Martin Whitely

Martin Paul Whitely (born 19 October 1959 in Perth, Australia), is a mental health researcher, author and was a Labor member of the Western Australian Legislative Assembly from February 2001 until he retired from state politics in March 2013.[1] During his parliamentary and research career Whitely has been a prominent critic of increasing child mental health medication prescribing rates.

Martin Whitely
Martin Whitely small.jpg
In office
10 February 2001 – 9 March 2013
Preceded byClive Brown
Succeeded byDave Kelly
ConstituencyBassendean
Personal details
Born (1959-10-19) 19 October 1959 (age 61)
Perth Western Australia
NationalityAustralian
Political partyLabor Party
ProfessionTeacher
WebsiteMartin Whitely Homepage

ResearchEdit

Whilst still in politics Whitely wrote Speed Up and Sit Still - The Controversies of ADHD Diagnosis and Treatment (UWA Publishing 2010).[2] Since retiring from politics he completed a PhD (thesis title ADHD Policy, Practice and Regulatory Capture in Australia 1992–2012).[3] Subsequently, he has researched Australian mental health policy and practice and pharmaceutical and medical device regulation.[4][5] His research has primarily focused on the drivers and outcomes of prescription mental health medication use by children, adolescents and young adults for ADHD and depression.

ADHD researchEdit

Whitely led two research projects examining the effect of relative-age within a school classroom on the probability of school-children being medicated for ADHD.

The first, Influence of birth month of Western Australian children on the probability of being treated for ADHD, was published in the Medical Journal of Australia in 2017.[6] It found that among West Australian school children aged 6–10 the youngest in class (born in June) were approximately twice as likely to take ADHD medication as their oldest classmates (born the previous July).

 
Dr Martin Whitely in 2020

The second, Attention deficit hyperactivity disorder late birthdate effect common in both high and low prescribing international jurisdictions: a systematic review, published in 2019 examined 22 studies in 13 countries covering 15.4 million children.[7] It found that is the global norm for the youngest students within a school year grade to be diagnosed with and medicated for ADHD than there older classmates.

Whitely also co-authored a paper published in 2020, Look west for Australian evidence of the relationship between amphetamine‐type stimulant prescribing and meth/amphetamine use [8] . It reviewed Western Australian (WA) evidence of the relationship between prescribing amphetamine type stimulants for ADHD and the illicit use of amphetamines. It found that the non-medical use of prescription ATS by WA secondary school students is the major component of their illicit amphetamine use. It also reported that since at least 2002 WA adults have been prescribed ATS at a much higher rate than other Australian adults and WA adult illicit amphetamine use rates have consistently been among the highest in Australia.

Research examining antidepressant use and suicide by young AustraliansEdit

Whitely led research published in 2020, Antidepressant Prescribing and Suicide/Self-Harm by Young Australians: Regulatory Warnings, Contradictory Advice, and Long-Term Trends.[9] It examined the Australian response to the US Food and Drug Administration’s (FDA) 2004 black box warnings that antidepressant use was associated with an elevated risk of suicidal thinking and behaviours in people aged under 25.This research found that in the four years following the 2004 FDA warning there was a 31% decrease in antidepressant prescribing and a small fall in the rate of suicide by young Australians. However from 2009 to 2018 the rates of antidepressant use and suicide by young Australians increased consistently. In 2009 there were 275 suicides by Australians aged under 25 years, in 2018 this number rose to 458.

Whitely, and his co-authors Prof Jon Juriedini and Dr Melissa Raven, concluded “correlation does not prove causation. However, given that the FDA warned that antidepressants were associated with an approximately doubled risk of suicidality relative to placebo, we are not surprised that rising dispensing rates have been accompanied by increasing youth suicide rates”.

Parliamentary careerEdit

Whitely represented the electorate of Roleystone from 2001 to 2005. Following the abolition of Roleystone, he represented the electorate of Bassendean and was the Parliamentary Secretary to the Minister for Agriculture, Food and Forestry from August 2006 until the Carpenter government lost office in September 2008.[10]

Anti-ADHD child medication parliamentary advocacyEdit

From 1995 until his election to parliament in 2001, Whitely was a secondary school teacher. During this period Western Australian ADHD child prescribing rates rose rapidly. By 2000 they were among the highest in the world and over twice the per-capita rate in of the second highest Australian state (New South Wales).[11]

In his first parliamentary speech (2001) he called for tighter ADHD prescribing controls.[12] In late December 2002 the Western Australian Health Minister Bob Kucera and Whitely jointly announced the abolition of “en bloc authorisation” which allowed “specialists to prescribe stimulants without individual patient authorisation”.[13] In August 2003 the Stimulant Regulatory Scheme began collecting detailed annual reporting of ADHD stimulant in Western Australia. Data from the Stimulant Regulatory Scheme shows after these changes the number of Western Australian children prescribing stimulants fell from 8,859 in 2004 to 5,636 in 2010, despite the state's population increasing by approximately 17%.[14] This approximates to a 46% decrease in per capita ADHD stimulant child prescribing rates over this period.

