Mark Butler

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“Personalities, rhetoric and charisma are driving the direction of mental health rather than science and evidence.” (Martin Whitely MLA, Parliament of Western Australia, 25 September 2012)

Related Media

Sue Dunlevy, News Limited Sunday papers, 7 October 2012, Doubts cast on youth mental health program. Available at

Also see Patrick McGorry’s ‘Ultra High Risk of Psychosis’ training DVD fails the common sense test

MARTIN WHITELY (Trancript of speech in the Legislative Assembly, Parliament of Western Australia, 25 September 2012): I want to use this opportunity to talk about some very serious concerns I have about the direction of the mental health policy in Australia. My basic contention is that personalities, rhetoric and charisma are driving the direction of mental health rather than science and evidence.

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By Martin Whitely MLA

The off colour Australian colloquialism ‘you can’t polish a turd but you can cover it in glitter’ is a fitting analogy for the danger of legitimising ADHD as a diagnosable mental illness by developing treatment guidelines. However, treatment guidelines are being developed and the more conservative the treatment guidelines, the fewer children risk damage with the long-term administration of amphetamines.

That is why I welcome the release by the National Health and Medical Research Council (NHMRC) of the Australian ADHD Clinical Practice Points (CPPs) as a small but significant step in the right direction. (The CPPs available at )

Eventually ADHD will be regarded as an embarrassing footnote of history and society will collectively wonder how anyone ever thought it would be a good idea to give amphetamines to children. But in the meantime improvements like those in the ADHD CPPs, although modest, will hopefully see fewer children diagnosed and drugged.

That said, the CPPs are far from perfect. The statement that, “…stimulants might be considered for this age group (under 7 years)” leaves the door open for drugging very young children.[1] The manufacturers prescribing information for all stimulants state they should not be used in children under 6 years, since safety and efficacy in this age group have not been established.[2] Any clinician ignoring the manufacturers warning is inviting a future law suit for negligence.

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The decision by Australian Government Mental Health Minister Mark Butler to suspend proposed cuts to the “Better Access” program from a maximum of 16 visits to counselling services to 10 per year appears to be a welcome and rare win for talking therapies over drug therapies.

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Today (Wednesday 13 July 2011) Mental Health Minister Mark Butler announced the membership of the committee responsible for developing new Australian guidelines on ADHD. Of the ten members invited to participate, two have significant conflicts of interest that should preclude their involvement. However, this compares very favorably to previous ADHD guideline development processes which have been dominated by pharmaceutical company allies who have relied on commercially compromised research.

It is also, for the first time, an open process. We know from the start who is developing the guidelines and the details of their conflict of interest declaration. (see ) Gillard Government Mental Health Minister Mark Butler deserves credit for this. Let us hope this creates a precedent for future commonwealth government medical guidelines and advisory committee processes.

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The Boston Globe reported yesterday[1. Harvard doctors punished over pay, 2 July 2011, Liz Kowalczyk Boston Globe] (2 July 2011) that three Harvard Professors, Bierderman, Spencer and Wilens, who were referenced 82, 46 and 32 times respectively in the discredited draft Australian Guidelines on ADHD, have been sanctioned by their employer for allegedly failing to disclose millions of dollars in pharmaceutical company payments. [2. ‘On June 8 2008 the New York Times first exposed how Dr Biederman was paid US$1.6 million in consulting fees from drug makers between 2000 and 2007 but did not disclose this income to his employer Harvard University. Gardiner Harris and Benedict Carey, ‘Researchers Fail to Reveal Full Drug Pay’. New York Times, 8 June 2008.] [3. Biederman received research funds from 15 pharmaceutical companies and serves as a paid speaker or adviser to at least seven drug companies. ‘The Evolving Face of ADHD: From Adolescence to Adulthood—Clinical Implications’. Available at (accessed 2 May 2008)]

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Former Australian of the Year, Professor Patrick McGorry, and to a lesser extent his close colleague Professor Ian Hickie, have dominated the long overdue debate about the future of mental health service delivery in Australia. Their claims of massive unmet need and proven 21st century solutions are being accepted almost without question by the Gillard Government, the Abbott Opposition, the independents, the media and the public.

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One year on from the release of the corrupted National ADHD Guidelines – The Gillard Government continues to turn a blind eye to drug company influence, ignore NHMRC advice, and expose Australian Children to unnecessary ADHD drugging.

The continuing refusal of Gillard Government Health Minister Nicola Roxon to abandon flawed and compromised draft national ADHD guidelines is risking the health and wellbeing of tens of thousands of Australian children. It is now over a year since Federal Government Health Minister, Nicola Roxon, rejected advice from the NHMRC to abandon the draft guidelines because of concerns about undue influence by ADHD pharmaceutical manufacturers.

In 2007 when opposition health spokesperson, Nicola Roxon expressed concern about the potential for undue pharmaceutical company influence on these ‘incredibly important’ guidelines. However, upon becoming the Health Minister Nicola Roxon refused calls to abandon the controversial guidelines process and appoint a replacement ‘conflict of interest free’ committee.

Throughout 2009 Health Minister Roxon came under pressure from both sides of the ADHD debate. ADHD critics concerned about the potential of the draft national ADHD guidelines to further accelerate the growth in child prescribing rates lobbied Roxon to abandon the draft guidelines and seek advice from psychiatrists without ties to the pharmaceutical industry. ADHD industry insiders, including members of the committee who drafted the guidelines, wanted them released.

In October 2009 the National Health and Medical Research Council (NHMRC) effectively offered Roxon an ideal circuit breaker. They announced that because of an investigation involving undisclosed drug company payments to US researcher Dr Joseph Biederman, who was cited 82 times in the draft guidelines, the guidelines had not been approved. The NHMRC issued a press release stating that ‘if the US investigation remains unresolved by mid-2010, NHMRC will move to redevelop the draft guidelines’.[1. NHMRC, ‘Draft Australian Guidelines on ADHD – NHMRC consideration deferred pending outcome of USA investigation’, NHMRC Noticeboard 2009. Available at (accessed  3 December 2010)]

Surprisingly Minister Roxon rejected this opportunity to defuse the issue and in December 2009 pressured the NHMRC to release the guidelines. The public and the medical profession were left with the mixed message that according to the NHMRC the guidelines were draft and subject to withdrawal, but that Roxon was pleased they finally offered ‘more up-to-date information on ways to identify and care for those in our community who may be suffering from ADHD.’[2. Renee Viellaris, ‘Medication not first option to beat ADHD’, Courier-Mail, 1 December 2009.]

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No sensible person would argue against Australian of the Year, psychiatrist Patrick McGorry’s call for early intervention to prevent psychosis; unless of course you know the detail of what Professor McGorry has advocated as early intervention. Put bluntly, Professor McGorry has advocated the use of antipsychotics, with a host of serious potential adverse side effects, on the hunch that adolescents may later become psychotic.

Specifically Professor McGorry is a leading international advocate for the inclusion of Psychosis Risk Syndrome, otherwise known as Attenuated Psychotic Symptoms Syndrome, in the next edition of the clinically dominant Statistical Manual of Mental Disorders (DSM-V) due for publication in 2013. He acknowledges that ‘the false positive rate may exceed 50-60%’ nonetheless has justified the use of pre-psychosis drugs by arguing ‘all those identified are by definition seeking help and need some form of care’.[1]

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