OYM Martin | Mental Health Australia

 

Australia is experiencing a mental health epidemic not much different from what the US has. If you are experiencing problems of any sort, go see your doctor, get them to prescribe a pill, and you’ll be alright. That’s what the system would like you to think. Most of the people in the health industry are aware that it’s not as simple as that but their voices carry no weight in the face of institutionalized overmedication supported by big pharma dollars. Not many people talk about this critical and sensitive issue but Martin Whitely has been at it for years. In early 2021, he published a book called Overprescribing Madness, which describes the factors that drive Australia’s growing dependence on antidepressant prescribing to solve mental health issues. Joining Dr. Timothy J. Hayes in this conversation, Martin explains how Australia’s otherwise excellent healthcare system enables this overdependence on medications and why this “solution” is like spraying napalm to put out a fire. He also talks about the undercurrent of integrative medicine that challenges the status quo despite being a tiny voice in comparison.

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Overprescribing Madness: Australia’s Mental Health Epidemic, Institutionalized Overmedicalization, And The Holistic Undercurrent With Martin Whitely

Essentially, Journey’s Dream is a not-for-profit that hopes to help rewrite the narrative on mental health to one in which optimal health and wellbeing are possible and expected, and where mental health challenges can become transformational rather than tragic. I’m donating my time to this group. I’m a psychologist in Illinois outside of Chicago. The purpose of the show is to help share a message of someone like you and the research you’ve done and your perspective on certain aspects of mental health with our public. Hopefully, the growing population of people who are working to normalize the conversation about mental health look at things other than just medications to stomp out symptoms, but to look at the whole person, etc. Hopefully, we’ll help your work and promote the Journey’s Dream vision and get more visits to your website from people interested in reading your book.

That’s very much sums up the things some of us were trying to achieve in Australia. That is less reliance on the medicalized model and more of a holistic approach to mental health, and more of an optimistic approach that abandoned that permanent disability model that’s inherent in documents like the DSM and recognizes that mental distress is often transitory. It’s our natural response to what’s going on in people’s lives, but people do get better. Most people will get better.

It’s certainly been a blessing in 2020 to interview people like these people at Same Here Global, a whole series of integrative psychiatrists, people who use functional medicine and the holistic approach rather than chasing labels and symptoms. Are you willing to talk to us about your book and what got you through this journey?

I’ve written a book called Overprescribing Madness, which tackles the issue of why 1 in 6 Australians is on some form of a mental health drug. The most commonly prescribed psychiatric medication in Australia is antidepressants. The most common of those is SSRIs, but 1 in 6 Australians is taking an antidepressant. Apart from Iceland, Australia was the highest user of antidepressants in 2000 and 2015 of 33 OECD countries. It doesn’t make a lot of sense when you look at the natural advantages we have in Australia, a functional and prosperous society.

By all reports, Australian self-report being fundamentally happy people. I look at why is it that so many Australians have adopted a medicalized approach to distress and suffering. There are several factors. Two of the chapters concentrate on the impact of Australian psychiatry and medical practice adopting the DSM model in an unquestioning fashion. It’s probably the greatest example of cultural capture that you could cite. It’s not understood widely in Australia that we’ve outsourced the definition of who’s signing and who’s mentally ill to the American Psychiatric Association.

The strength of a generalized health care has become weakness for mental health care because the latter is simply linked to the former.

That unquestioning adoption of the DSM. There was a small debate around 2013 when DSM V replaced DSM IV, but nothing like a debate that educated the US. It simply passed into practice that would follow the DSM model. That’s one of the drivers. Another driver is we’ve got some homegrown psychiatric disease mongers who grossly inflate the prevalence rates for psychiatric disorders. It ended up with claims nearly 1 in 2 Australians will experience a diagnosable psychiatric condition at some stage in their lives. We’ve had some influential key opinion leaders in Australia who have driven an even more medicalized model.

Another problem we have in Australia is that most mental health prescribing has done by general practitioners who have limited training in psychiatry and psychology. They have pills as their first and, in many cases, their only option. The book touches on those issues and others. It looks at it from an Australian perspective but the lessons that are in the book are equally relevant in other developed nations like the US and the UK.