Beginning in 2011 there was a rebound in child prescribing rates with most of the increase occurring after Whitely retired. By 2017, the number of Western Australian children who received at least one prescription of an ADHD stimulant had jumped to 9,587 . So from 2010 until 2017 the number of children medicated increased by 70% while the state's population increased by only 15%.[15]

Whitely also campaigned to influence national (Australian) ADHD policy. He unsuccessfully sought to prevent non-stimulant ADHD medication Strattera (Atomoxetine Hydrochloride) from being added to the Pharmaceutical Benefits Scheme because of its boxed warning for increased risk of suicidality.[16][17] Strattera was added to the PBS in 2007. Until 17 February 2018 the Therapeutic Goods Administration (TGA) had received 149 reports of adverse events. This included 78 reports of suicidal/homicidal/self-harm ideation or behaviour, with four incomplete suicide attempts (including a 7-year-old girl) and three completed suicides (including a nine-year-old boy).[18] Because adverse event reporting to the TGA by doctors is voluntary the actual number of adverse events associated with Strattera (or any medication) in Australia is unknown.[19]

He also campaigned to prevent the endorsement by the National Health and Medical Research Council (NHMRC) ADHD national treatment guidelines developed by the Royal Australian College of Physicians (RACP). The guidelines were never endorsed by the NHMRC because of concerns about conflicts of interest among guidelines panel members and the heavy reliance on research lead by high-profile ADHD medication proponents with undisclosed significant conflicts of interest, most notably Professor Joseph Biederman.[20]

Whitely's self-described “at times obsessive” campaign against the use of ADHD medications by children has attracted considerable criticism. Prominent Australian psychiatrists including Professors Florence Levy[21] and Alasdair Vance[22], have been highly critical of Whitely, who has no medical training, for politicising the disorder, ignoring scientific evidence and promoting an emotive and sensationalist debate. However, Whitely has received praise for offering a "proven public health cure...for the false epidemic of ADHD" from prominent American psychiatrist Professor Allen Frances who led the development of the DSMIV on behalf of the American Psychiatric Association.[23]

Criticism of the diagnosis of Psychosis Risk DisorderEdit

Whitely was also prominent in Australian efforts to prevent the official recognition of ‘Psychosis Risk Disorder’ in the influential American Psychiatric Association's, Diagnostic and Statistical Manual of Mental Disorders 5th edition (DSM5) published in 2013.[24] Psychosis Risk Disorder (officially termed Attenuated Psychosis Syndrome) was removed from the draft of the DSM5 after its inclusion lost the support of former prominent advocates including former Australian of the Year, psychiatrist Professor Patrick McGorry.[25]

