Foxes Guarding the Henhouse: the Role of the Chief Psychiatrist

John Read
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Part II in a series of installments investigating the plight of a man subjected to over 50 shock treatments against his will (and the efforts to put a stop to it). For Part I, see The Curious Case of Over 50 Consecutive ECTs in Melbourne. For more information about this case, watch the nine-minute news segment.

When GD’s father asked me to get involved in this case, my first step was to approach the state of Victoria’s Department of Health and Human Services. I was consistently directed to the Office of the Chief Psychiatrist as the only person who could respond to my concerns. Nobody else seemed permitted to engage at all. However, one senior DHHS official took my concerns seriously enough to approach the Chief Psychiatrist personally and ask him to meet with me.

Now, my faith in the ability of psychiatrists to investigate and control their own is not very high in general, and is especially low in relation to ECT (albeit based on an n of 2 study).

As a very junior Clinical Psychologist in Derbyshire, England, in the 1980s, a patient whose notes read “heart condition – ECT contraindicated” had been given ECT anyway. He died within an hour. My trying to discuss this at our team meeting the next day resulted in my being physically removed from the room. The page with the file note about the man’s heart condition was removed from his file. For over a year I tried to find an authority that would investigate. I failed.

More recently, during my time in New Zealand, I again had cause (a far less serious cause) to lodge a complaint against a psychiatrist. In an attempt to counter a service user-led public campaign to ban ECT, this psychiatrist had written in the NZ Herald the usual claims about memory loss being the depression not the electric shocks, but she’d added that she was currently running a very large ECT trial and that 80% of people were getting better. I wrote to her enquiring whether she was using a placebo group (a very basic requirement of efficacy research) and asking to see her data (an accepted process once a researcher has gone public with their findings). She was “professionally and personally insulted” by my letter, and refused to correct what I believed to be misleading public statements.

I wrote to the Royal Australian and New Zealand College of Psychiatrists informing them of my concerns, stressing that they were relatively minor but asking for their code of ethics and their complaints procedure. There followed more than a year of ignored emails and phone calls repeatedly asking to see their code and procedure and asking how, or whether, they were addressing my concerns. Eventually I received an embarrassed phone call from their CEO (on his last day with the organisation) apologising profusely, and explaining that the College could not send me their code of ethics or their complaints procedure because neither existed.

I did eventually get a letter saying that the NZ branch had looked into my concern (without asking me to attend a hearing, or even telling me about a hearing – if indeed one ever took place) and determined that there was no case to answer. I gave up. (The study in question was never published.)

Anyway… two of the four goals stated on the first page of the website of the Office of the Chief Psychiatrist in Victoria are:

  • promotes the rights of people receiving mental health treatment in public mental health services
  • is responsible for monitoring restrictive practices, electroconvulsive therapy and reportable deaths.

The Chief Psychiatrist is currently Dr Neil Coventry, head of Child and Adolescent Mental Health Services at the private healthcare company Austin Health, whose website states:

“We believe in consumer-centred care delivered with respect and integrity” and “We facilitate supported decision making with our consumers and acknowledge and respect a person’s capacity to make informed decisions.”

The email I received, however, came from the Deputy Chief Psychiatrist, Aged Persons, who is Emeritus Professor O’Connor, Head of the Aged Mental Health Research Unit based at Monash University. The Professor is an advocate of ECT, especially for older people. His University website page states: Major topics of interest at present concern ECT as a treatment of severe late-life depression and cites: O’Connor, D.W., 2008, Electroconvulsive therapy, in Oxford Textbook of Old Age Psychiatry, eds R Jacoby et al. Oxford University Press, UK, pp. 201-214.

Dr O’Connor wrote (28, January, 2016):

Dear Dr Read,

I understand that you have sought to meet with this office concerning the use of electroconvulsive treatment (ECT) in the case of a mental health client. You will understand that we are not at liberty to discuss individual people.

