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Doubts and scrutiny in public health

Posted by Martin Palin

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Apr 20, 2017 2:05:58 PM

Driving to work I heard ABC radio report on a new study suggesting that one in four Australian teenagers are at risk of having a “probable serious mental illness”.

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You can find the full published report here.

Two things occurred to me on hearing it.

First, it struck me that the estimate seemed a tad on the high side. Just from intuition, professional interest and personal experience as a dad of teenagers. It didn’t ring quite true and just seemed a bit high. I didn’t edit my reaction, it was just my natural response.
  • Second, I knew the estimate would not be publicly challenged or scrutinised. No one is going to start digging into the controversy around the measure of psychological distress they used (the Kessler 6) to form a view about whether it sets the criteria a little low. People see mental health as too important an issue to be seen as a contrarian.

However, there are always negative outcomes that might conceivably accrue from a lack of scrutiny of public health claims and surveys.

What if over-estimating the prevalence of mental health issues – and then widely publicising those estimates acts to reduce adolescent resilience in the community? No one really knows exactly what the broader impact of publicising those estimates is. What if high estimates of mental health illness distract young people from the reality of having to deal with the complicated, existential challenges that come as a result of trying to manage your day to day commerce with the world?

I know from past experience that public health claims often go unchallenged. I used to run the Quit Campaign in NSW and we could utter whatever creative epidemiology we liked about the impact of, say, passive smoking in the community. The end result was always to see those figures published and unchallenged.

It’s all part of the broader debate about freedom of speech. If we really do value freedom of speech then those who might have views counter to the current orthodoxy (or are inclined to challenge assumptions) need to be able to express those views without concern for being personally attacked.

In Sydney, cinemas are now cancelling their plans to show “The Red Pill”, a documentary that investigates the men’s rights movement and touches on men’s health.

Surely it’s better to let the documentary run and then criticise it if it’s bad, unbalanced or boring? Otherwise we’re just censoring debate and discussion in line with the accepted narrative.

Contrarians have a lot to offer. I think there is much more to be gained – especially in public health by arguing the issues and challenging assumptions. Certainly much more to be gained than intimidating the commentators and scrutineers.

Topics: public relations, health, health communications, health public relations, PUBLIC HEALTH, health news, public health report


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