At one point, Americans seemed to be unique in a sort of religious-like worship of the American psychiatry industry’s metastasizing ‘bible’ of mental disorders (the ‘DSM-5’), proselytized by Big Pharma and biomedical psychiatry ‘priests’ (with their clinical psychology ‘acolytes’ in tow). Forever in competition and not to be outdone, however, Australia apparently now not only has one of the world’s highest rates of private (individual, household) debt, we are said to have one of the highest rates of antidepressant drug prescriptions and consumption per capita of all OCED countries. Does the sunburnt ‘land down under’ really have a ‘mental health crisis,’ as is being claimed around Australia?
No, not according to an intrepid analysis by Martin Whitely PhD in his 2021 book, Overprescribing Madness: What’s Driving Australia’s Mental Illness Epidemic? Like a cackling kookaburra, Overprescribing Madness flies up over the cuckoo’s nest that it arguably shows Australia’s psychiatry-based mental health industry to be, and gives readers a panoramic view of what might be driving Australia’s ‘mental health crisis’.
Written in a laconic, conversational first person voice, Overprescribing Madness combines research data with Whitely’s own first-hand accounts with journalists, Australian psychiatrists, and individual people and their families who have suffered damage (or death) from psychiatric diagnoses and pharma drugs.
Overprescribing Madness is thus possibly one of the first books of its kind to expose the psychiatry-pharma mental health industry in Australia. Reading at times like a thriller novel, yet based on evidence and facts, Overprescribing Madness reveals the individual psychiatrist political lobbyists and their backers who have convinced the Australian people and our governments, to medicalize our sane social, political-economic distress responses into a mental illness epidemic; a ‘mental health crisis’.
Overprescribing Madness begins by acknowledging the current Covid-19 pandemic and the understandable distress many Australian people have and continue to experience, in response to the pandemic and its management. The book also names those psychiatrists in Australia who for years, have made repeated public cries of a ‘mental health crisis’ and then successfully lobbied (and continue to lobby) left and right-wing Australian governments for billions of public dollars to fund more and more (psychiatry-pharma) ‘mental health’ services.
Whitely explains the lack of consensus in the debate on where and how things need to change in Australia. He critiques the ‘Americanisation,’ and ‘Preventive Psychiatry’ approaches that are being sold by those influential psychiatrists in Australia, as effectively promoting growing rates of (DSM-5 mental disorder) diagnosis and aggressive interventions, which are profitable for Big Pharma and perhaps also for psychiatrists.
Whitely prefers instead what he calls a ‘Recovery’ approach that he lauds for being ‘consumer’ led. When implemented properly, a ‘Recovery Approach’ is said to respond to the individual, not their diagnosis, with ‘faith’ in their ability to ‘get better’ and thus respecting medicine’s Hippocratic Oath of ‘first do no harm’.
Whitely goes on to explain how non-medical human misery in Australia has been medicalized by our blind following of American psychiatry. As Whitely says, most Australians ‘are completely ignorant about the dominant role American psychiatry plays in contemporary Australia’ due in part to, ‘a combination of slick salesmanship, dishonest and incompetent medical practice (overlooked by timid regulators) and cultural, commercial, and political drivers [that] now see Australians hooked on a cycle of over-diagnosis and over-medication’.
Additionally, he outlines the dubious history behind the American Psychiatric Association’s Diagnostic and Statistical Manual of Mental Disorders (which is now in its fifth edition; the DSM-5). As most Australian people may be largely unaware of the true origins and questionable basis of all DSM-5 mental disorder diagnoses, Whitely explains it for the Australian reader.
Similarly, he also explains the phenomenon of inflated mental illness diagnoses caused by the DSM-5 when it was published in 2013. Whitely describes the adverse effect of the DSM-5 in Australia like this: ‘the Australian psychiatric profession let a group of American shrinks … define what is acceptable, what is normal…’ According to Whitely, mental health lobby groups and individual Australian psychiatrists dominate what has apparently been a planned strategic push to effectively medicalize non-medical human misery in Australia.
Whitely also addresses the overprescribing of antidepressant drugs for Australia’s teenagers and children, and the arguable failure of Australia’s regulator, the Therapeutic Goods Administration (TGA), to follow the example of the US FDA, which warned about the risk of increased suicidality in young people that might be caused by antidepressant prescription and consumption. He also cites evidence to show how leading psychiatrists and mental health groups in Australia have, at times, inaccurately cited research sources and statistics to rationalise the prescribing of antidepressant drugs to children and teenagers.
Whitely then focuses on the political lobbyist activities of a particularly influential Australian psychiatrist. In Whitely’s opinion, they are arguably the ‘world’s most prominent advocate of Preventive Psychiatry,’ who, despite a lack of objective scientific medical evidence to support their early intervention theory, is apparently devoted to a belief that psychiatrically medicating people before they ever experience a psychotic episode, is warranted.
