australiandoctor.com.au/news/hickie-attacked-over-antidepressant-claims- http://theconversation.edu.au/tackling-depression-and-poor-sleep-with-one-drug-1332