Scandal and how not to deal with it.

This week, the Australian and New Zealand Journal of Psychiatry (ANZJP), main journal of the Royal Australian and New Zealand College of Psychiatrists (RANZCP), carried a five page editorial on the Lake Alice unit scandal in New Zealand during the 1970s (it should be available here, if not, contact me for a copy). While it happened half a century ago and the main players are now dead, and I first heard of it just twenty years ago, it has taken this, the fourth enquiry, to expose the disaster. Fortunately, a Royal Commission to investigate abuse in institutional care has spent considerable time on the Lake Alice Child and Adolescent Unit, and has issued an interim report, available here.

The full report is 350 pages but the executive summary is much shorter. While I've quickly skimmed it so far, I think the full report should be required reading for anybody working in any sort of institutional care or where people's rights, of whatever age, sex, race, health or intellectual status, are suspended for whatever reason. This is especially true for the hundreds of thousands of people who have lost their rights without being convicted of a crime. But the part I want to focus on is the role of the RANZCP in this matter.

A good place to start is the RANZCP home page, which shows three lovely ladies having a lovely chat at what looks like a lovely graduation ceremony, and goes downhill from there. It tells us that...

Psychiatrists are specialist medical doctors who are experts in mental health ... Psychiatry allows you to see each person as a whole, taking into consideration their physical, social and mental wellbeing.

How they do this isn't explained because, as everybody (including all psychiatrists) knows, they don't actually have a scientific model of mental disorder, and certainly not an integrative model of mind and body. I suggest you read the page "A day in the life of a psychiatrist"and judge for yourselves whether it has any contact with reality. For example, under the heading "Research and innovate", it quotes a registrar (trainee/resident) as saying ...

We are in (sic) the cusp of something big that is going to evolve throughout the course of my career. It’s going to be very exciting to be sitting in the box seat as we get to unlock and better understand how the mind and brain works.

It's nonsense, of course, psychiatry has been "on the cusp of something big" since the dawn of time: that quote could easily have come from 1936, when ECT was invented. The point here is that they are trying to convey a particular impression of psychiatry and psychiatrists that is totally contradicted by the evidence in the Royal Commission's report. The NZ Health Dept, and the NZ Medical Board, and the police, and the college of psychiatrists, were all warned repeatedly that terrible things were happening at the Lake Alice unit but nothing was done. Part of the problem was the support provided to the psychiatrist by the psychiatric establishment. When offered the choice of believing dozens of patients or the psychiatrist, they closed ranks behind the psychiatrist.

On pages 275-77, the evidence of a Mr Kevin Banks is quoted, in which he was repeatedly given electric shocks by the chief psychiatrist, Dr Leeks, using an old-fashioned ECT machine applied to different parts of his body. When the matter was investigated, the main concern of the college, whose representatives had sat through the evidence (p278), was that it would damage the reputation of ECT and patients and their families would be reluctant to agree to it:

Dr Werry said that with the benefit of hindsight they should have been more forceful in trying to change things and to confront Dr Leeks after what they had heard at the inquiry. However, he acknowledged the difficulty in criticising colleagues ...

With the benefit of hindsight? The child had been tortured using electrical stimulators but he felt it was better to remain quiet than go to the trouble of criticising a colleague. Shortly after, the Lake Alice unit was closed and the psychiatrist moved to ... Victoria. In order to do that, he needed a certificate of good standing from the NZ Medical Board, which was apparently provided. He then worked in Melbourne as a child psychiatrist until he was investigated by the Board for assaulting a patient. Instead of aggressively defending himself, as he had done so many times in the past, he retired, which ended the complaint. However, he remained a member of the RANZCP until his death in early 2022. Some time after that, because of the appalling material coming from the Royal Commission, he was posthumously stripped of his membership, apparently the first time it has happened.

Shades of Chemsford. And Callan Park (1960; yes, I remember it). And Ward 10B in Townsville. And all the others. The point is, the RANZCP knows about these matters, at least unofficially, but sits on its hands until the proverbial hits the fan. Why did it wait over 25 years before expelling the Monster from Lake Alice? They knew exactly what he had been doing. I know, because about fifteen years ago, I rang the then college CEO, Mr Craig Patterson, and asked what they were going to do about it. Nothing, it seems. That rubbed salt in a wound because some years before, a senior college official, acting in that role, lodged a complaint about me with the NT Medical Board. I had had no warning whatsoever and was taken completely by surprise.

It was investigated extensively, at considerable cost to me and the Medical Board, until, nine months later, the complaint was dismissed as groundless. No apology or explanation was ever forthcoming. I can't say that it was fun but I have never doubted that that was the senior college official's intention: "Put the blowtorch on his arse so he learns who's boss in this show."

In 2015, I was contacted by a reporter from the Brisbane Courier Mail who wanted to ask questions about ECT for an article for Mental Health Week. Yes, it's a Murdoch toe rag but they asked and the reporter was polite and actually knew what he was talking about. In due course, his article was published, although I never saw it, and led to a complaint to the college, which I also never saw, but guessed it was something to do with saying "The main driver for the excessive use of ECT in Australia is the financial return it generates."

So an anonymous complainant lodged an unseen complaint which was investigated in camera by an unnamed committee with unknown conflicts of interest taking unsworn evidence from unknown witnesses who could not be cross-examined and the complaint was upheld. How very unexpected. I was advised my "file would be marked accordingly," or something, I've lost the letter. Compounding it, if I wanted the matter reviewed, it would cost me $1000, while an appeal would cost $5000. As though I cared. But I was sufficiently annoyed to dive into the ECT literature and write a review [1] which showed that each and every claim made by the RANZCP in relation to the safety, efficacy and life-saving necessity of ECT was false.