Further discussion in Overprescribing Madness reflects Whitely’s PhD research specialty: the over-diagnosing and over-drugging of ADHD (attention deficit hyperactivity disorder) in Australia, particularly among children and especially boys. Whitely is straight to the point when he says, ‘ADHD is big business – very big business’ and further, that ‘when ordinary Australians are shown the diagnostic criteria for ADHD, a common response is, ‘WTF? That is bullshit… fidgeting, disliking homework, playing loudly etc. are all normal childhood behaviours’.
Whitely clarifies that arguing ADHD is a fraud does not mean children are not distressed or not in need of support, because non-biological social/environmental factors are causing some children to feel distressed and hyperactive. Divorce, poverty, parenting styles, sexual abuse, and sleep deprivation are just some examples of what Whitely says do need to be identified and addressed (without ADHD diagnoses and drugs).
In this regard, Whitely cites the real-life Australian case of the late Claire Murray, who at 12 years old was sexually abused/raped at a school camp and then threatened not to tell anyone. Claire’s sudden behavior changes (a distressed response to the sexual abuse she suffered but which she did not disclose) led her parents to take her to an ‘ADHD’ expert.
The expert apparently did not enquire about what might have happened to Claire to cause her sudden behavior changes. Instead, they diagnosed her with ADHD and put her straight onto a high dose of dexamphetamine. That ADHD diagnosis with pharma drugs then put Claire into a state of amphetamine drug addiction which caused liver failure and her eventual death at 24 years old.
The equally, if not more disturbing fact revealed by Whitely’s account of Claire’s heart-breaking case, is the rather mean-spirited blame culture that seems to exist in Australia. This was demonstrated by the callous way some sections of Australia’s mainstream media, presumably unaware of the sexual abuse trauma Claire had suffered, had portrayed Claire as a ‘junkie’ (an ‘addict’ by choice). (There was also some uninformed public ridicule of Claire personally).
Little to no attention was paid, it seems, to enquiring about the actual causes of Claire’s distress and amphetamine addiction: the sexual abuse she suffered as an innocent 12-year-old girl at a school camp, followed immediately by an ADHD diagnosis and dexamphetamine drug prescription by an ‘ADHD expert,’ which forced her into a life-long drug addiction that led to her early death.
Claire’s case was publicized by the 2020 documentary ‘Wild Butterfly.’ Subsequent Australian media interviews have reflected on errors in Australia’s mental health system. As one commentator said, ‘There is evidence to suggest Claire’s PTSD following her rape was misdiagnosed as ADHD, that vital physical evidence regarding her sexual assault was lost, and educators did not act when the family reported Claire’s rape…’
Whitely’s insightful account of Claire Murray’s case, raises serious concerns about whether the Australian ‘mental health’ industry is psychiatrically medicalizing the sane distress responses of trauma and abuse victims.
Overprescribing Madness focuses on another powerful psychiatrist in Australia, by examining their political lobbying of Australian governments and their activities in psychiatry-led organisations and institutes. Whitely indicates that such activities may have been carried out whilst aligned financially with Big Pharma and private health insurance companies.
Whitely then swings a cricket bat at Australia’s national broadcaster, the Australian Broadcasting Corporation (ABC), giving it the disparaging epithet of ‘Australia’s BioPsychiatry Channel’. The ABC is lambasted for its biased reporting of mental illness diagnosis rates in Australia and its uncritical promotional coverage of the two Australian psychiatrists to whom Overprescribing Madness dedicates whole chapters. A real life account is shared of how these two Australian psychiatrists apparently brought pressure to bear on the ABC to prevent the airing of a media story that contained criticism of them by fellow dissident psychiatrists in Australia.
Whitely also gives accounts of how some ABC journalists in Australia have publicly promoted the use of antidepressant drugs in young children while not reporting the US FDA’s warnings of increased suicidality risk for children on antidepressant drugs. He then goes on to address Australia’s TGA, describing it as a ‘soft-touch regulator’ that has failed to regulate the prescribing and consumption of psychiatric pharma drugs in Australia.
Finally, Whitely offers 15 or so suggested reforms. These reforms include: stopping schools from demanding students be medicated; enforcing Big Pharma public disclosure of safety and efficacy data with heavy penalties for failures to disclose; strengthening consumer medication leaflets; replacing the DSM-5 with the European ICD manual; and banning Big Pharma political donations.
Overprescribing Madness’ author, Martin Whitely, PhD, is a former Australian politician (he was previously an Australian Labor Party member of the Western Australian State Parliament), who has been openly critical against individuals in Australian psychiatry before. In Overprescribing Madness, Whitely gives a direct, conversational account of the individuals, institutions, events, and policies that he considers to be the engine drivers behind Australia’s alleged mental illness epidemic or ‘mental health crisis’. Whitely’s views and opinions are supported by research and data, and are strengthened by what he has witnessed himself.
