Professor Patrick McGorry writes:
The Senate’s passing of a motion calling for a comprehensive network of headspace and Early Psychosis Prevention and Intervention Centre (EPPIC) services for young Australians with mental ill-health is to be welcomed as another positive step towards mental health reform in Australia.
However, the opposition of the Greens and ALP to this motion highlights a worrying fault-line that might herald a most unwelcome partisan divide on mental health reform. Such a divide is a cause of deep concern as its most likely consequence is further delay of meaningful mental health reform, with lives needlessly diminished or ended early as a result.
The ALP, Coalition and Greens all agree that much more needs to be done on mental health. All three parties also agree on the need to enhance supports and services for young Australians – the age group most affected by mental ill-health. All three parties agree that the best way of achieving this goal is to increase access to headspace centres (one stop shops for young Australians with mild to moderate mental ill-health) and EPPIC services (specialist youth mental health services for more complex and potentially more serious mental illness).
A parliamentary motion calling for better mental health care for young Australians through enhanced access to headspace and EPPIC would appear ripe for tri-partisan embrace.
Yet the ALP and Greens voted against just such a Senate motion when it was introduced by the Coalition this week.
The motion passed with the support of independents Nick Xenophon and Stephen Fielding. Many ALP and Green Senators probably voted against the motion with a heavy heart in the knowledge that they were letting down their supporters and the community as a whole. ALP and Greens voters are just as likely to experience mental ill-health as those who vote Coalition or independent.
As a result of Tuesday’s vote, Australians with mental ill-health from the left of the political spectrum may be wondering whether the parties they support will deliver for them.
Before the last election traditional ALP supporters who were disappointed with their party’s thin record in Government on mental health could at least entertain the idea they might get a better return by voting Green.
However, early signs from the new parliament – including the absence of any mention of mental health in the post election agreement entered into by the Greens and ALP – call into question if the whether the Greens are really offering all that much more on mental health than the ALP.
It would almost certainly be fair to say that there is a genuine desire to deliver on mental health in both parties and that both Julia Gillard and Bob Brown want to be positive enablers of making this happen.
What is less clear is whether either the ALP or the Greens are able to translate the desire to act into real outcomes for Australians with mental ill-health and their families. In particular, both parties have yet to demonstrate they have a plan to overcome some of problems they have created for themselves.
In the ALP’s case, their biggest problem is they have already committed almost all the growth funding they plan to invest in healthcare over the coming years to physical health and can’t seem to work out how to fix this problem.
The Greens on the other hand appear to either feel that their political capital is too scarce for investment in policy areas outside of their agreement with the ALP or else are just too inflexible in their negotiation strategy (the main stated reason given for rejecting the motion on Tuesday was that it did not include other aspects of mental health policy that the Greens supported – a clear case of if we can’t do everything we won’t do anything).
Both the ALP and Greens created barriers where there were none and as a result found themselves this week voting against providing services that they genuinely believe are vital to our young people.
Both parties need to do better.
Every day we delay with investment and reform in this space more young lives are lost or damaged, futures derailed and the hopes of parents dashed. Those who contribute to this unnecessary delay will one day soon be held responsible by the Australian people for the consequences of their actions.
• Patrick McGorry is Australian of the Year, and Executive Director of Orygen Youth Health
Is anyone else left a little cynical when Patrick continues to push for more funding for his own organisation? When he leverages his position as Australian of the Year, in conjunction with an emotive stance on mental health, all in a bid to further line his own pocket? Hasn’t the Labor party committed to the largest suicide prevention funding package ever in Australian history, while also funding EPPIC and Headspace? This constant demand for more and more money for his own projects is starting to look a bit self serving to me.
“a clear case of if we can’t do everything we won’t do anything”
I’m already ‘over’ that aspect of the Greens. Sick of them not being willing to compromise in order to get SOMETHING done, rather than nothing.
Hmmm… this reminds me of criticisms of the Greens for voting down the CPRS legislation. Perhaps there is a bit more to it than the article above suggests and the greens have voted down the resolution with a realistic expectation of something better.
Consider why the Coalition would have put forward this resolution now. They had control of both houses of parliament 3yrs ago, but didn’t do it. The current senate has been in place for the last 3 years, but the resolution has only come now, 8 months before the changeover in the senate. Call me cynical, but I don’t think the Coalition are acting altruistic, I think they are playing politics.
I can understand a bit of angst at the Greens and Labor over this, but maybe we should give them enough rope and wait for the new senate and see what they do with it.
