Volume 196 - Issue 10
Targeted primary care-based mental health services for young Australians
Authors: Ian B Hickie, Daniel F Hermens and Elizabeth M Scott
Med J Aust 2012; 196 (10): 627. || doi: 10.5694/mja12.10634
Published online: 4 June 2012
Published online: 4 June 2012
In reply: The detailed demographic, diagnostic and disability data we presented1 responds directly to the critics of headspace clinics. Following the initial establishment phase,1 our two centres now provide services to
390 and 411 young people per month, respectively (data from July to September 2011). Each of the 30 established headspace services now assesses an average of 265 clients ...
In reply: The detailed demographic, diagnostic and disability data we presented1 responds directly to the critics of headspace clinics. Following the initial establishment phase,1 our two centres now provide services to 390 and 411 young people per month, respectively (data from July to September 2011). Each of the 30 established headspace services now assesses an average of 265 clients per month and, collectively, they have assisted 64 167 young people from mid 2007 to the end of 2011 (data from headspace national office). Although some people do not recognise the extent to which headspace services connect with more young people, the more dispassionate reader is invited to make their own judgement.
The academic support that the Brain and Mind Research Institute provides to our headspace services is critical. We have a long track record of population health and health services innovation, and ongoing and systematic evaluation.2-5 By contrast, Raven’s characterisation of this work as “lobbying”, “misrepresentation”, “inappropriate medicalisation” and being informed by “undeclared competing interests” has no basis in fact. Our conclusions are based directly on the data presented. The references provided are relevant. With regard to the terminology describing “vocational impairment”, we simply reported the vocational disruption experienced by the young people.
We did not dismiss a key finding of the 1997 National Survey of Mental Health and Wellbeing — in fact, we did not reference it. We suggested that our findings challenge “existing beliefs about the extent to which young people with mental health problems do not perceive a need for care”,1 citing the relevant 2007 National Survey of Mental Health and Wellbeing reference. We did not omit any relevant links, financial or otherwise, with any entity that could be perceived to represent a conflict of interest with this report.
Against the view of some historical, professional and cultural interests, we have been at the forefront of the establishment of psychological care in primary care settings.2-5 Our data underpinned the original decision (in 2001, not 2006) to provide Australians with increased financial support for use of psychological services.5 This is not, and never was, an act of inappropriate medicalisation.
As recognised by the Australian Government (who are now supporting headspace to expand to 90 centres nationally), these clinics provide young people and their families with access to sophisticated assessment and appropriate psychological care.
Competing interests
We declare that all competing interests relevant to this letter and the original article were disclosed in association with the original article. Funding for the headspace project comes from the Australian Government. The support that the Brain and Mind Research Institute provides for evaluation of these services is supported by a National Health and Medical Research Council Australian Fellowship to Ian Hickie.
Consistent with advice from the Editor of the Journal, we also make the following declarations. Ian Hickie is a member of the Medical Advisory Panel for BUPA Health Insurance (Australia) and also a board member of the Psychosis Australia Trust. From 2012, he is a Commissioner on Australia’s new National Mental Health Commission. Until January 2012, he was a director of headspace: National Youth Mental Health Foundation. Ian Hickie was previously Chief Executive Officer (until 2003) and Clinical Adviser (until 2006) of beyondblue: the national depression initiative. He is supported principally for clinical research in depression and health services and population health initiatives in anxiety and depression by a National Health and Medical Research Council (NHMRC) Australia Fellowship (2007–2012). He has led projects supported by governmental, community agency and pharmaceutical industry partners (Wyeth, Eli Lilly, Servier, Pfizer, AstraZeneca) for the identification and management of depression and anxiety. He has received honoraria for presentations of his own work at educational seminars supported by a number of non-government organisations and the pharmaceutical industry (including Pfizer, Servier and AstraZeneca). He has served on advisory boards convened by the pharmaceutical industry for specific antidepressants. He leads a new investigator-initiated study of the effects of agomelatine on circadian parameters (supported in part by Servier but also by other NHMRC funding), and has participated in a multicentre clinical trial of agomelatine effects on sleep architecture in depression and in a Servier-supported study of major depression and sleep disturbance in primary care settings. As well as receiving support from national and international government-based grant bodies, he has been supported by various pharmaceutical manufacturers (including Servier and Pfizer) and not-for-profit entities (including the Heart Foundation, beyondblue and the BUPA Foundation). Daniel Hermens is currently supported by a grant from the NSW Health Mental Health and Drug and Alcohol Office, as well as by an NHMRC Australia Fellowship (awarded to Ian Hickie). In 2007, he received honoraria for educational seminars from Janssen-Cilag. Elizabeth Scott is the (unpaid) Clinical Director of headspace services at the BMRI, the (unpaid) Coordinator of the Youth Mental Health Research Program at the BMRI, and Deputy Director of the Young Adult Mental Health Unit at St Vincent’s Private Hospital. She has received honoraria for educational seminars related to the clinical management of depressive disorders supported by Servier and Eli Lilly. She has participated in a national advisory board for desvenlafaxine, manufactured by Pfizer.
References
- Scott EM, Hermens DF, Glozier N, et al. Targeted primary care-based mental health services for young Australians. Med J Aust 2012; 196: 136-140. 0_CACGIDEJ
- Hickie IB. “Not in your lifetime, Ian!” Med J Aust 2009; 191: 638-642. 0_i1142882
- Pirkis J, Hickie I, Young L, et al. An evaluation of beyondblue: Australia’s national depression initiative. Int J Mental Health Promotion 2005; 7: 35-53. 0_pgfId-1152491
- Hickie IB, Pirkis JE, Blashki GA, et al. General practitioners’ response to depression and anxiety in the Australian community: a preliminary analysis. Med J Aust 2004; 181 (7 Suppl): S15-S20. 0_pgfId-1152501
- Hickie IB, Davenport TA, Naismith SL, et al. Treatment of common mental disorders in Australian general practice. Med J Aust 2001; 175 (2 Suppl): S25-S30. 0_i1142888