Who needs to read Overprescribing Madness? First, anyone in Australia with any DSM-5 mental disorder diagnosis may need to read it. Second, every Australian medical doctor, psychologist psy-professional (therapist, counselor, social worker), and arguably all members of judiciaries and tribunals and all politicians (along with their staffers and public servants), ought to perhaps read this book. All Australian parents, school teachers, and anyone who is involved with and/or cares about children sincerely, will want to read this book. From there, anyone around the world who is curious to know another side of what goes on in Australia might wish to read this book.
Australians are distressed; the suffering is real. But Whitely’s book rightly encourages us all to query whether our distress is just an individual biomedical psychiatric mental health disorder inside our brains that needs psychiatric drug mental health ‘treatment’? Or whether instead, Australians are experiencing, en masse, a sane and ordered human distress response to the 24/7 survivalist (narcissistic) competition of neoliberal capitalism?
At times, the core argument in Overprescribing Madness seems somewhat confused. The book uses (perhaps unwittingly), neoliberal capitalist language, such as mental health ‘consumers,’ which seems to contradict its core arguments by, for example, supporting the efforts in Australia to ‘de-stigmatisate’ DSM-5 mental disorder diagnoses. Furthermore, perhaps to ensure the book’s opinions are accurate, balanced, and fair, Overprescribing Madness praises the two Australian psychiatrists who are also the subject of dedicated critique, such as by congratulating them for raising national Australian attention and awareness of the importance of ‘mental health’.
In this regard, Overprescribing Madness approves the appointment of special ‘Mental Health Ministers’ in Australia’s governments, and commends the fact that significant public resources are being given to expanded mental health services across Australia. Yet it is important to consider (as dissident psychiatrists have) whether expanded mental health services that are supported by de-stigmatisation campaigns, might actually keep people victimized, helpless, and dependent on mental health systems.
The conundrum with Overprescribing Madness is that by trying to respect the ‘mental health’ vernacular, it seems to necessarily pull all its punches. For example, the book says rightly at the outset that, ‘extra mental health funding would be entirely logical if the care on offer actually helped people distressed by unemployment, financial hardship and loneliness’, but ‘far too often the mental health care on offer’ (promoted by the Australian psychiatrists who are critiqued in Overprescribing Madness) ‘does more harm than good’. Whitely then claims later, however, that a ‘consumer’-led ‘Recovery’ approach is preferred because it has ‘faith’ in their ability to ‘get better’.
These are somewhat bewildering arguments given that the book’s core premise is that the alleged mental health crisis or mental illness epidemic in Australia is not a medical disease, illness, or sickness at all, but the psychiatric-pharma medicalization of Australian people’s sane social, political, and economic distress. Furthermore, high rates of private household debt, precarious insecure low-paid casual work, and the medicalized drugging of abuse and trauma victims (including children), might be some of the real non-medical causes of human distress in Australia, that alarmist language like ‘mental health crisis,’ ends up concealing.
Few scholars in Australia, whether on the left or the right, seem willing to address the impact that four decades of the competition-obsessed neoliberal capitalist agenda has had on the psyche (the heart, mind, and soul) of Australia’s people. This is perhaps where Overprescribing Madness might have gone further with its critical analysis and suggested reforms.
Another reform might be, therefore, legally mandating all ‘mental health’ services (in Australia), to adopt a professional standard of care that involves what is being referred to in Australia and around the world as a ‘trauma-informed approach.’ Many mental health service providers no doubt have good intentions and strive to do their best for those who contact them for help. However, requiring all psychiatrists, psychologists, and general practitioners (GPs), to ask every adult or child who sees them for emotional distress feelings – ‘what happened to you?’ might prevent unnecessary ‘early interventions,’ questionable DSM-5 mental health diagnoses, and psychiatric drug life sentences for victims of abuse, trauma, poverty and loss.
Nevertheless, Overprescribing Madness is a bold and well-informed book that has perhaps adopted an essential first-step approach for introducing a new channel into Australia’s national conversation. Unlike in the US or the UK and other parts of the world (and apart from Whitely and his few Australian co-authors on other articles), there seems to be little public dissent in Australia about the nature and origins of the ‘mental health’ and ‘wellbeing-wellness’ agenda. This might be due, in part, to the prevalent uncritical daily use of the psychiatric language of ‘mental health’ in Australia’s parliaments, professions, public and private services, in our day-to-day conversations in workplaces, schools, universities, media, and amongst our friends and families.
Overprescribing Madness helps to create a much-needed public platform from which legitimate and evidence-based dissent on the mental health zeitgeist can now be expressed publicly, freely, and openly in Australia. A fascinating, passionate, and well-researched account of how the psychiatry-pharma mental health industry operates in Australia, Whitely’s Overprescribing Madness is a commendable clarion call to citizens in Australia and around the world, to scrutinize urgently the power and influence of DSM-5 psychiatry, in the land down under.
Author’s Note: The opinions and views expressed in this article are the author’s own and are not to be associated or affiliated with any institution, organization, or department, in any way.
Mad in America hosts blogs by a diverse group of writers. These posts are designed to serve as a public forum for a discussion—broadly speaking—of psychiatry and its treatments. The opinions expressed are the writers’ own.