ECT is endorsed by the Office of the Chief Psychiatrist as an effective, evidence-based treatment modality. We have recently updated our clinical guidelines which can be found on our website. We take the application of ECT very seriously indeed.

With kind regards,

Daniel O’Connor
Deputy Chief Psychiatrist, Aged Persons (Mon, Tue, Thu)
Department of Health and Human Services | 50 Lonsdale Street, Melbourne, Victoria, 3000
T: 61+3 9096 7571| F: 61+3 9096 7697 I E: Daniel.O’[email protected]

I read the ‘recently updated’ (December, 2015) guidelines carefully.

It is one of the most pro-ECT sets of guidelines I have seen in my 40 years of involvement with these issues. It claims, for example (with no research in support), that ECT should be used “as a treatment of choice” “rather than as a treatment of last resort” as is the case almost everywhere else in the world; and even that “ECT is sometimes the safest treatment of serious mental disorder during pregnancy” (again with no research to support this particularly idiosyncratic opinion).

I replied (29, January, 2016):

Dear Dr O’Connor

Thank you for your swift response.

I think there may have been a misunderstanding.

I do not wish to discuss an individual patient.

I wish to discuss the conduct of the psychiatrists at Upton House, Dr Katz in particular, who have been responsible for the administering of over 50 ECTs consecutively to a patient, and have reportedly repeatedly restrained this patient to a bed, on one occasion for approximately 60 consecutive days.

I request that you intervene to stop this unprecedented and potentially very damaging excessive use of ECT.

I wish to lodge a formal complaint against this unprecedented excessive use of ECT, which has absolutely no research evidence base to support it, and request an independent investigation. Are you authorised to receive such a complaint and investigate it?

I assume so, since your website states that one of the four primary purposes of your Office is to ‘promote the rights of persons receiving mental health treatment from public mental health services’.

If not, please advise me as to who in the DHSS is the appropriate body to complain to. Thanks.

Thanks for referring me to your guidelines on ECT (which I note have been updated just last month, since the case in question came to public attention). I find it a rather problematic and biased document in that it barely mentions the cognitive impairments so often caused by ECT. It is of grave concern that an Office representing the State of Victoria should issue guidelines without citing a single research study in support of any of the statements in the document. Some of the claims are contentious in the extreme. For example In keeping with international guidelines, the document accurately defines a ‘Course of ECT’ as ‘A single course of ECT limited to a maximum of 12 treatments performed over a period that cannot exceed six months (p 8), but then goes on to contradict this by claiming that ‘One course may immediately follow another’ (p. 13). This is not at all consistent with international guidelines, and there is no research to support this somewhat bizarre suggestion. A suspicious person might wonder whether the timing and some of the content of these updated guidelines are an attempt to justify the conduct of the Upton House psychiatrists.

You state, in your email and in your guidelines, that ECT is an effective, evidence-based treatment. Please send me references to any study that shows that ECT has better outcomes than simulated ECT beyond the end of the treatment period. I attach my peer-reviewed review showing that there never has been such a study.

And, if you find the administration of over 50 consecutive ECTS by Dr Katz and his colleagues acceptable, please send me the research showing that anyone who has not improved after 10, 20 or 30 is likely to improve with further treatment.

Finally are you aware of the research (attached) showing that the number of ECTs is the best predictor of long term cognitive impairment in the form of anterograde amnesia? The earlier somebody intervenes to put a stop to Dr Katz and his colleagues in this case, the smaller the chance of permanent brain damage.

I hope that you will take this issue seriously as it is has the potential to seriously undermine the confidence of the public in our public mental health services and the profession of psychiatry in particular.

I look forward to hearing from you and arranging a time for me to meet the Chief Psychiatrist now that the misunderstanding has been cleared up.

Professor John Read

At the time of writing this, four weeks later, I have had no reply whatsoever to this formal complaint and direct appeal for immediate action. Not even an acknowledgement.

