You’d think mental health was firmly on the political radar, judging by the column inches devoted to the topic. But it’s mostly smoke and mirrors, from public relations and vested interests peddling assumptions rather than the genuine community conversation needed.

The poverty of the current public discussion of mental health can be seen in two political struggles currently underway: one nationally very much in the media, the other in Victoria which isn’t on the radar but should be. At the national level, high-profile advocate Patrick McGorry is selling his multi-billion dollar product to the federal government and to the community that will pay for it.

Down south, in a state which boasts of its human rights leadership, the government is sneaking through a draconian new Mental Health Act that violates the state’s own Human Rights Charter.

Reading the mainstream media you’d think the McGorry bandwagon was the only mental health game in town. McGorry’s international reputation is based on his work on the early intervention of psychosis. He believes he can reliably predict those young people who are at high risk of developing a psychotic disorder prior to them displaying symptoms that would warrant such a diagnosis.

It’s controversial, even among McGorry’s peers in psychiatry. The notion of early intervention represents a very wide diagnostic net that would capture many people who would never go on to develop psychosis. The number of such ‘false positives’ is usually quoted in the literature as 60-80%.

Once a young person is caught in the net, McGorry believes anti-psychotic medications can help prevent the onset of psychosis even though there is no scientific evidence for these drugs as prophylactics against psychosis. This has been compared to giving chemotherapy to prevent cancer in someone with a family history of cancer but otherwise no other symptoms. Most alarming of all is that McGorry seems unconcerned about giving these dangerous drugs to the large number of false positives caught in his pseudo-diagnostic net.

McGorry’s allies in selling this controversial medical model include beyondblue, the Brain and Mind Institute (led by former beyondblue CEO Ian Hickie) and other medical model enthusiasts such as John Mendoza. But dissenting voices are not permitted in the room to disturb this medical juggernaut. McGorry’s ubiquitous presence in the media throughout 2010 is not public debate, it is public relations.

In stark contrast to the McGorry media frenzy, Victoria’s Mental Health Act. Now, Victoria is the only state with a Human Rights Charter (along with the ACT). Its champion is Attorney-General Rob Hulls, who acknowledges that mental health laws contain some of the most serious limitations of human rights that a society might impose on a person.

The scandal began at the very start of the review (May 2008) when it was given to the Department of Human Services (DHS) rather than the Law Reform Commission, which is the obvious agency to conduct a review of legislation with such serious human rights issues. Having the DHS review the Mental Health Act has been compared to having the police review criminal justice law.

An eight-person expert advisory group was established without a single mental health consumer among them. The review team then prepared a consultation paper (December 2008) for a very stage-managed — and very brief — community consultation process during the summer months, concluding in February 2009. A community consultation report was then produced (July 2009) and law-makers went into their bunker to write the draft bill released in September.

Throughout the review it was apparent the government intended to maintain involuntary medical treatment as the foundation of any new Mental Health Act — indeed the only reason why such an Act is required is to give legal sanction to such human rights limitations. But the Human Rights Charter was now law in Victoria and it imposes — or is supposed to impose –strict legal obligations on any proposal to limit any of the rights now protected under the Charter. In particular, it says any limitations of a Charter right must be “demonstrably justified in a free and democratic society” and gives some criteria that must be considered in any such justification.

The draft bill contains serious limitations of numerous Charter rights but after more than two years there has still not been one word of justification from either the DHS or the government. That won’t come until the Statement of Compatibility, which is required when the new bill goes before the parliament, expected in mid-2011. Public debate of very serious human rights issues is being deliberately suppressed by this review.

There is a great thirst in the community for a broad-ranging conversation around the many complex issues that come under the mental health banner. Suicide, drug and alcohol problems, prisons as de facto mental asylums, the excessive medicalisation of human suffering, the social determinants of mental health and many other urgent issues are needed in this conversation.

What we have, on the one hand, is the hard sell of the McGorry medical model, and on the other a government’s very deliberate stifling of debate on mental health and human rights.

*David Webb (PhD) is a disability rights activist who has represented both national and international disability organisations at the UN on the rights of people with disabilities.