Let children cry
Author: Jon N Jureidini
Published online: 4 May 2015
In reply: Doctors have a duty to relieve suffering, but with qualifications: the target is overall, not immediate, suffering; and the primary injunction is to do no harm.
McGorry and colleagues would presumably agree that interfering with healthy mourning does more harm than good, even if it lessens immediate suffering. Where we disagree is that I have faith in families' own resources to deal with a broader range of distress, while McGorry and colleagues claim there are benefits from pre-emptively attracting distressed individuals into the mental health system. Evidence needs to be provided to support the idea that medical intervention does more good than harm for less than severe impairment. Too often, selective or exaggerated evidence is offered.1
While it is true that the majority of headspace clients at one site received interventions other than psychotropic medication,2 nevertheless, 20% (168/858) of those who fell short of threshold diagnosis were medicated. De-identified headspace data should be made accessible to allow independent research groups to analyse headspace's impact on disability and functioning.
Competing interests
No relevant disclosures.
References
- Amos AJ. A review of spin and bias use in the early intervention in psychosis literature. Prim Care Companion CNS Disord 2014; 16: pii: PCC.13r01586. doi: 10.4088/PCC.13r01586. lefthere
- Cross SP, Hermens DF, Hickie IB. Treatment patterns and short-term outcomes in an early intervention youth mental health service. Early Interv Psychiatry 2014 Sep 27 [Epub ahead of print]. doi: 10.1111/eip.12191. 2