What chance would a service user, or family member, or a whistle-blowing nurse, have of getting a genuine response from this Office, I wonder?

Yet this is the Office to which the Department of Health and Human Services refers all mental health concerns, and which the Minister of Mental Health has charged with investigating Drs Katz, Segal and Mackay at Upton House and their Managers at Eastern Heath.

The next installment will cover the actions of the Mental Health Tribunal.

17 COMMENTS

  1. Thanks for this update of your attempts to get sense out of the person/office responsible for psychiatry in Victoria.

    Q: “What chance would a service user, or family member, or a whistle-blowing nurse, have of getting a genuine response from this Office, I wonder?”

    A: none whatsoever.

    Q: what evidence base is needed to inflict dangerous and/or unwanted “treatments” on patients with or without their consent?
    A: None whatsoever. Claiming that a patient is “dangerous” is sufficient justification to restrain, drug, and torture them in whatever manner a psychiatrist may dream up. Fundamentally, if you see a psychiatrist, you are fair game for this treatment.

    And this is how Australian psychiatrists expect it to be. I was actually told by a member of the ACT’s Human Rights Commission (which is charged with ensuring patient rights in the Australian Capital Territory) that a certain section of one law designed to protect patients had been drafted as it had been because psychiatrists wanted it that way. It guarantees psychiatrists’ rights, not patients’ rights and contradicts human rights legislation, and Australia’s compliance with international human rights treaties….but psychiatrists rein supreme and patients have fewer rights than convicted criminals. The ACT is VERY proud of its human rights compliant prison, though…shame is that “mental health” patients don’t get the same consideration.

    Looks like it’s the same down your way.

    PS I was glad to read that the patient whose case has been at the centre of this issues has received a temporary reprieve from ECT, but it looks like they’re really trying to mess him up with drug cocktails now so they can claim he REALLY does need ECT.

    My golly…if you are a reader who is contemplating seeing a psychiatrist in Oz or is already seeing one and is still able to do so….run away!!!!!!!!!

  2. We basically have the same thing going on in the US. It’s horrendous, the doctors are given free reign to murder anyone they want, for any reason, especially to cover up iatrogenesis and child abuse, it seems. And the government bodies responsible for protecting patients and abused children do nothing. One of my doctors was even eventually arrested for having lots of well insured patients medically unnecessarily shipped long distances to himself, “snowing” patients, then performing unneeded tracheotomies on patients for profit. And the judge let him off scot free, no prosecution, no explanation for why the charges were dropped. I would imagine he’s likely back to killing patients for profit again. It’s all sick, and wrong.

  3. Hi John,

    This is an admirable series of letters you wrote. The main function of these letters however, as you expected will not be to produce any meaningful response from the corrupt psychiatrists involved… rather, it will be to expose this horror show to the public and build pressure from on the hospital and psychiatrists to stop these abuses.

    The psychiatrist and hospital managers running such a treatment clinic can be likened to a legalized cartel, or an officially-sanctioned Mafia organization, in several ways. They rake in massive profits by selling fraudulent, harmful products (ECT, antipsychotic drugs), products lacking evidence of efficacy but having great evidence of long-term harm. They publicly disguise, deny, avoid, and rationalize the harms of these products by calling them “standard” and “therapeutic”, operating mostly “behind a veil”, out of the public eye. They persist in denying the harms because it is so profitable, because existing privacy and drug trial laws allow them to hide and distort the data, and because much easier than engaging with the social problems causing the suffering of the people they “treat”.

    Psychiatrists’ methods are quite similar to how criminal drug dealers deny the harms of their products and operate in even greater secrecy, being willing to do almost anything to preserve their business. The book McMafia by Misha Glenny profiled several leaders of large scale criminal cartels in different countries, and their “veil of secrecy” and avoidance and denial of the harms of their drugs, guns, slaves, and other illicit products is often similar to the way these psychiatrists operate. To give the “real” criminals credit, a few of the “real” drug lords were surprisingly honest about the harms of their product, something that is even rarer among psychiatrists, who must present more of a front to the public.