Needless to say, their current practice guidelines for ECT don't mention my paper, just as they don't mention that ECT is banned in some parts of the world and hardly available in many other parts, and those unfortunates get along just fine. In particular, it blathers on about the need to get informed consent (p4) before administering ECT which, as everybody knows, is a furphy as patients who decline the offer are immediately detained under the Mental Health Act and get it anyway. As it happened, I never got an apology from the secret committee to say they'd got it all wrong. Especially the bit about the financial returns on ECT which, as last week's post showed, will light the rockets on March 1st next year.

Moving on, in early 2017, I lodged a submission with the Human Rights Commission's investigation of Australia's duties under the Optional Protocol to the UN Convention Against Torture (UN CAT). In it, I said that patients detained under mental health acts met the Convention's definition of "detained persons"; they were subjected to involuntary "treatment" within the definition provided by the UN CAT; many of them complained that their experience was best described as "torture"; and the definition of torture depends on what the victim feels about it, not what the perpetrator has in mind. Therefore, detained patients in Australia would come under the jurisdiction of the UN Convention Against Torture.

Well, hush mah mouf, I say. One mustn't say things like that in nice company, and psychiatrists like to think of themselves as "nice company." In no time, a complaint lobbed through the doors of the Medical Board. Again, it was anonymous and I couldn't see it, only a few snippets, which were not just patently false but laughably so. As shown below, the Medical Board has the authority to dismiss complaints but they didn't; months of back and forth followed, at vast cost to all concerned, only for the complaint to be dismissed as groundless. But to make it worse, there was nothing I could do about this cheerful bit of character assassination. There is a section in the Medical Act that says that anybody who takes any action against a complainant will be penalised for "reprisal," for which the penalty then was $20,000 fine and up to two years in the slammer and, most damaging of all, exposure to a civil claim of damages for tort. Those sorts of claims have no end. There have been other incidents but recounting them gets boring but ... when the boot is on the other foot, it's different.

In February 2018, the internationally renowned researcher, Prof. Peter Gotzsche, of Denmark, said in a talk in New Zealand that antidepressants were dangerous and should be severely restricted. Two weeks later, the RANZCP issued a press statement essentially saying Dr Gotzsche didn't know what he was talking about:

The prescription of antidepressant or antipsychotic medications is something that a psychiatrist only ever does in partnership with the patient and after due consideration of the risks and benefits (emphasis added).

Two weeks later, I lodged a lengthy complaint with the college that the claim was, as everybody knew, completely false (this link shows the press release, which had immediately been taken down). My complaint was dismissed, so I lodged another. That too was dismissed, so I complained to the Queensland Medical Board. In 24 hours, they dismissed it on the basis that none of the members of the Board of RANZCP lived in Queensland and they had no jurisdiction. Medical boards don't do anything in 24 hours; but they got it wrong, anyway, as the vice-president of the college, who had dismissed my complaint re the president, was the director of mental health in Qld and had lived here for years. In due course, my complaint reached something called the National Health and Privacy Ombudsman (no, I hadn't either) who, predictably, dismissed the complaint, albeit on the novel grounds that it had previously been dismissed twice by the Medical Board. Five complaints that the president of the RANZCP had lied to the general public on a matter of utmost gravity, all dismissed.

Oh well, who cares? Obviously not the people charged with protecting the general public. Which reminds me, this email arrived an hour ago from a psychiatrist:

Have to share this with you. Was involved in the care (as opposed to treatment) of this voluntary middle aged guy on the brink of being discharged, when community team looking after him 'demanded' that I give him a depot injection (of an antipsychotic drug). The patient heard about this (not from me) and left no doubt with his colorful lingo that he did not want an injection. I assured him that was OK with me and left it at that. I was then informed 'they' asked for a second opinion. So a guy from the community gives his second opinion which was - and this is hard to believe - that I should place the patient under the Act so I can hold him down and legally give him the depot! I'm sure worse things have been done, but for this idiot to say I should break the law and certify him when he was not at all psychotic, just so I could do his bidding and jab him, confirmed the oft revealed lunacy of the so-called colleagues we work with. You have no doubt been involved in equally crazy episodes. Chrs

What's the problem? If my informant refuses to give the injection and something goes wrong, he will be crucified, but if he relents, orders the injection and then something goes wrong, everybody will say "So sad, we did everything we could but..."

When the institution of psychiatry wants to, it closes ranks and defends its own but when it feels like putting the boot in, that is exactly what it does. As I know. Specifically, it manipulates the existing machinery of authority (medical boards, etc.) to further its covert agenda. This is what institutions do, the world over. It's called power. As Lord Acton said:

Power corrupts, and absolute power corrupts absolutely ... And remember, where you have a concentration of power in a few hands, all too frequently men with the mentality of gangsters get control.

Please read the Executive Summary of the New Zealand report, if not the whole thing, and decide whether the men (they were all men) who had the power to act were genuine in their action of repeatedly choosing not to act.

Reference:

1. McLaren N (2017). Electroconvulsive Therapy: A Critical Perspective. Ethical Human Psychology and Psychiatry 19: 91-104. DOI: 10.1891/1559-4343.19.2.91