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Healing A Troubled Mind: A Personal Perspective On Victoria’s Stagnant Mental Health System

Person standing near lake

The Royal Commission’s report on the Victorian mental health system sent shockwaves throughout the State, one of which landed squarely on a patient of mine. They noted that Victoria’s mental health system is “not geared for…change”. Just to ensure we got the message, and despite a Federal Government TGA approval, my request to treat my traumatized patient with MDMA-assisted therapy was declined by our state’s regulatory authority.

To be clear, my disappointment lies not with the state government regulators, nor with the medical opinions suggesting MDMA-assisted therapy should not be used for treatment of traumatized patients (despite excellent emerging evidence that it works with little risk). I understand these opinions, though I certainly do not agree with them.

My issue is a more troublesome one. Underlying these opinions is a problem with how we practice psychiatry, which in turn reflects the alienated community in which we live. Mental health paradigms are always a reflection of the society which supports them. You see, us Australians are alienated both intra-personally (from our own emotional worlds) and inter-personally.

Our current paradigms tend to view mental illnesses in a biologically reductive way. In other words, mental illnesses are both understood and treated primarily as biological diseases (which they are not). The posters at your doctor’s rooms will teach you – depression is just like any other medical disease, such as heart-failure or emphysema. In this paradigm, entities such as addictions and depression are seen as distinct phenomena. They are treated in our current system as totally different diagnoses by entirely different teams. The alienated individual who suffers from depression and addiction is labeled with the alienating and erroneous term ‘dual-diagnosis’, which enshrines the division. Furthermore, if addictions are understood (as they are) as inherited conditions (which they are not), and primarily as brain diseases based in dysfunctional dopamine rewards circuits, they will be primarily treated as inherited brain diseases, by doctors with medications.

But what if we have got it all wrong (which we do). You see, addictions are heritable but not inherited (there is a big difference, I recommend looking it up), and the chemical dopamine in no-way explains addictions. Rather, it is the human experience of dopamine (along with numerous other chemicals) which explains addictions, suggesting that addictions are rooted in difficulties with the human experience of life, rather than the neural correlates of those experiences.

The events which lie at the root of illnesses such as addictions and depression are those which overwhelm the mind’s ability to process and integrate. We know that the presence of adverse childhood experiences is present in the majority of (if not all) people with addictions and chronic depression. But rather than seeing these conditions as consequences of trauma (which they are) and treating the underlying emotional issues (which would help), our society mistakes the symptoms (depression and anxiety) for the disease itself. We treat depression as depression and addiction as addiction and all the while we are missing the forest for the trees. The real disease is the high prevalence of trauma, alienation, and neglect in our society. After all, it is these conditions which twist and distort the mind into the contortions which fill the latest catalogues of mental illnesses.

Which brings me back to my patient. Traumatized when young, she has suffered from every diagnosis a psychiatrist’s finger can point at. She has had every treatment a medical guideline can fathom. Yet her trauma remains in place, because no-one has been able to reach it. Suddenly, on the horizon, a change is coming. Treatments like MDMA-assisted therapy appear to touch the root of the trauma, allowing individuals to process the unintegrated parts of their minds, and offer the chance of real healing. But we don’t change. Our outlooks have ossified, our diagnoses have desiccated. And all the while we suffer in our own blindness. People continue to kill themselves, and my patient will continue to suffer in silence until the Victorian Government allows me to access a new treatment which may finally bring peace to a troubled mind.

Dr Eli Kotler

MBBS MPM FRANZCP Cert. Old Age Psych. AFRACMA

Eli is a consultant psychiatrist, holds an academic position at Monash University through the Alfred Psychiatry Research Centre, and is the medical director of Malvern Private Hospital, the first addiction hospital in Australia. He is a member of the Australasian Professional Society on Alcohol and other Drugs (APSAD). Clinically, Eli is interested in the deep connections between trauma and addiction and works within a neuro-psychoanalytic framework. Eli has overseen the development of a clinical program for addictions focused on trauma, particularly developmental trauma. This has led to an interest in medication-assisted trauma therapy. Eli worked for many years researching neurodegenerative diseases and was the principle investigator on numerous trials for novel therapeutics. He is founding member of the Melbourne Neuropsychoanalytic Group and welcomes new members. Through involvement with Monash University, Eli oversees the addiction rotation for medical students.

Eli graduated from the first intake of the Certificate in Psychedelic-Assisted Therapies (CPAT) in June 2021. He has also been recently appointed as the Principal Investigator to lead Emyria’s upcoming MDMA trial.

Mind Medicine Australia Celebrates 2-Year Anniversary

Second anniversary

 

This week Mind Medicine Australia turns two years old! In our two years, we have made remarkable progress in growing public awareness of Psychedelic-Assisted Therapy in Australia. We are already seeing a paradigm shift in the curiosity, acceptance and interest into the use of medicine-assisted therapy for depression, addiction, PTSD, obsessive-compulsive disorder, anorexia and other mental and physical illnesses in our communities.

In order to help those who are suffering with mental illness we have focused on four key strategic areas. Please see our strategic objectives to build the ecosystem in Australia for these medicines here.