ReferencesEdit

  1. ^ "Extract from the Western Australian Parliamentary Handbook". 2007. Archived from the original on 31 August 2011. Retrieved 10 April 2008.
  2. ^ Full copy available at https://www.psychwatchaustralia.com/speed-up-and-sit-still-freeadhdbook
  3. ^ Available at https://espace.curtin.edu.au/bitstream/handle/20.500.11937/1776/225953_Whitely%202014.pdf?sequence=2
  4. ^ Whitely M for the Health Consumers’ Council of WA submission to the Senate Select Inquiry into Health, Licensing and Subsidising Pharmaceuticals in Australia - Reforms needed to deliver Transparency, Safety and Value for Money, 2014 Submission 46 available at: https://www.aph.gov.au/Parliamentary_Business/Committees/Senate/Health/Health/Submissions
  5. ^ Whitely M, Joint submission by Health Consumers Councils across Australia to the Senate Inquiry into the number of women in Australia who have had transvaginal mesh implants and related matters (July 2017) http://www.hconc.org.au/wp-content/uploads/2017/07/Combined-Australian-State-HCCs-Final-Report-Transvaginal-Mesh-Senate-Inquiry-31052017.pdf
  6. ^ Whitely M. Lester L. Phillimore J. Robinson S. Influence of birth month of Western Australian children on the probability of being treated for ADHD, Medical Journal of Australia, 23 January 2017. https://www.mja.com.au/journal/2017/206/2/influence-birth-month-probability-western-australian-children-being-treated-adhd
  7. ^ Whitely M, Raven M, Timimi S, Jureidini J, Phillimore J, Leo J, Moncrieff J, Landman P,  Attention deficit hyperactivity disorder late birthdate effect common in both high and low prescribing international jurisdictions: systematic review, Journal of Child Psychology and Psychiatry, October 2018 https://onlinelibrary.wiley.com/doi/abs/10.1111/jcpp.12991
  8. ^ Whitely M. Allsop S. Look west for Australian evidence of the relationship between amphetamine‐type stimulant prescribing and meth/amphetamine use. Drug and Alcohol Review. 20 April 2020 Available at https://onlinelibrary.wiley.com/doi/full/10.1111/dar.13067
  9. ^ Whitely Martin, Raven Melissa, Jureidini Jon, Antidepressant Prescribing and Suicide/Self-Harm by Young Australians: Regulatory Warnings, Contradictory Advice, and Long-Term Trends. Frontiers in Psychiatry. June 2020 https://www.frontiersin.org/article/10.3389/fpsyt.2020.00478
  10. ^ "Extract from the Western Australian Parliamentary Handbook"the original. Retrieved 10 April 2008 http://www.parliament.wa.gov.au/web/newwebparl.nsf/iframewebpages/Legislative+Assembly+-+Current+Members
  11. ^ 1.    Berbatis Constantine G, V. Bruce Sunderland et al (2002), ‘Licit psychostimulant consumption in Australia, 1984-2000: international and jurisdictional comparison’, Medical Journal of Australia, 177; 10, p.540 https://www.mja.com.au/journal/2002/177/10/licit-psychostimulant-consumption-australia-1984-2000-international-and
  12. ^ "INAUGURAL SPEECH" (PDF). 3 May 2001.
  13. ^ Department of the Premier and Cabinet Media Statements - New policy targets diagnosis and treatment of ADHD https://www.mediastatements.wa.gov.au/Pages/Gallop/2002/12/New-policy-targets-diagnosis-and-treatment-of-ADHD.aspx
  14. ^ Department of Health, (2019), Western Australian Stimulant Regulatory Scheme 2017 Annual Report, Pharmaceutical Services Branch, Health Protection Group, Department of Health, Western Australia. https://healthywa.wa.gov.au/-/media/Files/Corporate/general-documents/medicines-and-poisons/PDF/Stimulant-Regulatory-Scheme-2017-Annual-Report.pdf
  15. ^ Department of Health, (2017), Western Australian Stimulant Regulatory Scheme 2016 Annual Report, Pharmaceutical Services Branch, Health Protection Group, Department of Health, Western Australia. http://ww2.health.wa.gov.au/~/media/Files/Corporate/general%20documents/medicines%20and%20poisons/PDF/Stimulant-Regulatory-Scheme-2016-Annual-Report.pdf
  16. ^ https://www.parliament.wa.gov.au/Hansard%5Chansard.nsf/0/2598b9814bffe6cdc825757000325a0b/$FILE/A37%20S1%2020061123%20p8772b-8774a.pdf
  17. ^ https://www.theaustralian.com.au/news/health-science/adhd-drug-earns-subsidy-despite-suicidal-side-effects/news-story/b3b160f4015d339adf0a5b4870929e04?sv=c37a234f437d056d1c69b21a45797b64
  18. ^ Adverse events are searchable at https://www.tga.gov.au/database-adverse-event-notifications-daen
  19. ^ https://www.tga.gov.au/overview-how-tga-manages-medicine-adverse-event-reports
  20. ^ https://www.racgp.org.au/afp/2012/march/adhd-guidelines/
  21. ^ Levy, Florence (2013). "Child psychopharmacology: Politics versus science". Australian & New Zealand Journal of Psychiatry. 47 (10): 961.  doi10.1177/0004867413498938
  22. ^ Vance, Alasdair L (2015). "Commentary on 'ADHD diagnosis continues to fail the reliability and validity tests' by Martin Whitely". Australian & New Zealand Journal of Psychiatry. 49 (6): 574–5. doi10.1177/0004867415585322PMID25922350
  23. ^ https://www.huffpost.com/entry/add-epidemic-_b_1293556
  24. ^ David Weber, Australian Broadcasting Commission, The World Today, 25 May 2012. http://www.abc.net.au/worldtoday/content/2012/s3511017.htm
  25. ^ David Weber, Australian Broadcasting Commission, The World Today, 25 May 2012. http://www.abc.net.au/worldtoday/content/2012/s3511017.htm

External linksEdit

Western Australian Legislative Assembly
Preceded by
Clive Brown
Member for Bassendean
2005–2013
Succeeded by
Dave Kelly