Patrick McGorry

Patrick Dennistoun McGorry (born 10 September 1952) is an Irish-born Australian psychiatrist known for his development of the early intervention services for emerging mental disorders in young people.

McGorry is Professor of Youth Mental Health at the University of Melbourne.

He has written more than 640 peer-reviewed articles with more than 56810 citations, published in journals including The Lancet, the British Journal of Psychiatry, the American Journal of Psychiatry and the Medical Journal of Australia. He is executive director of Orygen, The National Centre of Excellence in Youth Mental Health and founding editor of Early Intervention in Psychiatry published by the International Early Psychosis Association.

McGorry also advocated strongly for the establishment of the Australian government funded National Youth Mental Health Foundation, which became headspace, and is a founding board member of that organisation.

McGorry played a key role in leading the design, advocacy and scaling up of headspace services.

McGorry and his colleagues developed an approach for young people who have symptoms of psychosis for the first time, based at the EPPIC clinic in Melbourne.

This EPPIC clinic has played a key part in an early psychosis treatment paradigm for psychiatry and has led to significant reform of mental health services, especially in the United Kingdom.

The EPPIC program's approach is best represented by the catch phrase "A stitch in time."

A linked development is the PACE clinic: a service for young people with sub-threshold symptoms who are at risk of developing psychosis.

Initial evaluations of EPPIC showed that it was not only effective compared to the previous traditional model of care but that it was also cost effective.

McGorry was awarded the Centenary Medal in 2003 in recognition of his work on the EPPIC program.

McGorry has also led research and new models of care for early intervention with young people who seek help for symptoms and impairment, and are known to be at risk for more severe psychosis, but whose psychotic symptoms are less intense, including the use of safer interventions than antipsychotic medication.

He has generated a body of research to determine the correct sequence of treatment, that includes psychosocial interventions.

McGorry has advocated to the Australian government to create a national network of early psychosis intervention centres, based on evidence that early treatment may improve long-term outcomes.

He has worked with all sides of politics in Australia to establish and improve early psychosis services.

Other criticism published around this time, 2009-2013, reiterated that evidence of long-term benefits was ambiguous and future economic evaluation of early-intervention programs would be needed to correctly value costs, while also recommending further studies be conducted, systematically comparing the EPICC model with mainstream treatment.

McGorry responded to some of these claims at the time, saying they were 'at odds with commonsense and what the facts clearly demand'.

Since these criticisms were made further evidence has accumulated.

Cochrane level 1 evidence now exists demonstrating the effectiveness of early intervention for first episode psychosis and for those at ultra-high risk for psychosis.

Early intervention services for psychosis have been effective in reducing mortality rates and providing a return on investment.

They are also a preferred service model for consumers.

In the past two decades evaluations in England and Denmark have shown that early intervention is effective over the first two years of care at least, but when patients return to traditional care some of the gains are lost.

Canadian data indicates that if patients remain in early intervention services for five years the gains are sustained.

McGorry's views on giving antipsychotic medication to at-risk young people have been criticised by a number of people, including Allen Frances the Chair of the DSM-IV Taskforce, on the basis that pre-emptive treatment may be risky.

McGorry and his colleagues have responded to this criticism, arguing that critics have blurred the key distinction between clinical recommendations and ethically approved research designed to build evidence to more firmly guide clinical practice.

A proposed trial of the antipsychotic medication quetiapine, led by McGorry, attracted criticism on ethical grounds, though McGorry insisted the decision to abort the trial was unrelated and came months before the complaint was received by Melbourne Health.

McGorry is published advocating for supportive therapies as a first-line intervention.

He has been accused of having a conflict of interest in using his position on a government advisory committee to advocate for programs that he founded.

McGorry denied that he had any conflict of interest and said the critics were an 'irresponsible' minority who were misusing evidence to 'protect their turf and the traditional ailing mental health model'.

Early intervention in psychosis has paved the way for a broader model of care ("headspace") that targets a range of youth mental disorders.

McGorry was a key architect of the headspace model, which has been replicated internationally.

Headspace was originally founded under the Howard government with its support continuing under the Gillard government.

Its design and national rollout has gained bipartisan support.

The early psychosis model of care has garnered bipartisan support, and was originally funded under the Gillard Labor government in 2011.

McGorry has previously faced some criticism of his work, though this is unsupported by current evidence.

Early intervention for psychosis was initially met with resistance due to a claimed lack of evidence.

In 2011, a systematic review concluded: "There is some support for specialised early intervention services, but further trials would be desirable, and there is a question of whether gains are maintained."

During the 2013 Australian Federal election, McGorry appeared in the media together with then Opposition Leader Tony Abbott at the launch of the Liberal-National Coalition's mental health policy.

Abbott promised that, if elected, he would provide additional financial support for research and translation programs associated with Patrick McGorry.

After being elected to government, the Coalition announced in its first budget the allocation of $18M over 4 years to Orygen Youth Health Research Centre for establishment of a National Centre of Excellence in Youth Mental Health and $14.9M to headspace for the expansion of its youth mental health services.