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THIS COMMENT HAS BEEN EDITED BY THE MODERATOR. CROAKEY WELCOMES ROBUST DEBATE, BUT NOT POTENTIALLY DEFAMATORY PERSONAL ATTACKS.
With all due respect Patrick, the bastards are so busy creating illness and using billions in tax payers money to do it to fund a system that has not shown one ounce of evidence it actually works.
My grand-daughter had a psychotic break a few months ago after bottling up domestic abuse by a boyfriend, no amount of head room clinics could have stopped the results.
(PARAGRAPH EDITED OUT)
There is zero evidence that anyone ever stopped a single case of paranoid schizophrenia, delusions, bi-polar or anything else because they can only be diagnosed after they are manifestly evident.
Instead of the bleating that hundreds of thousands of young people are at risk, you should be more honest and say you just want to throw more money at a service that has no discernible benefit because most cannot even afford it.
(THIS COMMENT HAS BEEN EDITED)
A few comments on a previous post.
The serious and false claim (EDIT) against Patrick McGorry have already been comprehensively dealt with by Prof. McGorry both in Crikey ( http://blogs.crikey.com.au/croakey/2010/08/17/patrick-mcgorry-defends-early-intervention-on-youth-mental-health/ ) and in The Age ( http://www.theage.com.au/national/letters/mcgorry-has-led-vital-campaign-in-flawed-system-20100809-11ty2.html ). The evidence of the effectiveness of specific mental health interventions is well established by research and the services advocated for by Prof. McGorry are overwhelmingly free or low cost to service user.
So, mental illness prevention doesn’t work because the people in whom it’s prevented don’t have a mental illness. 5-star thinking thinking there, Marilyn.
Your grand-daughter’s situation sounds horrible, but you sound painfully ignorant by asserting that psychiatric services somehow failed an adult woman about whom we know nothing except that she chose to remain in an abusive relationship. Even if we accept that she has absolutely no responsibility for her own health and safety, it’s the social workers you should be complaining about.
Jon Jureidini is indeed excellent, and his published critiques of the mental health system in Australia are mostly debunkings of the sort of uninformed crap you’ve written above. God knows what you’re reading into it.
Also, a quick tip: if, in future, you don’t want to sound utterly clueless by ranting about diagnosis and manifest evidence, look up the terms “prodromal” and “first-episode psychosis”. What you’ve just done is the equivalent of going to a meteorology blog and declaring that it’s impossible to forecast the weather.
I sincerely ask you to stop posting on the internet, Marilyn. The Australian Left will cope without you, and by the look of it you’d be much happier working for the Scientologists to help save Brooke Shields from the evil psychiatric industry.
In fact, why do you even have a computer? If you lived by the values you preach you would have sold it to give some poor Afghan tribesman in detention the money to send his teenage daughter overseas to marry a geriatric and have her clitoris chopped off.
I love the way claims for ‘more money please’ without producing the hard evidence for improved mental health outcomes, should necessarily induce in anyone a willing act of faith to just go along for the ride. Governments should be rightfully wary of pouring billions of extra dollars into the bottomless font of biopsychiatry, and hype should give way to reason in making sure that each and every big ticket mental health intervention is ‘independently’ evaluated.
I’m reluctant to criticise the moderation, considering that my post is left standing unedited, but I don’t recall Marylin making any comments that are harsher than what I’ve written to her, above.
Croaky should be able to host robust discussions about mental health without appearing to favour a particular approach or opinion.
Psychiatry is an evolving field of healthcare, and criticism of particular approaches or practices should not be verboten.
So many experts here and no one has a clue.
I have been suffering from clinical depression for 17 years. It took 15 years before my psychiatrist and I found a combination of medications that improved my situation. I have a list of all the medications that we tried.
The medications I use are expensive, only two are under the PSB, the third cost $75 for 56 tablets.
I am lucky because I have private health cover. it enabled me to be treated in private clinics and consult a psychiatrist in private practice.
IMO the public system is not very good. I had one admission to a public hospital psychiatric section and it didn’t compare well with my admissions to a private psychiatric clinic.
From experience I can say that psychiatry is very much a hit and miss affair.First you need to hit on a competent doctor who can diagnose you reasonably correctly and then tries all the treatments that are available to improve your situation.
This is a lenghty and costly process.
In conclusion, money is important because it helps to find good doctors and sustains the lenghty process of treatment.
As a patient you must prevent yourselves from killing yourself and hang in for the long ride.
Maybe we should turn this one on its head?
