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Wednesday, June 15, 2011

Patrick McGorry Responds to Criticism by Allen Frances

Patrick McGorry

Australian Psychiatrist Patrick McGorry has responded publicly to criticism aimed at him and his early intervention program by Allen Frances.

Frances, a former chair of the DSM-IV Task Force, has openly criticised McGorry with an article he wrote in Psychology Today last month [Back Story]

This prompted McGorry to respond in his own article, although he sought the help of Alison Yung to draft it. The article [response] appeared The Australian, an online newspaper that reaches out to a global audience.

Reading through McGorry's response leaves me somewhat baffled. Here he has a chance to explain how his early intervention program actually works, instead, it appears, he juxtaposes Allen's argument by criticising the American Health system, citing that it "has seriously failed the mentally ill." Furthermore, McGorry adds that Frances "is not in a strong position to give us advice."

McGorry continues his tirade against Frances accusing him of being ignorant to the early intervention module and "patronizing" to the Australian community.

In his final para McGorry quotes Tom Insel, Director of the National Institute for Mental Health in Washington DC. He writes:

The director of the National Institute for Mental Health in Washington DC, Tom Insel, recently told a workshop on mental health research in Canberra, that Australia was a decade ahead of the US in early intervention for psychosis and other mental ill-health in young people. He also emphasised that classification systems such as the DSM have failed.

Wow! The DSM a failure? Who would have thought it?

Nowhere in the article does McGorry, or indeed Yung, offer any scientific evidence to show that the early intervention program actually works. McGorry basically justifies the money being pumped into his Headspace initiative by citing figures of young Australian people with mental disorders. He adds that the Headspace initiative isn't about using psychiatric drugs on children, he writes:

Frances, like other critics of early intervention in psychiatry, seeks to confuse the treatment of first episode psychosis with efforts to intervene at an earlier stage, the subthreshold or ultra-high risk stage. The latter is not a focus of the Australian reforms. Finally, unlike in the US healthcare system, these models are guided by young people and their families, not dominated by medication, and are heavily influenced by the value of psychosocial care, which is covered within our system of health insurance.

Again, there is nothing from McGorry that shows scientific proof about intervening before first episode psychosis occurs.

Are we led to believe that McGorry will never use prescription medication on children who may or may not hit the first episode psychosis stage?

Can he openly declare that neither he or his team will offer psychiatric medication to children who he and his team suspect may fall foul of a mental disorder? Could he also admit, one way or the other, that the choices of medication for children with mental disorders are safe and effective for children? If so, could he provide the proof?

I find it amusing that two psychiatrists are publicly having a slanging match, more importantly though, I find it enlightening that more and more people are voicing their opinion on McGorry's Headspace initiative.

Debate is good but scientific evidence is even better. To my knowledge there is no supporting scientific evidence that backs McGorry's initiative. Figures quoted may prove to McGorry that Australian kids need more help but hey even I, a blogger from Birmingham, UK, can quote figures by using the adverse reaction reports to psychiatric drugs that are posted on Medicine regulatory websites, the figures are drastically under reported yet still alarmingly high.

McGorry may believe he is the new Messiah for Australian youth. If he were to NOT use psychiatric medication on them I, for one, would kiss his feet!

McGorry's response to Allen Frances can be read in full HERE.


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Australian Member of Parliament, Martin Whitely, also speaks out against McGorry's Headspace initiative HERE.