General News — 22 August 2012

The fierce debate over the controversial new ‘social and emotional wellbeing’ checks for three-year-olds has been reignited by a scathing attack on Australian mental health policy.

The comments, from DSM-IV lead author Professor Allen Frances, have been described as “extraordinarily inflammatory” by the chairman of the expert working group on the Healthy Kids Check, Professor Frank Oberklaid.

Professor Frances, who sparked the controversy over the check proposal with comments at a Sydney conference in June, has now described it as an “absurd” plan that “does not pass the laugh test” in a new article published in the Australian and New Zealand Journal of Psychiatry, which includes several papers  for and against the checks.

“To an outsider, Australia’s infatuation with untested prevention models is a source of wonder and alarm,” he wrote.

“This program for three-year-olds is just the most extreme in a series of high stakes gambles on largely untested programs that may cause more harm than good.

“Simply stated, this is a bad idea on psychiatric grounds and unjustifiable as public policy.”

He added that “general practitioners may be even more inclined [than child psychiatrists] to overvalue the clinical significance of the all too fallible toddler test results”.

“Rates of medication use in young children went up dramatically in New Zealand when a similar screening program was instituted three years ago,” Professor Frances told MO in an email.

Professor Oberklaid said  Professor Frances had no understanding of the prevention agenda, GP training or the Australian healthcare system.

“He knows nothing about what we are recommending, of the deliberations of the committee and the caveats we have thought through,” he said. “It’s extraordinarily inflammatory.”

The RACGP representative on the expert panel, Dr Michael Fasher, said it was odd that Professor Frances had “raised such a head of steam with no knowledge of the measure that is the subject of his concern”.

The expert panel’s guidelines were submitted to the government two weeks ago and a roundtable discussion with key stakeholders will be held later this month, a federal health department spokesperson said.

“The expanded Healthy Kids Check Medicare item and supporting documentation is expected to be available in early 2013,” the spokesperson said.

As first appeared in Medical Observer. Source: Aust NZ J Psychiat 2012; 46:695

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