What prompted you to get into this? What’s driving your passion for this work?

Initially, I was a teacher in the 1990s in Perth, Western Australia. Outside of North America, Perth had the highest rates of ADHD prescribing in the world at the time. I was a teacher at a boy’s school. It was a very good and prosperous school, and fantastic academic results, but it had extraordinarily high rates of ADHD prescribing. I taught 12 to 17-year-old boys. I was concerned about the number of boys that were on medication and heavy doses of medication. As a teacher, I couldn’t see them benefiting from it. Initially, I’m concerned about ADHD.

OYM Martin | Mental Health Australia

Overprescribing Madness: What’s Driving Australia’s Mental Health Epidemic

In 2001, I was elected to the West Australian Parliament. As a member of parliament for twelve years, I made driving down ADHD Prescribing Rights part of my focus. From my interest and knowledge of ADHD and concerns about either medicalization of childhood behavior, I broadened out and saw similar patterns in things like the treatment of depression and the high rates of antidepressant prescribing in Australia. I was starting to see consistent patterns of behavior. What started off as a fairly narrow interest as a teacher became a broader interest in my time in politics. Since leaving politics in 2013, I’ve primarily worked as a mental health researcher and broadened my interest in mental health, still with a focus on ADHD prescribing as a major concern.

You mentioned that the majority of people who are prescribing this are only primary care physicians. They don’t have a specialty in psychiatry or psychology. Is there a movement in response to people like you and your book to try and shift that towards a wider array of possible interventions other than just medication?

Australia has a very good health system in the sense that we have universal access to low-cost primary care. You can go to your general practitioner. For poor people, they can do it at no cost. For everyone else, they can do it at a minimal cost. What they’ve done is they’ve dovetailed the mental health system onto the back of the primary healthcare system. What is it? In fact, the strength has become a bit of a weakness. The strength of generalized health care has become a weakness for mental health care. They’re simply linked mental health care to the primary health care system. The model of health care in Australia is you get a heavily government-subsidized visit to the general practitioner who is allocated roughly fifteen minutes to see you.

In fifteen minutes, general practitioners can’t get to the crux of what’s causing distress in people’s lives. Hence, you’ve got this highly medicalized model and also pharmaceuticals are government-sponsored. Not only is it the most readily accessible level of care, but pharmaceutical responses are the cheapest response for the consumer. We need to tackle that systemic problem. Part of the problem is that when the bean counters look at what’s the most efficient way of responding to mental health, a visit to a GP and a quick prescription in terms of dealing with the number of cases is the fastest. Superficially, it’s the most efficient way of dealing with the problem, but it doesn’t take into account the fact that you’re often exacerbating problems and making things worse, and you’re causing repeat visits.

I think we need a more holistic approach to mental health. We do need in Australia to have a rethink about how we deliver mental health services, rather than piggybacking on the back of a health system and otherwise functioning health system. On a positive note, one of the research projects I led looked at the relationship between antidepressant prescribing and suicide in Australia. I and some other researchers looked at the Australian response to the FDA’s black box warning on antidepressant use that was issued in 2004 and 2007.

We found that immediately following that warning. There were similar warnings issued and there was a small fall in antidepressant prescribing to young people in Australia. From 2009 onwards, there was a backlash where people argued against the worthiness of the FDA warnings. Since then, there has been an up-spike, continuous growth in antidepressant prescribing to young people. Corresponding with that, there’s been a significant rise in the suicide rates of people aged under 25. That’s bad news.

Overprescribing antidepressants for mental health issues is like dousing fire with napalm. It worsens rather than solves the problem.

The good news is that our research instigated a review by the Australian government who at last is taking this seriously. There is an appetite for a less medicalized approach, and I’m speaking as a former politician. On the whole issue of mental health, politicians and policymakers know that something needs to be done about it, but they don’t say simple answers. Those who are offering the simple answer of, here’s your tick box approach to psychiatry as promoted through the DSM. Here are the pills that’ll fix the problem. It has the superficial appeal of being a simple solution. The problem for people like me is we have to compete with that. We have to find ways that respond appropriately to people’s concerns and distress.

