Rethinking Evidence-Based Medicine in Mental Health: Transitioning to Evidence-Based Care

Abstract:  Evidence-based medicine (EBM) has revolutionized healthcare globally. However, when it comes to mental health and other complex clinical conditions influenced by social determinants, there are serious questions about the extent to which this model is fit for purpose. The assumption that clinical outcomes derived from trials can seamlessly translate into everyday care is not supported in practice, as studies reveal limited evidence of population-wide benefits from current practices. In this presentation, I explore the limitations of EBM, particularly for Veterans and First Responders, who represent a significant patient group at St John of God Richmond and Burwood Hospitals. I propose a paradigm shift toward evidence-based care that emphasizes long-term patient journeys. Through continuous healthcare monitoring, this approach aims to enhance decision-making and patient outcomes, ushering in a new era of mental healthcare.

Bio: Prof. Zachary Steel holds the St. John of God Chair of Trauma and Mental Health, a partnership between Richmond Hospital and the UNSW School of Clinical Medicine. With over three decades of clinical and research expertise, he focuses on trauma-impacted populations, including veterans, emergency service workers, refugees, and asylum seekers. Prof. Steel is the past president of the Australasian Society for Traumatic Stress Studies (2019-2021), and past member of the Department of Veteran Affairs Clinical Reference Committee (2014-2018). He currently serves on the board of Service for the Treatment and Rehabilitation of Torture and Trauma Survivors (STARTTS), and Integra Service Dogs Australia, a national agency based in Canberra placing assistance animals with injured veterans and first responders.