An Erudite Encounter with: Patrick McGorry,AO

Patrick McGorry is Professor of Youth Mental Health at the University of Melbourne and Executive Director of Orygen, the National Centre of Excellence in Youth Mental Health. After graduating in medicine in 1977 and training initially in internal medicine, he completed his psychiatry training in 1986. Since then his work has focused on developing new concepts, scientific evidence, international societies and novel systems of care (exemplified by Early Psychosis Prevention & Intervention Centre [EPPIC] and headspace) to support early intervention, initially in psychotic disorders and subsequently across the diagnostic spectrum in young people. He is currently President of the Society for Mental Health Research in Australia, the Schizophrenia International Research Society, the International Association of Youth Mental Health and Editor in Chief of the journal, Early Intervention in Psychiatry. In 2016, he was elected as a Fellow of the Australian Academy of Science:

Recognition of Professor McGorry in 2010 as Australian of the Year was fitting given his esteemed accomplishments but also because of his Australianness – reflected by his penchant for wearing bohemian apparel. Indeed he often combines these passions – wearing jeans and a T-shirt at conferences, where he can be found gesticulating wildly, enthusing others with his latest ideas. It was as a recipient of one of these animated inductions, that I noticed his Kara – a steel bangle worn by Sikhs. He acquired it when he visited the Golden Temple in Amritsar many years ago and to my mind this epitomises Pat – demonstrating his intrinsic acceptance of others and unrelenting commitment to help.

• What drives you? For as long as I can remember, I have felt ‘driven’ in a general sense. I always assumed this came from my background as an Irish immigrant, fuelled by the enormous hopes that my parents held, for me in particular as the eldest child. However, I’ve seen through my youngest son that such forces can be innate and be present from the earliest days of life, and maybe this was true for me too. I was a child of the 1960s, was deeply influenced by this zeitgeist. I was constantly inspired by causes that tackled injustice and oppression, and had an overwhelming desire to become involved in the struggle against these forces. Having reluctantly studied medicine, which initially failed to inspire, I found within psychiatry the perfect channel for this vocation. The plight of the mentally ill was a massive worldwide scandal, which sadly still ticks all the boxes of injustice and discrimination. The shocking neglect and crude treatment of the mentally ill had given rise to antipsychiatry, an attractive proposition at the time to a young medical student. Looking back, I feel I was offered a precious gift, an opportunity to play a part in the fight for a fair deal for people with mental illness, who are among the very last people in society who continue to suffer serious neglect and discrimination. This struggle continues, and despite the huge challenges that remain, I am now convinced more than ever it is a battle that can be won. This is what ‘drives’ me and sustains me.

• What advice would you give to your younger self? I spent a long time training in medicine, psychiatry, psychotherapy and medical research, so that I was nearly 40 before I felt confident enough and in a position to actually do something potentially creative and decisive. I have been really fortunate to have had many kindred spirits as colleagues, but it had been a long gestation period. Looking back, I would have liked to overcome my shyness and have had more self-belief at a much earlier stage of life.

• As a psychiatrist what have you learnt about the human condition? Seeking a deeper understanding of the human condition was a compelling reason for becoming a psychiatrist, and I have learned so much more than I ever expected. The psychodynamic perspective was invaluable, but the experience of being part of the lives of countless patients, and to have experienced the diversity of human experience has been a great privilege. The most valuable single thing that I have really learned though is the positive power of the relationship with the person in the therapeutic process. I also learned the value of fully committing as a doctor to patients in the traditional or vocational way, with many fewer limits than we were originally taught in psychiatry. And I have seen just how much this approach is appreciated and respected. I learned this flexibility and confidence especially through working with refugees but equally with young people and families.

• Research is fundamental to psychiatry because … it is a field of medicine but, perhaps more importantly, research is essential for the discovery of new, safer and more effective treatments and how to deliver them. It also means major mistakes are more likely to be avoided and overall research improves safety. Blending research with clinical care almost always improves the standard of care, attracts better staff, creates optimism, and protects staff from burnout and services from external threats.

• The topic in psychiatry I am most passionate about … is young people with mental ill health because they are impacted at such a critical phase of life when the challenges can be so overwhelming and yet they are inexperienced in how to respond or to seek and accept help. Furthermore, they have the greatest capacity to benefit from mental health care and it is their major health issue. They have been badly neglected by society and the health system, and yet investing in their futures is such a vital and rewarding task. I believe I have a strong affinity for this focus and style of work. I have also loved working with asylum seekers and refugees, whom I have found totally inspiring, and who helped me early on to see the need for a much more active approach to political advocacy within a clinical context.

• What is the future of psychiatry? Psychiatry must have a hugely positive future because mental ill health is a massive public health problem. However, to realise this, we must overcome inertia, learned helplessness and the self-interest of professional groups. The need for expertise in mental health care is great, and we must attract the very best talent into our specialty. We need people with the great vocational gift of dedication and an ability to deeply connect with patients. We need brilliant researchers of even better quality than other medical researchers. We need a cohesive phalanx of new leaders who will campaign fiercely and effectively alongside strong allies and the public to finally put an end to the discrimination and lack of parity, which persists in health care in relation to mental health.