It comes to mind to ask, have you read Robert Whitaker’s book? Do you know about that book, The Anatomy of an Epidemic?

I dip in and out of it as I need to. It’s a fantastic piece of work from a very good man.

One of the things that came out of a book like that is the realization that the blanket and the long-term prescription of these medications is causing more harm than good. If you start there and you say, “We recognize that this thing that we thought was going to be a solution is creating more problems than it’s solving,” then it can give people a motivation to start looking to, “What are some of the other solutions?” There isn’t anything as quick, down and dirty as going to a doctor for fifteen minutes and getting a pill. There are things that are far more effective that look at the cause and long-term outcomes that are based on looking at the whole person. They’re based on an integrative psychiatric or a functional medicine approach.

I don’t have any knowledge of what therapy accessibility is in Australia. I know that there was quite a bit of a movement in Australia for EFT tapping and the energy psychology movement. It wasn’t exactly EFT tapping but they had another name for it. They adopted the work of Gary Craig and they had large EFT tapping down under. Can you talk a little bit about what is the level of access to therapists or alternative approaches in Australia?

OYM Martin | Mental Health Australia

Mental Health Australia: We need to rethink how we deliver mental health services rather than just piggyback onto an otherwise functioning health system.

 

As I said, the standard response is you go to your general practitioner or your local doctor who gives you fifteen minutes and a pill. There is a government-funded program called Better Access, which enables visits to up to ten and in some cases, twenty visits to a psychologist a year. In terms of mainstream government-funded access to services, that’s the new innovation. It’s a good innovation but there are some concerns that it’s the worried well in a sense. That’s the term that’s used and I don’t want to insult anybody with that. The takeout rates in prosperous parts of Australia are higher for those government-funded psychological services than they are in less prosperous areas.

At least it isn’t an attempt to move away from a totally medicalized pill-oriented approach to mental health. There are isolated efforts and some very good practitioners, psychiatrists and psychologists, but in terms of a coordinated organized movement, I’d have to say the efforts of people who think of what we do are fairly amateurish and aren’t having a big impact. Going back to Robert Whitaker’s book and your observation in terms of global outcomes associated with rising rates of prescription, I’d go back to that piece of research we did on antidepressant prescribing in Australia. Since 2009, rates of antidepressant prescribing to people aged under 28 have risen by approximately 66%. There’s a per capita rate after you adjust the population.

Over that same period, the rate of suicide for people aged under 25, the per capita rate has risen by 50%. Interestingly, the people who argue that antidepressants, in very simple terms, are a good thing for young people to use often use the argument that without antidepressants, we would have an increase in youth suicide. In fact, the opposite has occurred. As antidepressant prescribing rates have increased, the rates of youth suicide have increased. That’s population data. It would be wonderful to have more case-specific data so you could track individual stories. Hopefully, some of the research that’s happening in Australia is leading in that direction. Nonetheless, it’s entirely consistent with that picture that Robert Whitaker paints of increased prescribing rates and worse outcomes.

If the medications were working according to the thesis that Robert Whitaker puts out there, then we would expect to see a decrease in all kinds of rates, including the percentage of people that go on mental health disabilities. Those rates have skyrocketed as the medication prescriptions have increased.

That’s fundamental in the DSM American Psychiatric Association model that we’ve adopted in Australia, this model of permanent disability. We’ve had some homegrown proponents of what I would argue as a permanent disability model that would use a different language. In fact, sometimes it might be appropriately the language of recovery. What they’re doing is looking for new ways to find emerging mental illness in people. One of the big debates we had with DSM V and one of the small victories for people like us was the removal of psychosis risks disorder from the draft of the DSM. We’ve got a homegrown proponent of that, Professor Patrick McGorry, who was Australian of the Year in 2010. He’s been incredibly influential in setting up a network of government-sponsored clinics in Australia.

It’s not ethical for any clinician to prescribe a medication that they don’t have the skills to help somebody withdraw from.

