Updated: February 14.

“…he’s being accused of blurring the distinction between science fiction and science, between informed fantasy and hard won proof – being driven by ambition and/or outside forces.” – Dr. Mickey Nardo.

Dr. Mickey Nardo has added further commentary regarding the growing criticism of Professor Ian Hickie. His blog post at 1boringoldman.com here.

My September 2011 post on the accusations of conflict of interest in the Australian mental health reform agenda against Professors Ian Hickie and Patrick McGorry can be found here.

A response to the The Australian article by an Australian mental health consumer can be found here.

A response to Professor Hickie’s recent claims by Ben Mullings of the Alliance for Better Access can be found here.

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Ian Hickie in The Australian

The Australian newspaper has posted an article in which prominent Australian psychiatrist and recently appointed member of the newly-formed National Mental Health Commission, Professor Ian Hickie, accuses vested interests of targeting him in a personal campaign.

“This is part of a more concerted campaign, a reaction against our advocacy for new investment in mental health . . . against basically taking forward the mental health agenda in this country” – Ian Hickie.

It is, in many ways, similar to his ad hominem gripe published in the National Times in September last year where Professor Hickie attacked his critics as “..an odd mix of armchair critics, conspiracy theorists and a former chairman of the American Diagnostic and Statistical Manual taskforce, Dr Allen Frances,..” amongst others, such as the Church of Scientology. Fellow Australian psychiatrist, Dr. Tad Tietze provided an excellent primer on some of the background issues that have seen Professors Ian Hickie & Patrick McGorry become the focus point in a growing international backlash.

‘Campaign’ conspiracy theory

What has been most surprising is that Professors Hickie and McGorry have lashed out at the ‘conspiracy theorists’ who allege they have been acting in the interests of the pharmaceutical and private health insurance foundations who fund them by responding with their own cry of a conspiracy of vested interests composed of “the mental health establishment”, cultists, new world order advocates, etc. Seriously, WTF?! It’s disingenuous for Professor Hickie to suggest that he and Professor McGorry are not atop “the mental health establishment” in Australia given that they receive extensive media coverage of their work , have regular opportunities for comment, are supported in numerous articles written by colleagues that often get published at the same time as their media comments, they are regularly supported by the CEO of the Mental Health Council of Australia and have the full confidence of the Minister, the Hon. Mark Butler who regurgitates Hickie/McGorry PR despite being given much correspondence and evidence that should have him taking a more cautious approach to their lobbying.

Conflict of interest concerns remain

The level of concern grew in scope and size recently with the publication in The Lancet of a paper co-authored by Professor Hickie, six letters of criticism that were subsequently published, and a series of tweets from Richard Horton, the editor of The Lancet.

Richard Horton tweet Sat Feb 11,2012

Editor of The Lancet, Richard Horton.

“This paper seems to break new ground for sponsored writing in medical journals, with conflicts of interest hidden in plain sight while bias continues.” – Bernard J Carroll

Pharma, pills and public policy

It’s not the first time that Professor Hickie has been embroiled in controversy over pill-pushing while having an active role in federal mental health policy delivery, nor is the Lancet article the first time that Jon Jureidini and Melissa Raven have felt the need to speak out against allegedly misleading claims.

In the late 1990s, with pharmaceutical company funding, Professor Hickie developed the SPHERE national mental health training program for GPs.

Screen capture of Lifeblood website
Screen capture of a page on the Lifeblood website before it was removed.

“In 2001 Pfizer Australia joined SPHERE as an implementation partner. This partnership saw the SPHERE project offered to all Australian GPs. Through the implementation of the SPHERE training modules, the Pfizer sales team gained regular, unprecedented access to these key GPs, who had significant interest in mental health. This activity assisted in restoring the market share and growth of the Pfizer antidepressant Zoloft®, restoring it to the Number One product in this market.” – SPHERE website 2007.

Says The Australian newspaper: The Lifeblood claim was made on behalf of SPHERE, a mental health program undertaken by 12,000 GPs since 1998. Pfizer has been a commercial partner of the program since 2001. The Brain and Mind Research Institute headed by Ian Hickie helped establish SPHERE and has an ongoing commercial relationship with the program.

In a National Times piece published last year, Sydney Morning Herald columnist and psychiatry registrar Dr. Tanveer Ahmed provided this critique of Professors Ian Hickie & Patrick McGorry:

“It was launched by Professor Ian Hickie, who has been rightly recognised for giving mental health a greater profile, but who has also played politics to do so.

Hickie has done more than any other clinician to promote tick-a-box diagnosis, particularly among general practitioners, who now regularly prescribe antidepressants through questionnaires alone. With former Australian of the Year Professor Patrick McGorry, Hickie has made overblown claims about the prevalence of mental health.