Strategy

What we have achieved in our two years with your support:

Awareness and Knowledge Building

Access to Medically Approved Therapy

Professional Development Program (Certificate in Psychedelic-Assisted Therapies)

Asia-Pacific Centre for Emerging Mental Health Therapies (CEMHT)

The progress we are making in public education was exemplified in several headline media articles including in the Australian Financial Review, The Australian, the Age, Herald Sun, The Saturday Paper and Vogue Australia and media interviews including with The Project, ABC and other stations.

Our primary focus over the next couple of years will be on psilocybin-assisted psychotherapy and MDMA-assisted psychotherapy, given their “Breakthrough Therapy Designation” with the Food and Drug Administration (“FDA”) in the United States and the strong clinical evidence that supports both their effectiveness and safety. We are also interested in developing other medicines to treat a variety of conditions.

Behind the scenes, we are working closely with key stakeholders to ensure that these therapies will be accessible and affordable to all Australians needing these treatments in medically-controlled environments, so that cost and geography doesn’t become a barrier.

In the last year, we have assembled a comprehensive leadership team with expertise in mental illness including psychology, neuroscience and pharmacology, non-profit development, business practices and networks, public health, events and educational development.

Mind Medicine Australia is also supported by an outstanding Board, Ambassadors and an Advisory Panel of over 60 local and international experts in medicine, psychiatry, psychology, pharmacology, research, science more broadly, ethics, law, policy, anthropology, business and therapeutic practices.

We are currently preparing for our International Summit on Psychedelic Therapies for Mental Illness to be held at the Sofitel in Melbourne this November. We have a global line-up of world leaders in medicine-assisted psychotherapies and other outstanding thought leaders on topics ranging from medicine and anthropology to neuroscience and ethics. We are now confirming financial, endorsing and media partners and would appreciate as much support as possible to produce a brilliant event.

Our much anticipated Certificate in Psychedelic-Assisted Therapies launched in January 2021. We are thrilled to welcome a wonderful group of GPs, psychiatrists, psychologists, psychotherapists, mental health nurses, social workers, occupational therapists, addiction specialists and counsellors.

As we begin 2021, our vision and capacity continues to grow, as does the need to make medicine-assisted psychotherapy a legally available treatment through our medical system for the increasing number of individuals suffering as a result of the pandemic, environmental challenges and global trends which challenge social cohesiveness and social inclusion.

We ask for your continued and expanded support so that we can fund the path for psilocybin-assisted psychotherapy and MDMA-assisted psychotherapy to help treat the millions experiencing mental illness in Australia. This is personal for every one of us.

“Psychedelics are to the study of the mind what the microscope is to biology and the telescope is to astronomy.” – Dr Stanislav Grof

Enormous gratitude to all of our supporters, partners, Board, Ambassadors, Advisory Panel, Team, Chapters and volunteers.

This is a collective mission and we need all of you by our sides.

On behalf of Mind Medicine Australia

Peter Hunt AM, Chair & Tania de Jong AM, Executive Director

Tania de Jong AM

LL.B (Hons), GradDipMus

Tania de Jong AM is a trail-blazing Australian soprano, award-winning social entrepreneur, creative innovation catalyst, spiritual journey woman, storyteller and global speaker. Tania is one of Australia’s most successful female entrepreneurs and innovators developing 5 businesses and 3 charities including Creative Universe, Creativity Australia and With One Voice, Creative Innovation Global, Mind Medicine Australia, Dimension5, MTA Entertainment & Events, Pot-Pourri and The Song Room.

She works across the public, private, creative and community sectors and is passionate about mental health, innovation, diversity and inclusion.  Tania speaks and sings around the world as a soloist and with her group Pot-Pourri releasing twelve albums. She is Founder and Executive Producer of future-shaping events series, Creative Innovation Global.

She was appointed a Member of the Order of Australia in June 2008. Tania was named in the 100 Women of Influence, the 100 Australian Most Influential Entrepreneurs and named as one of the 100 most influential people in psychedelics globally in 2021. Tania’s TED Talk ‘How Singing Together Changes The Brain’ has sparked international interest. Tania’s mission is to change the world, one voice at a time!

Peter Hunt AM

B.Com, LL.B

As an investment banker Peter Hunt AM advised local and multi-national companies and governments in Australia for nearly 35 years.  He co-founded and was Executive Chairman of one of Australia’s leading investment banking advisory firms, Caliburn Partnership (now called Greenhill Australia) and continued as Chairman of the Firm after its sale to Greenhill Inc in 2009. Peter was a member of the Advisory Panel of ASIC and chaired the Vincent Fairfax Family Office.

Peter is an active philanthropist involved in funding, developing and scaling social sector organisations which seek to create a better and fairer world.  He is Chairman of Mind Medicine Australia which he established with his wife, Tania de Jong, in 2018. He founded Women’s Community Shelter in 2011 and remains on the Board. He was previously Chairman of So They Can, Grameen Australia and Grameen Australia Philippines. Peter is a Director of Project Rozana and an Advisory Board member of the Monash Sustainable Development Institute. Peter also acts as a pro bono adviser to Creativity Australia. 

Peter was made a member of the General Division of the Order of Australia in the Queen’s Birthday Honours List in 2010 for services to the philanthropic sector.

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