You’d think mental health was firmly on the political radar, judging by the column inches devoted to the topic. But it’s mostly smoke and mirrors, from public relations and vested interests peddling assumptions rather than the genuine community conversation needed.
The poverty of the current public discussion of mental health can be seen in two political struggles currently underway: one nationally very much in the media, the other in Victoria which isn’t on the radar but should be. At the national level, high-profile advocate Patrick McGorry is selling his multi-billion dollar product to the federal government and to the community that will pay for it.
Down south, in a state which boasts of its human rights leadership, the government is sneaking through a draconian new Mental Health Act that violates the state’s own Human Rights Charter.
Reading the mainstream media you’d think the McGorry bandwagon was the only mental health game in town. McGorry’s international reputation is based on his work on the early intervention of psychosis. He believes he can reliably predict those young people who are at high risk of developing a psychotic disorder prior to them displaying symptoms that would warrant such a diagnosis.
It’s controversial, even among McGorry’s peers in psychiatry. The notion of early intervention represents a very wide diagnostic net that would capture many people who would never go on to develop psychosis. The number of such ‘false positives’ is usually quoted in the literature as 60-80%.
Once a young person is caught in the net, McGorry believes anti-psychotic medications can help prevent the onset of psychosis even though there is no scientific evidence for these drugs as prophylactics against psychosis. This has been compared to giving chemotherapy to prevent cancer in someone with a family history of cancer but otherwise no other symptoms. Most alarming of all is that McGorry seems unconcerned about giving these dangerous drugs to the large number of false positives caught in his pseudo-diagnostic net.
McGorry’s allies in selling this controversial medical model include beyondblue, the Brain and Mind Institute (led by former beyondblue CEO Ian Hickie) and other medical model enthusiasts such as John Mendoza. But dissenting voices are not permitted in the room to disturb this medical juggernaut. McGorry’s ubiquitous presence in the media throughout 2010 is not public debate, it is public relations.
In stark contrast to the McGorry media frenzy, Victoria’s Mental Health Act. Now, Victoria is the only state with a Human Rights Charter (along with the ACT). Its champion is Attorney-General Rob Hulls, who acknowledges that mental health laws contain some of the most serious limitations of human rights that a society might impose on a person.
The scandal began at the very start of the review (May 2008) when it was given to the Department of Human Services (DHS) rather than the Law Reform Commission, which is the obvious agency to conduct a review of legislation with such serious human rights issues. Having the DHS review the Mental Health Act has been compared to having the police review criminal justice law.
An eight-person expert advisory group was established without a single mental health consumer among them. The review team then prepared a consultation paper (December 2008) for a very stage-managed — and very brief — community consultation process during the summer months, concluding in February 2009. A community consultation report was then produced (July 2009) and law-makers went into their bunker to write the draft bill released in September.
Throughout the review it was apparent the government intended to maintain involuntary medical treatment as the foundation of any new Mental Health Act — indeed the only reason why such an Act is required is to give legal sanction to such human rights limitations. But the Human Rights Charter was now law in Victoria and it imposes — or is supposed to impose –strict legal obligations on any proposal to limit any of the rights now protected under the Charter. In particular, it says any limitations of a Charter right must be “demonstrably justified in a free and democratic society” and gives some criteria that must be considered in any such justification.
The draft bill contains serious limitations of numerous Charter rights but after more than two years there has still not been one word of justification from either the DHS or the government. That won’t come until the Statement of Compatibility, which is required when the new bill goes before the parliament, expected in mid-2011. Public debate of very serious human rights issues is being deliberately suppressed by this review.
There is a great thirst in the community for a broad-ranging conversation around the many complex issues that come under the mental health banner. Suicide, drug and alcohol problems, prisons as de facto mental asylums, the excessive medicalisation of human suffering, the social determinants of mental health and many other urgent issues are needed in this conversation.
What we have, on the one hand, is the hard sell of the McGorry medical model, and on the other a government’s very deliberate stifling of debate on mental health and human rights.
