“The bias in this paper is very disturbing…It is this kind of complicity that damages any hopes of a positive partnership between medicine and [the pharmaceutical] industry.” – Lancet Editor tweet on recent Hickie research
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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 http://www.nhmrc.gov.au/guidelines/adhd-conflicts-interest ) 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.
Tags: ADHD guidelines, Australian ADHD Guidelines 1997, conflict of interest and ADHD, Daryl Efron, Jon Jureidini, Joseph Biederman, Learning and Attentional Disorders Society (LADS), Mark Butler, Michael Kohn, Michelle Toner, Minister Butler, NHMRC, Nicola Roxon, Roger Patterson, Tony Abbott
The following is an edited excerpt from a speech Martin Whitely MLA made in the Western Australian Legislative Assembly on Wednesday 25 May 2011
Mental Health was a centrepiece of the federal budget, with an additional $2.2 billion being identified over five years for mental health initiatives, of which $419.7 million was split between the Early Psychosis Prevention and Intervention Centre (EPPIC), and Headspace. An additional $2.2 billion for mental health is a good thing and to the extent that people such as Professor Patrick McGorry, Professor Ian Hickie and Professor John Mendoza, have contributed to putting mental health on the agenda, they deserve praise. However, I am concerned that the devil is in the detail. My criticism is not about extra funding but about the lack of an evidence base for the decisions that have been made.
Tags: Allen Frances, attenuated psychosis syndrome, David Cappo, DSM5, EPPIC, headspace, Ian Hickie, Independent Mental Health Reform Group, John Mendoza, Julia Gillard, Mental Health Expert Working Group, Patrick McGorry, Psychosis Risk Disorder, SSRI antidepressant 'off label' prescribing, Tony Abbott
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.
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 http://www.nhmrc.gov.au/media/noticeboard/notice09/091130-adhd.htm (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.]
Tags: Daryl Efron, David Forbes, Drug abuse and ADHD, Indigenous ADHD, intellectual disability and ADHD, Joseph Bierderman, Julia Gillard, Laurance Greenhill, Linda Graham, Mark Butler, NHMRC, NHMRD draft National ADHD Guidelines, Nick Xenophon, Nicola Roxon, Polypharmacy and ADHD, prison screening and ADHD, Royal Australasian College of Physicians, Tony Abbott