Shrink rapped: top child psychologist guilty of ‘unprofessional conduct’
Gauteng father whose son was diagnosed with ADHD by Dr Brendan Belsham feels vindicated by finding
The Health Professionals Council of South Africa (HPCSA) has slapped a prominent Johannesburg child psychologist with a R40,000 fine after they found him guilty of unprofessional conduct.
The finding against Dr Brendan Belsham, author of the book What's the Fuss About ADHD, was delivered on Monday April 1.
Belsham said he was aware of a preliminary guilt finding against him but said there was no finding of wrongdoing.
“I am aware that the HPCSA has made a preliminary finding that I am guilty of ‘unprofessional conduct’. I have seen the contents of the determination and it is disappointing that I was not given the opportunity to comment on the draft, given that it does not say what conduct on my part was unprofessional.
“On the contrary, the finding states that the HPCSA found no wrongdoing on my part. I always adhere to internationally accepted evidence-based guidelines in the diagnosis of ADHD as well as any other psychiatric condition. The diagnosis of ADHD is made clinically and does not rely on the Conners rating scale or any other.
“I will be taking time to reflect on the outcome and consider my options," said Belsham.
The finding follows a complaint to the council in February 2018 which was levelled against Belsham by Johannesburg father David Nefdt-Epstein.
Nefdt-Epstein’s complaint centred on the accuracy of tools Belsham was using to assist in diagnosing children, including his son, with attention deficit hyperactivity disorder [ADHD].
Belsham diagnosed his son with ADHD in 2017.
Belsham had claimed to use the Conners Rating Scale to make the diagnosis, according to the complaint.
The scale – used by health professionals internationally –consists of a checklist of behaviours that caregivers, teachers, parents and children over the age of eight can complete.
In February 2018, the Sunday Times reported that the checklist that Nefdt-Epstein was given was in fact distributed to health professionals by Novartis South Africa, the makers of the ADHD medication Ritalin, in about 2002.
At the time, SA company JvR Psychometrics, the sub-Saharan representative of the copyright holder of Conners, which is based in Canada, told the Sunday Times the version distributed by Novartis was “an old, short form used many years ago for research” and was no longer internationally accepted.
JvR’s MD, Dr Jopie de Beer, was quoted as saying that those using it would probably not have the scoring-key manual that was provided and as such would not be able to generate “norm-referenced” scores.
“[These] are very important because they take into account the age of the individual and compare them to a normal population. Without normed scores, there is no reference point to understand the severity of the symptoms,” De Beer said, adding that this would violate “professional and legal requirements”.
JvR issued cease-and-desist letters to health professionals using the outdated questionnaires as they owned the copyright in SA for the Conners Rating Scale.
Novartis South Africa spokesperson Vaychel Raman told the Sunday Times in 2018 that they shared materials with healthcare professionals regularly to keep them updated on the latest trends in clinical practice.
“These materials are regularly updated and old materials withdrawn from circulation when updated.
In its finding. the HPCSA states: “The Committee resolved that Dr Belsham is guilty of unprofessional conduct [and] to impose a penalty of R40,000.
“Further noted that in terms of his management of the patient there was no wrongdoing (he followed appropriate procedures, the rating that he used is readily available although modified) [sic].”
Nefdt-Epstein said it had been an enormously tough journey “not only for us but especially for my son”.
He said Belsham had used the outdated diagnostic scale in assisting with the diagnosis of ADHD with his son, and then prescribed a treatment plan using Ritalin. But Nefdt-Epstein said he believed his son did not require such an extreme intervention, especially with a diagnostic tool that had no merit in determining the severity of the diagnosis.
“We feel vindicated in terms of the HPCSA’s ruling. The ultimate goal was to show that parents should not be afraid to question and stand up against the so-called experts.
“When we take our children to the professionals, we as parents should expect the highest level of integrity beyond reproach. It is all about accountability, which there has to be.”
* This article was amended on April 12 to update it with comment from Belsham