Wednesday 3rd of June 2020

Mental Health

There is currently an invitation out there to make a submission to the Senate Inquiry into Mental Health. I've taken a look at the guidelines and fear that there will be little change to be made.

The National Mental Health plans call for more involvement of General Practitioners as Primary Carers for the mentally ill and to this end, government has made additional allowances available for GPs to spend more time with their mentally ill clients. This is a very good thing but ultimately pays no attention to the fact that GP numbers seem to be decreasing, and many have now closed their books in an effort to gain control over their office hours. The other solution as seen by the government has been to throw money at NGOs who put up their hands for dollars to take care of the mentally ill. But NGOs will not employ trained and experienced mental health workers: instead, they give their workers a 6 week crash course and expect them to cope. They do not. They can not.

Now, in NSW, the Carr government is proposing to close another 244 mental health beds, in spite of strong evidence that this would be an illconsidered decision. Closing 244 beds when every hospital (including the proposed closure) in this state is at 100% occupancy and often over numbers every day of the week, is flat out stupid.

Staffing issues for hospital and community are always at the forefront as well... not enough positions, not enough money to pay for staff, not enough qualified experienced staff, not enough not enough.

It's time that both Federal and State Governments stopped trying to dodge the responsibility for the mental health of the Australian populace. Its not going to go away and sweeping it under the carpet of GPs and NGOs is going to backfire in a way you cannot possibly imagine, but those of us at the "coalface" can see it coming a mile away.

Worry about psych patients being in jail or on the streets and in parks and under bridges? Its only going to get worse under the current Plan.

Change is needed. NOW.

Cognitive therapy

Chris Pyne, Parliamentary Secretary to the Minister for Health and Ageing, gave a speech on "community concern over the Codex, community concern over the country of origin labelling issue and the concern raised by the shadow minister for health over spending on mental health" on May 31st. (See Hansard). Mark my words, this lad is next Minister for Health.

On June 1st, at Melbourne Fabians meeting, Victoria's Minister for Health Bronwyn Pike, spoke to an audience of about 100, comprised mainly of people with a direct interest in the topic, on Victoria's new mental health initiatives. As to the detail of the $180 million extra spending over the next four years, it didn't come out in the talk, and I can't locate it on the government websites.

Ms Pike fielded a couple of searching, even demanding, questions. But she served it right back, saying the professionals in the field - meaning, I would guess, psychiatrists in public hospitals - have to stand up and say what is needed. Fair enough, but the other speaker, from a community-based NGO, had just finished explaining that the biggest problem is the non-sharing ethos left over from Kennett's competitive tendering models. That is, individual programs may have devised good tools, but they are not likely to let them spread across to the mob who will be fighting them for crumbs in the next round of the funding battle. Individual program heads who speak out from public hospitals run the great risk of being crushed or marginalised by the administrative machinery.

The last question to Ms Pike was a beauty. A woman gave an impassioned and articulate presentation of a dilemma. A young person is working, paying off a home, but has chronic depression. The person is taking medication, but wants to do more. They contact Beyond Blue, and receive a package of information. One of the brochures promotes cogntive therapy, but they discover it is both expensive, and not on the Medicare Schedule. Straight after the talk, the people who asked the question were surrounded by professionals with offers of help. What should Ms Pike have done? Politicians like to have their photos taken with "successes", and people with chronic mental ill-health generally don't brush up as well as a famous personality with cancer. Here was a golden opportunity - with some risk. Cognitive Therapy may have been very helpful to the person in question here. A little bit of encouragement from the Minister may go a long, long way - with "wins" for all concerned, and the therapeutic tool itself. A young person with improved future, very happy parents, another step towards rebate for CT, and smiles all round for the photo.

Insomnia and spin doctors

Pills vs. cognitive-behavioral therapy, at Slate.

For one thing, it isn't readily available. At the moment, there are few CBT practitioners specializing in sleep and few programs to train more of them. But even if their numbers begin to grow, the chances are small that this therapy will catch on as the standard best-practice approach. Already, patients who complain of sleeplessness to their primary care doctors are typically handed a prescription for Ambien (or referred to a psychiatrist who then writes the same Rx). Next month's ad launch will no doubt reinforce this pattern, by putting pills—with all their magic bullet simplicity—front and center in doctors' and consumers' minds. And while drug companies pour money into their own clinical trials, CBT has no sugar daddy. Proponents have to compete for grants from foundations or government sources like the National Institutes of Health. Nor do they have a friend in the insurance industry, which is generally less willing to pay for psychological treatments than for pills.

Australian readers beware: we do not have direct-to-consumer advertising of medicines. (New Zealand does, and there is a move to stop it.)

Marketing of medicines in Australia is primarily through the prescribers. Another recent article in Slate explains how it's done.

Spin Doctored
How drug companies keep tabs on physicians.
By Shannon Brownlee and Jeanne Lenzer

The industry's semi-secret weapon is prescriber reports, weekly lists of every prescription written by each of the 600,000 doctors in the United States. Relatively few physicians know about prescriber reports, also known as prescriber profiles. But their existence makes it far more difficult to imagine that pharmaceutical marketing has no effect on the doctors it targets.

Mercury and autism

Deadly Immunity: Mercury, Autism, Children... by Robert F Kennedy

I devoted time to study this issue because I believe that this is a moral crisis that must be addressed. If, as the evidence suggests, our public-health authorities knowingly allowed the pharmaceutical industry to poison an entire generation of American children, their actions arguably constitute one of the biggest scandals in the annals of American medicine.

The drug companies are also getting help from powerful lawmakers in Washington. Senate Majority Leader Bill Frist, who has received $873,000 in contributions from the pharmaceutical industry, has been working to immunize vaccine makers from liability in 4,200 lawsuits that have been filed by the parents of injured children. On five separate occasions, Frist has tried to seal all of the government's vaccine-related documents -- including the Simpsonwood transcripts -- and shield Eli Lilly, the developer of thimerosal, from subpoenas. In 2002, the day after Frist quietly slipped a rider known as the "Eli Lilly Protection Act" into a homeland security bill, the company contributed $10,000 to his campaign and bought 5,000 copies of his book on bioterrorism. Congress repealed the measure in 2003 -- but earlier this year, Frist slipped another provision into an anti-terrorism bill that would deny compensation to children suffering from vaccine-related brain disorders. "The lawsuits are of such magnitude that they could put vaccine producers out of business and limit our capacity to deal with a biological attack by terrorists," says Andy Olsen, a legislative assistant to Frist.

Warning: anyone trying to get our government to look into this issue could well be labelled a 'Terrorist'.

Mercury and Autism

T.G. Kerr, I agree with you that anybody that tries to get the Government to look at any issue is seen in the same way as a terrorist or rebel - Governments like compliant robots who accept being bullied and used as guinea pigs.

What has happened with this Mercury situation is unforgivable.  This is an interesting link that  an overseas friend sent me today in relation to this subject.

It's alarming.