*David Webb (PhD) is a disability rights activist who has represented both national and international disability organisations at the UN on the rights of people with disabilities.
I have been mildly depressed over the years due to continued incurable illness which causes all sorts of problems for me and my family but I am not a mental health patient and never will be.
McGorry’s claim that he can prevent even one attack of psychotic behaviour is really laughable.
My grand daughter had a bried psychotic break in June this year, not one person saw it coming or the reasons for it.
Because kids and people in general do not talk about what is making them crazy for the simple reason that they have no clue what it is about themselves.
The notion that we should spend billions on a prevention program when others have concluded that McGorry is largely making it up is somewhat deranged.
David, I found reading this piece very negative. You say what you are against but not what you are for. What is your alternative treatment model? What is your alternative to involuntary treatment?
The word ‘psychotic’ comes from the greek, ‘abnormal thought/mind’, it does not refer to any specific disease entity whose etiology can be demonstrated, despite generation of psychiatrist slapping this label, brain organ unexamined, on people who dare become distressed in life. The drugs called ‘antipsychotics’ were called ‘major tranquilisers’ until a PR job was done on the drug name itself. They REMAIN nothing but major tranquilisers, and they are forced violently without consent, against expressed nonconsent, into the bodies of tens of thousands of Australians, Australians who have not be charged with any crime, not been afforded even the right to a competency hearing before a judge, not been afforded the right to legal counsel free and clear of forced mind altering drugs, and none of us who survive this rape of our never proven diseased brains, are people Australia cares about. We are the forgotten people, that is for sure.
As for this part of this piece…
“This has been compared to giving chemotherapy to prevent cancer in someone with a family history of cancer but otherwise no other symptoms. ”
Yes, it is like that in a way, apart from the fact cancer is a real disease a doctor discovers in YOUR biology after investigating your biology, where as ‘psychosis’ is just name calling done by a quack who possesses not even so much as stethoscope in his office, yet tells the world he is some kind of quasi-neurologist, which is just a lie, and wishful thinking.
“Jenny Haines
Posted Thursday, 18 November 2010 at 3:16 pm | Permalink
David, I found reading this piece very negative. You say what you are against but not what you are for. What is your alternative treatment model? What is your alternative to involuntary treatment?”
Oh you know what Jenny, I found being detained indefinitely without charge, stripped naked and thrown in solitary confinement, forcibly drugged, and denied any due process whatsoever to be ‘very negative’. I’m for freedom, I’m against the government doing violence to innocent people on the basis of your mere belief that there are doctors out there who can prove a brain is diseased without ever once examining that organ. I’m against human rights abuses, I’m ‘for’ people like you who believe in this quackery not forcing it on others at the ballot box when you empower governments to push us around based on mere unproven hypotheses about biology they don’t examine examine!
‘What’s your alternative to involuntary treatment’?
Well let me make clear, we don’t have an agreement here on the word ‘treatment’, at all. We have forced tranquiliser drugs, being stabbed into the bodies of people whose thoughts and behaviors we don’t like. People whose brains are not subjected to any investigation demonstrating any disease at all, by a dishonest profession up to its gills in drug company money, also a profession who labeled every gay and lesbian in this world as having ‘sexual orientation disorder’ until a generation ago, when they voted that ‘disease’ out of existence due to political pressure, this is not science, this is quackery.
So asking what the alternative is to involuntary psychiatric relations, is like asking what the alternative is to involuntary sexual relations or involuntary labour relations, rape and slavery.
It’s not ok to hoover up countless people into a violent mental health system by force. It’s not ok to force us to live in fear of a violent, atrocious system where we have no rights. It’s not ok at all. It is not ok to hate people like me, by voting for governments who enact laws that act is if I am a subhuman animal.
Jenny, David has made a critique about the sham claims of Patrick McGorry and does not necessarily have to provide alternatives. I’m a little confused by your last question, are you suggesting we involuntarily treat the youngsters in case they may develop a psychosis?
Antipsychotics aren’t a walk in the park and have serious long term side effects, the epidemic of diabetes sweeping through mentally ill people should make us look more closely at these proposals.