Patrick McGorry

Professor Patrick McGorry AO
McGorry in 2010
Born	Patrick Dennistoun McGorry[1] (1952-09-10) 10 September 1952 Dublin, Ireland
Residence	Melbourne, Australia
Nationality	Australian
Education	Bishop Gore School Newcastle Boys' High School
Alma mater	University of Sydney Monash University University of Melbourne
Occupation	Psychiatrist
Organization	Executive Director, Orygen, The National Centre of Excellence in Youth Mental Health
Known for	Development of the early intervention services for youth psychosis
Title	Australian of the Year
Term	2010
Predecessor	Mick Dodson
Successor	Simon McKeon
Spouse(s)	Merilyn Hawke (m. 1980)
Children	Three
Awards	Order of Australia
Website	www.patmcgorry.com.au

Patrick Dennistoun McGorry AO FAA FASSA FRCP FRANZCP born 10 September 1952) is an Irish-born Australian psychiatrist known for his development of the early intervention services for youth experiencing symptoms of psychosis.

Position

McGorry is Professor of Youth Mental Health at the University of Melbourne.^[2] He has written numerous peer reviewed articles, published in journals including The Lancet, the British Journal of Psychiatry, the American Journal of Psychiatry and the Medical Journal of Australia. He is executive director of Orygen, The National Centre of Excellence in Youth Mental Health^[3] and founding editor of Early Intervention in Psychiatry published by the International Early Psychosis Association. McGorry also advocated strongly for the establishment of the Australian government funded National Youth Mental Health Foundation, which became headspace, and is a founding board member of that organisation.^[4]

Early intervention in psychosis

McGorry and his colleagues developed an approach for young people who have symptoms of psychosis for the first time, based at the EPPIC clinic in Melbourne.^[5] This EPPIC clinic has played a key part in an early psychosis treatment paradigm for psychiatry^[6][7][8] and has led to significant reform of mental health services,^[9] especially in the United Kingdom.^[10] The EPPIC clinic is best represented by the catch phrase "A stitch in time"^[11] and its development of a service for those at risk of developing psychosis.^[12]

Initial evaluations of EPPIC showed that it was not only effective compared to the previous traditional model of care but that it was also cost effective.^{[13][14][15][16]} Professor McGorry was awarded the Centenary Medal in 2003 in recognition of his work on the EPPIC programme.^[17]

McGorry has advocated for early intervention with young people who are at risk of psychosis, but who are not currently psychotic, including the use of antipsychotic medication.^[18]

McGorry has advocated to the Australian government to create a national network of early psychosis intervention centres, based on claims that early treatment may improve long-term outcomes.^[19] During the 2013 Australian Federal election, McGorry appeared in the media together with then Opposition Leader Tony Abbott at the launch of the Liberal-National Coalition's mental health policy. Abbott promised that, if elected, he would provide additional financial support for programs associated with Patrick McGorry.^[20] After being elected to government, the Coalition announced in its first budget the allocation of $18M to Orygen Youth Health Research Centre for establishment of a National Centre of Excellence in Youth Mental Health and $14.9M to headspace for the expansion of its youth mental health services.^[21]

Criticisms

McGorry has faced a number of criticisms of his work.

Some critics have argued that he has exaggerated the evidence for early intervention and that long-term benefits and economic savings have not been established,^{[22][23][24][25][26][27][28]} and one has gone as far as alleging that McGorry has "systematically misled" the Australian government about the nature and implications of his evaluation study on EPPIC by misstating the description of the control group.^[29]

In the past two decades evaluations in England and Denmark have shown that early intervention is effective over the first two years of care at least, but when patients return to traditional care some of the gains are lost.^[30][31] Canadian data indicates that if patients remain in early intervention services for five years the gains are sustained.^[32] While more rigorous evaluations of early intervention services have been carried out in other countries, a systematic review of these studies concluded: "There is some support for specialised early intervention services, but further trials would be desirable, and there is a question of whether gains are maintained."^[33] His views on giving antipsychotic medication to at-risk young people have been criticised by a number of people, including Allen Frances the Chair of the DSM-IV Taskforce, on the basis that most at-risk young people will not become psychotic and pre-emptive treatment may be risky.^[34][35][36] McGorry and his colleagues have responded to this criticism, arguing that critics have blurred the key distinction between clinical recommendations and ethically approved research designed to build evidence to more firmly guide clinical practice.^[37][38][39] A trial of the antipsychotic medication quetiapine, led by McGorry, attracted criticism on ethical grounds and was discontinued.^[40][41]

He has been accused of having a conflict of interest in using his position on a government advisory committee to advocate for programs that he founded.^[42] McGorry has denied that he has any conflict of interest and a spokesperson for the Australian government stated that Professor McGorry was just one member of the Mental Health Expert Working Group, which was made up of experts from a range of health and non-health sectors, plus consumer and carer representatives and 'while these consultations helped to inform the development of the government’s record mental health package, decisions on the specific content...were solely a matter for the government'.^[43] On 25 September 2012, Western Australian member of parliament Martin Whitely made a speech in parliament criticising the Australian Federal Government for its support of McGorry's proposals. Whitely said that McGorry had made overblown claims for his programs and that they had been accepted without proper scrutiny.^[44]

Recognition

In January 2010 he was named Australian of the Year for his services to youth mental health.^[45][46][47] In June 2010 he was appointed an Officer of the Order of Australia.^[48] In 2013 Professor McGorry was honoured with the National Alliance on Mental Illness Scientific Research Award, the first time the award has been bestowed upon a researcher outside of the United States.^[49] In 2015, McGorry was awarded the Lieber Prize for Outstanding Achievement in Schizophrenia Research, given by the Brain & Behavior Research Foundation.^[50]

Patrick is also an ambassador for the Beehive Foundation, an Australian charity that provides resilience programs for young people.

References