Patrick Dennistoun McGorry FAA FASSA FAHMS FRCP FRANZCP (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.
Position
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.
Early intervention in psychosis
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. The early psychosis model of care has garnered bipartisan support, and was originally funded under the Gillard Labor government in 2011.
Criticisms
McGorry has faced a number of criticisms of his work.
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." Some critics have argued that McGorry has exaggerated the evidence for early intervention and that long-term benefits and economic savings have not been established, and one has gone as far as alleging that McGorry has "systematically misled" the Australian Government about the nature and implications of his evaluation study on EPPIC by misstating the description of the control group.
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.