One of the core functions of those is identifying those perceived to be at risk of becoming psychotic or those who are considered to be pre-psychotic and on a pathway towards schizophrenia. While Professor McGorry would use a different language, I’m critical of his approach because I think it’s an extension of this permanent disability model. We’re looking for new ways to define people as being disabled rather than looking for ways to support people to get well again.

For some people, significant mental illness can be lifelong and completely disabling but most people who are experiencing distress and even psychosis, with appropriate response or support, will recover and lead meaningful and happy lives, or even have intermittent episodes. The model that we have adopted is one of permanent disability. I’m using the words of the others here and I’m paraphrasing them, those that I’m critical of, “We’ve got this massive unmet need where we have these people who are mentally ill that we haven’t recognized yet.” That I think is a real concern and has been particularly influential in Australia through the work of people like Professor Patrick McGorry.

The idea is it’s a wonderful thing to do early identification and intervention, but if the intervention is just meds, you’re in a real rut. The statistics and the research show that if you start giving medications to those people with no other tools or intervention, you are probably going to ensure that they do have a progressive illness over time that gets worse and little hope of full recovery. Whereas if you have an assortment of tools, skills and early intervention, meds are often not needed and/or only needed for a short period of time.

The history of those people who have a depressive episode or even a psychotic episode who are given the support that is non-medication based get through it. They don’t have anywhere near as many relapses or periods of episodes of recurring depression or psychosis. The question is, how in a place like Australia can you make those kinds of skills and tools that are already known? It’s not like we have to reinvent the wheel. There are many good things out there that help people through a mental health episode that has been known for decades.

We need to do two things. We need to do exactly what you’re saying, that is to provide alternatives of work. Even if we can’t achieve that, the first thing we need to do is stop doing things that make things worse. There’s plenty of evidence. Our response to suicide prevention in Australia has, at least superficially, made things worse. The suicide rates of young people have spiked dramatically. In Australia, people like Professor McGorry and others that I could name have been very good at raising awareness on mental illness.

OYM Martin | Mental Health Australia

Mental Health Australia: Critics of the medicalized model have had continuous victories on debates about the issue but none of these has impacted prescribing rates.

 

We need to respond and recognize that people need support for mental health and that’s been picked up by the popular media. The second part of the message has been if you’re unwell, don’t ignore the symptoms. Go and get help. The underlying assumption in that message is that the help helps. As detailed in Robert Whitaker’s book and in my book, the evidence is that in many cases, the help takes people backward and is permanently disabling. It’s great to and we should try to build a system that helps people. In the meantime, we need to have a second priority, which is to avoid the things that make people worse.

We have to quit spraying napalm on the fire. I had the pleasure of interviewing Beatrice Birch who is an art therapist who founded Inner Fire in Vermont. She was an art therapist over in Europe. When she came back to America, she was shocked to find that the people that they were dealing with in Europe have all the same kinds of diagnoses with almost no meds. She came back here and every one of them has meds, and 2, 3 and 4 meds. She was shocked at the system.

She worked in a hospital where the basic protocol was to load people up with meds to try and stomp out the various symptoms, which every medication then has its own effects that are not so pleasant. Sometimes you have to give 2 and 3 meds for the symptoms that are caused by the meds. The crisis that she reached was when so many of the people who connected with her personally would ask her to help them get off the meds, before she could make that happen, a good number of them died of suicide. That motivated her to get out of that system and start her own residential treatment center in Vermont. The essence of the message is exactly what you said. At some level, we have to quit doing what we know only makes things worse.

One of the things I argue in my book is that 90% of antidepressants are prescribed by general practitioners in Australia. They have limited mental health training and absolutely no training. The vast majority of them had to deprescribe. I don’t think it’s ethical or responsible for any clinician to prescribe a medication that they don’t have the skills to help somebody withdraw it from. This is only starting to be an awakening of the dangers and the difficulties of withdrawing from common mental health drugs like antidepressants.