    When interacting with psychiatrists selling these products, it should be remembered that their ability to make $200-300,000 Australian dollars a year is tied directly to maintaining the myth that the disease model they perform treatment under is valid, and that their treatments including ECT and drugs are effective and “standard”. If they admitted or even considered seriously the fraudulence of what they are doing, it would become clear both to them and the public that they should be shut down and/or paid much less. This would result in great loss of income and prestige. Therefore, they must deny the facts about ECT, drugs, and the medical model, because to admit the harms would be professional suicide.

    The only type of message – like true gangsters – that these people understand is force. The primary weapons against them should be:

    1) Continued and increased exposure in the media of these harms.

    2) Lawsuits leading to massive fines and potential prison time for treating psychiatrists and hospitals. In this regard, it would be very helpful if more lawyers could begin to take cases against psychiatric hospitals and psychiatrists. They would need to be educated on how to make the case to judges/juries against psychiatric diagnoses and treatments. If successful in some cases, this could be a powerful weapon against psychiatrists and hospitals. The threat of millions of dollars in fines, and even more so, being thrown out of the profession of psychiatry and/or being imprisoned with other common criminals, would finally strike fear into psychiatrists. Without these threats, there is no reason for these legalized criminals (psychiatrists) to abandon what is a very profitable scam.

  4. To call Australia from the U.S., just follow these simple dialing directions:

    First dial 011, the U.S. exit code.
    Next dial 61, the country code for Australia.
    Then dial the area code (1 digit).
    Finally the phone number (8 digits).

    Tell them what you think of the treatment of Garth. If they don’t like your phone calls they can call John Kerry at the state dept and see how far they get. LOL

    United States Department of State/Customer service
    1 (202) 647-6575

    Hi John Kerry, this is Australia and some people from your country are disrupting our psychiatric torture center, I mean hospital. They are saying mean things, Please help.

  5. Our current Chief Psychiatrist came from the Royal College where he was credited with doing an excellent job of promoting the interests of psychiatry and psychiatrists.

    His role is now to protect the rights of consumers, carers and the community, and provide expert legal advice to the Minister. There is a protection of a standard of “reasonable grounds” in our Act which requires factual evidence before the provisions can be invoked. This states that the ” mental health practitioner who suspects on reasonable grounds that a person should be made an involuntary patient may refer the person for examination by a psychiatrist.” When my lawyers wrote to the OCP and questioned my detention on grounds which had been fabricated the Chief Psychiatrist responded with “the AMHP need only ‘suspect’ on grounds they believe to be reasonable that a person requires examination by a psychiatrist”

    Not only is the Chief Psychiatrist misrepresenting the law here, but has effectively removed any protection provided by our Act, and changed the consequences from incarceration to a cozy little chat with a doc..

    After a number of letters to the OCP trying to have the law clarified (not difficult as he should have a copy) I sent a letter to our Minister pointing this removal of protections. I was informed that the new Act included added protection. My response? What good are added protections when the person who is responsible for ensuring their enactment doesn’t even know what they are? At this point the Minister was unable to discuss our Mental Health Act (never mind individual cases)

    I think the Chief Psychiatrist has not left his past role behind him, and has found a method of continuing to promote the interests of psychiatry and psychiatrists, rather than perform the role and duty he is charged with. Those rights and protections were paid for in blood, and what disrespect he shows our community with the delusional belief that he can remove them with a stroke of a pen.

    Our laws are meaningless if they can be passed through parliament and then rewritten to suit the purposes of one group of stakeholders.

    Good luck John and thank you for assisting.

    • It is worth keeping in mind that if the statutory authority “suspects on reasonable grounds” that a criminal offense has occured that their is a duty to report the matter to the Corruption and Crime Commission. Failure to do so?