It is disingenuous to suggest, as McGorry has done, that there is no conflict of interest because their organisations are non-profit. Their bodies shared in $2.2 billion of funding in the federal budget. Their exorbitant claims – such as one in four people will suffer mental illness – are indicative of a blurring of the lines between illness and normal, human responses to adversity.”

Further, advocates within the ADD/ADHD community have raised concerns about Prof. Hickie’s numerous public statements that endorse stimulant use for the treatment of Attention Deficit Disorder but which minimise the benefit of non-pharmacological interventions; while many remain concerned that the man who oversees the guidelines for treatment for Chronic Fatigue Syndrome in Australia has stated that ME/CFS is a somatoform disorder to be medicated with antidepressants and who downplays the biomedical factors that have also shown some merit in defining CFS.

As I have previously stated, “Some critics may suggest a conspiracy in the close connections between these key advisers to government, the EPPIC/Headspace teams, and the redistribution of federal mental health funding to these & similar organisations. Such claims should not nullify the concerns of fellow psychiatrists, mental health workers, consumers and carers that have repeatedly surfaced surrounding allegations of conflicts of interest, failures to disclose an interest, etc.”

 Ian Hickie needs to put up and directly answer his critics

It is time for Professor Hickie (and McGorry for that matter) to answer his critics’ concerns given the level of interest in his conduct that has arisen internationally amongst academics and mental health professionals, as well as grassroots concern from consumers & their carers.

“Because he [Hickie] has enormous influence on Australian mental health policy (including being a member of the new National Mental Health Commission), and because he uses his academic publications (and media pronouncements) as lobbying tools, it has significant implications that go far beyond potential financial conflict of interest” – Melissa Raven.

Up until now, Professors Hickie and McGorry have characterised their critics as armchair critics, malcontents and Scientology cultists. The truth is that the majority of their critics are fellow psychiatrists, psychologists, allied mental health professionals, mental health consumer and carer advocates, and members of the general public who critical observe the  influence of private interests in public health policy.

Ian Hickie should shut up and let consumers speak

Furthermore, it’s time for mental health consumers and their carers to set the direction for mental health care rather than being called in to the process once the general direction of government has been set. Why should the lobbyists of  our for-profit non-government mental health organisations get to wine and dine our politicians and bureaucrats, when consumers and carers do not have that opportunity unless it is mediated by a gatekeeper national consumer body that is not completely independent?
Numerous policy papers have been written and published by our federal and state governments seeking greater consumer and carer participation in mental health policy and service delivery yet the reality is that the majority of mental health consumers and carers are not given the opportunity to be part of the team.
So my advice to Ian Hickie and a few of the other power-brokers in Australian mental health:  Shut up. Let’s hear from consumers and carers across Australia and not just the Expert Working Group. If they happen to think you’re a jerk and share that on social media you’ll just have to deal with it. Seems it’s a popular opinion at the moment.

Ian Hickie should resign from the National Mental Health Commission

While the storm clouds of allegations of Conflict of Interest continue to surround  ‘Bupa’s Professor‘ I call on him to resign his appointment with the National Mental Health Commission while debate surrounding the Valdoxan (agomelatine) paper threatens to become a scandal.
The Australian mental health sector and the general public who have show wonderful support for reform within mental health need time to answer the question posed by Western Australian Labor MP, Martin Whitely – Professor Ian Hickie – Visionary Mental Health Reformer or Paid Pharmaceutical Industry Opinion Leader?
Disclosure: I am a mental health consumer and carer campaigning with the Alliance for Better Access for the full re-instatement of MBS-funded psychological sessions previously provided under the ‘Better Access to Mental Health’ initiative.

Further reading:

Professor Ian Hickie – Visionary Mental Health Reformer or Paid Pharmaceutical Industry Opinion Leader? – Martin Whitely MP, Speed Up & Sit Still, February 12, 2012.
Long overdue – Dr. Mickey Nardo, 1 Boring Old Man, January 26, 2012.
A Servier Drug And A ‘Flawed’ Paper In The Lancet – Ed Silverman, Pharmalot.com, January 24, 2012.
Prescient remarks about mental health funding – John Alchin, JohnAlchin.info, October 24, 2011.
Hickie criticised over drug claims -David Brill, Australian Doctor, January 20, 2012.
The psychological backlash against Hickie and McGorry – Melissa Sweet, Crikey, Novemeber 30, 2011.
Cutting Better Access hurts us all – Mike Stuchbery, Mike-Stuchbery.com, October 11, 2011.
The McGorry-Hickie reform controversy: Why has mental health become so political? – Tad Tietze, Left Flank, September 24, 2011.
Prescient remarks about mental health funding – John Alchin, JohnAlchin.info, September 24, 2011.
Ian Hickie rejects Better Access in mental health reform debate – John Alchin, JohnAlchin.info, September 23, 2011.
Novel melatonin-based therapies: potential advances in the treatment of major depression – Ian B Hickie, Naomi L Rogers Lancet 2011; 378: 621–31