There’s an appetite for it. The other thing that we need to realize is that as you’re tackling an incredibly well-resourced behemoth, the efforts of people like ourselves are amateurish in comparison. The ADHD industry, for instance, the global sales of ADHD medications in 2021 will top $25 billion. That rate is expected to double to $50 billion by 2030. I’ve been involved in the ADHD debate for many years. In terms of intellectual victories and the context about the validity of the diagnosis and the safety of the drugs used to treat it, critics like myself and others have had continuous victories. None of this has impacted prescribing rates. In America, they’re out of control. In places like Australia, Canada, Germany, India and all around the globe, the rates of prescribing are going up.

It’s unfortunate that Australia is just a matter of years from following the US’ lead in antidepressant dependence.

Despite the fact that the evidence-based diagnosis and prescription of drugs for ADHD is getting weaker, the market is getting bigger. That’s an incredibly difficult problem to tackle. There’s no obvious economic base for critics of ADHD prescribing. There’s no way for a clinician who is skeptical about ADHD to become a specialist in it. How do they earn an income? Those that amplify the voices of the industry are very well-supported. It’s a $24-billion US industry now and it’s anticipated to double in the next ten years. One of the victories that I was talking about was the ADHD late birthday effect or the relative age effect.

There’s been a number of studies around the globe, including one that I led in Western Australia, including the US that has shown that children who are the youngest in their classroom are typically much more likely to be put on ADHD medication than the older children in their classroom. In Western Australia, the youngest children in a classroom are born in June. The oldest kids are born in July. In Western Australia, primary school children are age 5 to 10. If you’re born in June, you are twice as likely to be put on an ADHD medication as those born in July. The obvious explanation is that you are younger and less mature.

Your whole neurology is still developing. It’s almost a year behind with some of your classmates.

This happens the whole way around the globe. It happens in North America, Europe, Asia and Australia. I led a systematic review of studies conducted around the globe and it showed the same thing happens. It doesn’t matter whether it’s a high prescribing jurisdiction like the US and Canada, where there are high rates of ADHD prescribing, or even some of the Scandinavian countries where rates are relatively very low in comparison. This relative risk remains.

The argument is that there is a safe level of prescribing ADHD medications if the clinicians get it right. If we reduce the rates of prescribing, we would get it right simply doesn’t hold up even in countries like Finland, where they have relatively low rates in absolute terms of prescribing compared to the US. The relative age effect is still strong. It’s the clearest indication that’s available. There is no safe level of ADHD prescribing where we can be confident that the diagnosticians have got it right. Even when things like that come up, what happens is when we produced our paper for 1 or 2 days, you get a round of media and people go, “This is terrible. This shows that ADHD is a flawed diagnosis.”

OYM Martin | Mental Health Australia

Mental Health Australia: General practitioners feel pressured to prescribe antidepressants to young people after surgery because if anything goes wrong and they haven’t done anything, they might be held professionally responsible.

 

What happens is that you get 1 or 2 days, in some cases maybe even a week of media, and it goes away. The organized message of the ADHD industry, which is that ADHD is a common neurological condition that is determined by genetics that affects 5% to 10% of the population is continuously marketed by this multi-billion-dollar industry. It’s very hard to compete with that. You did the best that you can, but you need to be realistic about what you’re up against. That is a very highly organized and profitable industry. ADHD is one example of the power of big pharma.

I’m not one to tilt that windmill. I like to put something out there that might help an individual who’s looking either for themselves, a family member or a friend for what might be a viable alternative to taking a pill. That’s what the Journey’s Dream project is about and what this show has tried to do in the past years. It simply highlights people who’ve been trained in functional medicine or the holistic, integrative psychology and psychiatry approaches. There are so many good things out there that help a person learn how their body and mind system works together, and learn to regulate the two sides of their system, the parasympathetic and the sympathetic nervous system.

With a little bit of education and a little bit of skill-building, not everyone but many people can move past an episode where they might have run to the doctor for medication without any need for medication whatsoever. That’s where some of our biggest hope is. If we can start to educate the people, then they don’t keep running to the doctor. It’s a big challenge because if you turn on your television here in America and you watch for a day, especially any kind of sporting event, you’re going to see many advertisements for drugs. Many times, you’re going to be told, “Go ahead and ask your doctor for this.”