Do any of the mentally healthy believe that the left-right construct has any basis in reality at all nowadays?
I certainly don’t. The whole “left-right” dynamic is something that has nothing to do with our world nowadays.
The people labeled nowadays as “left” would probably have ended up labeled as reactionaries and sent to the Gulags in Communist Russia.
Neither the Labor party or the Liberals nowadays can be seen as heirs of any intellectual – political position beyond basic pragmatism. That is why the Greens did so well last time- at least they stood for something more than “Vote Me”.
re Peach 1:
I could not agree more about your criticism of psychiatry. I had to burn through 7 psychiatrists before I found one competent to diagnose and treat me.
The ultimate diagnosis – Adult ADHD. 18 months only on medication- and 2 years after diagnosis I am off medication, and a very happy and functional person. No medications- and have been told there is no real need for me to see anyone any more.I endured the care of an alleged professor of psychiatry for 14 years- and all that time “got by” OK – but not sorted, still needing medication, still thinking of myself as something less than I really am.
Maybe my disease was stupidity- for being such a “good patient”.
I’m not convinced. Pat McGorry needs to respond to the critics and non-supporters, such as the Greens and Melissa Raven, with more than derision questioning their commitment to the promoting a better mental health system. (see http://blogs.crikey.com.au/croakey/2010/08/17/patrick-mcgorry-defends-early-intervention-on-youth-mental-health/ )
Practices such as the distortion of statistics, emotive arguments and potential conflict of interest because of corporate funding, such as those highlighted by Melissa Raven, are serious concerns that Professor McGorry has not responded to adequately. I’m more disappointed that GetUp would support this motion uncritically, particularly as variations of the aforementioned behaviour has been a target of their campaigns in the past.
The motion itself is questionable because of the large amount of funding it is looking to pour into essentially one kind of mental health service. Securing more mental health funding from the government should be a priority, but no less a priority than how we propose to use it.
I don’t doubt that Professor McGorry does good work, but I do doubt that his ‘one stop shops’ for mental health intervention will fix the complicated problems of the mental health system. Why then should all the funding be going to headspace and EPICC, noble as they are? Committing a large amount of funding to a single kind of service will deprive other organisations who are equally deserving of funds, either in the short or long term. I bring this up because I’m disturbed by the constant association of this motion with the mental health crisis or mental health funding GENERALLY when these services clearly offer a narrower focus. Imagine the good that could be done with that amount of funds in existing mental health services who already have an engaged clientele, as well as through the expansion of new services.
One thing I am sure of is that Professor McGorry’s patronising and emotive statements (such as ‘ALP and Greens voters are just as likely to experience mental ill-health as those who vote Coalition or independent’) are not raising the tenor of the debate, which is disappointing given the much needed exposure that his increased public profile has brought to mental health in Australia. I agree with Billbang, it is starting to sound self-serving. Prove me wrong Professor McGorry, justify your position and explain to us why and how headspace and EPICC will produce the real mental health outcomes at the expense of other services.
Trolling is not the same as criticising.
Patrick McGorry and Melissa Raven’s evidence are both available to the public. A quick academic search through a resource such as http://scholar.google.com would provide you with a good starting point.
Having experienced my first psychotic episode at 19 (and a lifetime of mental illness after that) I believe that headspace is a great initiative. However I am a bit concerned about whether anyone has the ability to predict if people are going to have psychotic episodes or not until they actually happen. They seem to me to come out of the blue and be different every time.
The other thing that concerns me is that sometimes people are better off not knowing they have a serious mental illness. If I had known at 19 I never would have married or had children for example. Other people with serious mental illness have told me the same thing. I have only ever been hospitalized once and that was at the age of 52, so I haven’t done too badly just muddling through. I lived many years, experiencing the odd psychotic event (hallucinations etc) without them causing me too much trouble. An advantage of finding out late about a major mental illness is that you aren’t on drugs for a for a long time and the drugs are often worse than the illness.
The other side of this is that your life can be very difficult if you don’t have insight into your mental condition.
I am not against a short dose of anti-psychotics. When I first was put of Resperidone at age 52, the clarity of mind was incredible. However I think it should be for a shorter time, 3 – 6 months rather than the 6-12 that is being suggested. If they are going to work on you, they will work pretty well straight away.
I hope Prof McGorry is not forgetting the “talking therapies” for delusions etc. I write about the importance of talking about and questioning delusions here: http://stopthrashingaround.wordpress.com/2010/07/14/foucault-descartes-socrates/