      173. Public officer refusing to perform duty

      Any person who, being employed in the Public Service, or as an officer of any court or tribunal, perversely and without lawful excuse omits or refuses to do any act which it is his duty to do by virtue of his employment, is guilty of a crime, and is liable to imprisonment for 2 years.

      Though the problem arises here when the Chief Psychiatrist does not recognise a burden of proof and would therefore could claim that he did not suspect on grounds he considered to be reasonable, and even with documented proof of offenses would never need to report to the watchdog authority. And this any problems within the system would never be investigated or prosecuted.

      Not only are the foxes guarding the henhouse, but the watchdog has been defanged, overfed and drugged into a stupor.

  6. ECT WORKS! If you damn escape the torture, god damn it, you run, and never ever look back, you certainly cant complain about it, they just give you more. Yes torture is used in Psychiatry.
    By doctors who think they are GOD himself. What do they call it when you are so blinded by your own ideas of greatness, you never, ever question yourself? Well thats a psychiatrist.

  7. Despite the best efforts of many, obviously nothing has changed with regards to the way the authorities respond to and manage complaints about members of the psychiatric profession here in Victoria in decades.

    This may have something to do with the fact that so many of those who were the ‘leaders in the profession’ 30 years ago still hold prominent and leading positions in the so-called “mental health” industry in this country now. The dominant paradigm of care here is very much a bio-medical one, with ECT obviously also supported, despite the utter lack of evidence for it’s efficacy and much evidence ti causes harm.

    The only training course in adult psychotherapy accredited by the College of Psychiatrists for advanced training in this city was ended a year ago due to not enough interest from qualified practitioners/teachers to take over from the older generation who could no longer sustain the task of maintaining the course. What hope for the profession to change and evolve when there simply is no-one either interested or qualified to teach the younger generation of students and professionals any approach other than the purely bio-medical?

  8. “What chance would a service user, or family member, or a whistle-blowing nurse, have of getting a genuine response from this Office, I wonder?”

    You ask the magic question. How on earth, indeed? There is no listening or dialogue, it is merely one power struggle after another. Begins with responding to what is not asked and avoiding the issue presented, then you get ignored altogether; or if you get a response, it may be something like “I don’t have time for this,” or perhaps it is with attitude, mind games, and putting you on the defensive–again, to avoid addressing the actual issue at hand. I’ve found these to be quite common in the mental health world.

    This is how psychiatry, the system, and its tangents are, literally, insane-making. ADA law actually protects people on disability–reasonable accommodation for reasonable request. But apparently, having a direct, clear, and neutral dialogue is not considered to be ‘reasonable.’ Having grievance responded to in a fair and just matter in the mental health world is something I have yet to run across.

    Best of luck on your quest for reform. I hope your grievance can make a difference.

  9. Restraining a person in a bed for any length of time is likely to drive them insane anyway. This is uncalled for and totally inhumane treatment.

    I haven’t experienced anything remotely as distressing as this in my 30 years in the UK . What I have experienced is black and white denial of genuine professional wrongdoing, by one regulator after another – but in my case I am in a position to talk out and challenge (as I do).

  10. “My trying to discuss this at our team meeting the next day resulted in my being physically removed from the room.”

    No whistlebloweres charter in psychiatry eh?

    I had a similar experiece, and I was a freind who acted as an advocate.

    I heard of a man who protected his wife from psychiatry being treated in a similar way.

  11. Hi John–another John here- thanks for your post– I can identify with exactly the same responses youve recieved– ive been writing for fourteen years– to everyone and anyone connected to psychiatry and mental health– heres just a few at a particular time during that fourteen years-
    Mary Woodbridge
    Robert Clark
    David Davis
    Nicola Roxon
    Attorney general–robert mclellan
    Mark Butler
    The Chief Psychiatrist
    The Health Services Commission
    Human Rights Commission
    Mental Health Review Committee
    Premier of Victoria
    DHS or Mental Health Services
    The Ombudsman
    Mental Health Legal
    Mental health Commissioner
    Department of health
    Department of health and ageing
    The Medical Board
    The Treating Doctor and the assisting doctor(the back up guy)
    (Their puppets)the mental health nurses association– doing the psyches dirty work
    RANZCP
    the prime minister
    Melbourne university(and all universities) psychiatric departments.
    The TGA
    Drug companies etc. thzat was when maybe we could have really saved her—now its a miracle thats needed.