We don’t allow the advertising of medications directly to the public in Australia. The few times I’ve been to the States, what I have been impressed about is the fact that they list all the side effects. I think, “Why would you take Cymbalta if you knew that it had all of those different side effects,” but nonetheless, it’s an insidious thing having direct advertisement to consumers. In Australia, what happens is we don’t advertise the product but we do advertise the disease. We have this massive push to create disease awareness. The ending message is, “This is an under-recognized condition, go and see your doctor for help.” Sometimes that’s a paid message and sometimes it’s a very well-meaning public message.

Marketing is probably a little more subtle but nonetheless, it can be just as effective. Probably the rates of antidepressant prescribing in Australia are comparable with the US. Other rates like ADHD prescribing are concerning and high but nowhere near as high as the US. I think in Australia and many countries around the world, we’re a matter of years behind. We’re following the US lead, which is unfortunate.

We need to amplify the voice of common sense within the medical community, even with the pharmaceutical industry going against us.

There will come a global tipping point when people do realize the fundamental message in Robert Whitaker’s book that the more we do, in many cases, the worst things have got. The answer isn’t as simple as the label on the pill. There’s an appetite for that message. As someone who’s prominent in the media in Australia, it’s easier to get that message into mainstream papers. Journalists are more receptive to it. In a sense, the worst things get, the more obvious it becomes that there’s a problem. I think there will become a cultural tipping point whereby not only do we stopped doing the things that harm us, but we’ll also be more receptive as a society to the things you’re talking about, the things that can help us. There’s a big fight to be had before that happens.

I’m hoping that the groundswell picks up momentum. People like Dr. Jodie Skillicorn who got her medical degree and was practicing as a psychiatrist. She ran into Robert Whitaker’s book, read it and said, “They didn’t teach me this in medical school. They didn’t show me all of this data on how this is causing more problems than it’s solving.” She then had to re-educate herself and get some Integrative and Functional Medicine Training and find out how she could help people that come to her in ways other than prescribing the meds, which now she knows from the research is a non-answer.

It’s a compounding problem, not a solution. There’s the SameHereGlobal.org website where they’re trying to pull together this realization at a grassroots level that mental health episodes and issues affect far more than 1 in 5 people. There are things to do other than take a pill for it or chase the symptoms. Learn at a systemic level how your mind and body work together, and the tools and skills you can learn to change your life for the better. Eventually, the hope is enough of those doctors and there are lists of psychologists, psychiatrists and other practitioners who have awakened to the fact that what they were taught in their medical school training and their psychologist training was woefully lacking in usefulness in day-to-day experience with patients. The more that happens, the more people find out about it, the more they’re likely to ask their provider, whether it’s a medical doctor, “Is there something I can do instead of a medication?” Hopefully, that’ll start to turn the tide.

It’s been both pleasing and disappointing has been the response of most. I’ve been surprised at how many psychiatrists and pediatricians, particularly in response to ADHD, are very sympathetic to the things we’re saying. I would suggest that most of the psychologists that I encounter in Australia, not in data but in broad terms, would agree with most of what we’re saying. Unfortunately, it’s not the majority that does the majority of the damage. One of the things that I was most proud of that I did when I was in politics was to tighten up prescribing accountability measures for ADHD.

Prior to me coming to politics, Western Australia, Perth, outside of North America, had the highest rates of prescribing in the world. The local ADHD industry was in denial and said, “No, we’re in line with worldwide practices and everything is done responsibly.” When we tightened up prescribing accountability measures and started to reduce annual reports, we found that one particular pediatrician in Perth had prescribed to 2,077 children in a 7 to 8-month period. The vast majority of ADHD prescribing, something like 90%-plus was being done in a city of about two million people. Probably San Diego would be an equivalent city, but the vast majority was done by a handful of prescribers. It was primarily pediatricians.

While many of the other pediatricians would privately agree with me, they abandoned the field. They left the lunatic fringe of prescribers takeover and dominate mainstream practice. I think there is more support in terms of professional support within psychiatry and the medical profession than what we get to hear. Those that are most motivated, the biggest income and frankly the best-resourced become the loudest voices in this area and dominate the debate. There are reasons to be hopeful that there is room for a broader coalition, but the disappointing aspect is how quiet and polite they have been in their criticisms of their peers.

People have mistakenly said to me that the work I do is courageous. It’s not. I was a teacher, then a politician and now a researcher. My livelihood has never depended upon not insulting mainstream medical practice. Whereas many of these doctors say, “I wish I could do practice in another way but the system is headed towards doing this way.” There’s an absurd situation in Australia where some general practitioners feel pressured to prescribe antidepressants to young people that come into their surgeries. If anything goes wrong and they haven’t done anything, the fear is that they’ll be held professionally responsible.

We need to amplify the mainstream voices and more common-sense voices within the medical profession and within psychiatry that are critical of this feel-free real approach. It’s hard to do that when you don’t have that billion-dollar resource base that the pharmaceutical industry has. That’s a challenge, but there is some room for optimism.

I’m glad to have someone like you out there writing about it on another continent. I’m honored that you take and share this time to interview with us. Give us the full title of your book, please.

It’s called Overprescribing Madness: What’s Driving Australia’s Mental Illness Epidemic. If they Google Overprescribing Madness, that would take you to the book.

It comes up right away with you, Martin Whitely, as the author. I appreciate so much your time and all the work you’re doing to try and bring awareness to this critical issue.

Thank you for reaching out and the work that you do.

If you get another book out, we’ll have you back and talk about it.

I write a book once every decade.

Hopefully, by then, we will not have lived into the prophecy that you’ll double the prescribing rates.

I hope so.

Thank you so much for your time. It’s appreciated.

Thank you. It’s my pleasure.

Important Links:

About Dr. Martin Whitely

OYM Martin | Mental Health AustraliaMartin Paul Whitely (born 19 October 1959 in Perth, Australia), is a mental health researcher, author and was a Labor member of the Western Australian Legislative Assembly from February 2001 until he retired from state politics in March 2013. During his parliamentary and research career, Whitely has been a prominent critic of increasing child mental health medication prescribing rates.

Whilst still in politics Whitely wrote Speed Up and Sit Still – The Controversies of ADHD Diagnosis and Treatment (UWA Publishing 2010). Since retiring from politics he completed a PhD (thesis title ADHD Policy, Practice and Regulatory Capture in Australia 1992–2012). Subsequently, he has researched Australian mental health policy and practice and pharmaceutical and medical device regulation. His research has primarily focused on the drivers and outcomes of prescription mental health medication use by children, adolescents and young adults for ADHD and depression.

ADHD Research

Whitely led two research projects examining the effect of relative age within a school classroom on the probability of school children being medicated for ADHD.

The first, Influence of birth month of Western Australian children on the probability of being treated for ADHD, was published in the Medical Journal of Australia in 2017. It found that among West Australian school children aged 6–10 the youngest in class (born in June) were approximately twice as likely to take ADHD medication as their oldest classmates (born the previous July).

Dr. Martin Whitely in 2020

The second, Attention deficit hyperactivity disorder late birthdate effect common in both high and low prescribing international jurisdictions: a systematic review, published in 2019 examined 22 studies in 13 countries covering 15.4 million children. It found that is the global norm for the youngest students within a school year grade to be diagnosed with and medicated for ADHD than their older classmates

Whitely also co-authored a paper published in 2020, Look west for Australian evidence of the relationship between amphetamine‐type stimulant prescribing and meth/amphetamine use. It reviewed Western Australian (WA) evidence of the relationship between prescribing amphetamine-type stimulants for ADHD and the illicit use of amphetamines. It found that the non-medical use of prescription ATS by WA secondary school students is the major component of their illicit amphetamine use. It also reported that since at least 2002 WA adults have been prescribed ATS at a much higher rate than other Australian adults and WA adult illicit amphetamine use rates have consistently been among the highest in Australia.

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