    so as you can see i didnt just watch– I wrote to all those people to step in and help– even flew to canberra to meet with Nicola Roxon– and not one of them would help stop electrocuting at the time— they all just said basically –were sorry to hear– we sympathise– but we cant do anything-and wont— write to one of those twenty and talk to them–all exactly the same– these were letters about long term psychotropic adverse drugging-ECT-etc– drugging at all-seeing it was a temporay drug induced psychosis-speed psychosis–first time–a temporay condition– with an ethical treatment- requiring sleep from two to ten days- and- sleepers at the most-drug wise- good food- a course of multi vitamins and a massive dose of ascorbic acid-a peaceful loving environment- and the “waylaying” of drug induced thinking-encouragement-thats ethical treatment of speed psychosis- that not one psyche ward adheres to- and in spite of that psychosis lifting after- two to three days-slept off-have been tagged-adversely drugged-electrocuted-raped-bashed- restrained-straight jacketed- and incarcerated 12 times for “neuroleptic withdrawal psychosis” seen as and called -ever since– each time called a lie -a relapse back to your real mental illness–when theyve never had a mental illness– other that the mental illness withdrawal from psyhotropics -and the debilitating effects on it–the cause of any mind distress-or mind illness- to imagine anything outside of normal reaction-effect in withdrawal- in this case–the withdrawal psychosis- is a lie–so they lie and call whats clearly a withdrawal psychosis– a relapse– and if they’re lying every day at a psyche ward near you– right now- what makes anyone think theyre ever going to answer appropriately or tell the truth — when they’re clearly liars– anyway– the last letter after the last incarceration– i wrote to the premiers office about the chief and MHCC being corrupt – and in bed together-and not answering appropriately to the complaints-that i had written them– MHCC and the chief psychiatrist wrote their standard letters of —we sympathise, but wont, and cant do anything about it again,- which is what i explained in my letter as well–where i was saying they are basically, complicitly criminal-because of their response- anyway nearly two months had passed, and i still hadn’t gotten a response– so i rang them– i spoke to this bloke who said to me- ver batum– we rang the chief psychiatrist– and they said to the premiers office rep-the guy i was talking to—They’d heard it all before– so just dont answer him– thats what this guy told me– i couldnt believe it– anyway when i tried to growl at him for even speaking to them-let alone listening, and then taking advice from them- when my letter was specifically about them being complicitly criminal–he hung up–so i tried ringing back to ask him if he could just write that response to me– by answering my email- he again said he wouldnt– so i made a lot of noise about it again and again-lots of phone calls- and somehow it must have gotten back to him– and then i got an email –saying–Your correspondence has been referred to the Minister for Mental Health, the Hon Martin Foley MP, for a direct response.-for the third time mind you– anyway that was twenty days ago-this started end of nov 2015– and im still waiting–this was a brand new complaint– about the abusive and poor treatment of/at the last incarceration–specifically- there have been three of four incarcerations ive complained about over twelve years- in a big way– but were all individual complaints–for individual circumstances-different hospitals-different psyche wards-different doctors and people– and varied-all to some extent similar– but where isnt their similarities in a complaint about the same organisations-organisations make certain mistakes all the time-their is always similarities in complaints– but to say weve heard it all before- so fuck off–and tell someone else – is disgusting in any language or response-but is what you will laways get from mental health/psychiatry-standard-par for the course- either sorry to hear-we sympathise-tell this person–or silence–the third trick of psychiatry-sorry- and of a liar-the more you trap and ithdrawalexpose them fro their crimes-the quieter they get.

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