Personcentrerad psykiatri och health promotion med socialpolitisk inriktning

Transcription

1 Personcentrerad psykiatri och health promotion med socialpolitisk inriktning Wolfgang Rutz, MD, PhD Professor Stockholm / Sweden Coburg University / Germany CCM Lund 2013

2 Generally: I am I and my Circumstances ( O. y Gasset) HEALTH PROMOTION: Resilience Health Wellbeing Welfare Happiness Holistic Approach: Physically mentally - existentially

3 Från Wolfgang Rutz 2007 till Ing-Marie Wieselgrens blogg 28 maj 2013 Samhället behöver hjärnan psykiska ohälsan växer Är psykisk ohälsa då en ondviklig utveckling? Jag tror inte det. Vi kan lära oss Frågan är bara hur många människor som ska fara illa under tiden och hur mycket lidande och resursslöseri vi kommer att drabbas av. Det är dumt att vänta. Det är dags för kraftfulla, tidiga, generella insatser överallt i samhället.

4 WHO Health For All - The Solid Facts Determinants of Health and Welfare -Control: mastery, participation, self-directedness -Connectedness: social significance, to care, to be cared for -Caseness: ( Ipseity, Personhood Personhood ) : Autonomy, integrity, identity, status, dignity, equality -Cohesion: existential values, meaning, self-transcendence -Cohesion: WHO: Health for All 2000 World Health Report Research Evidence, Marmot 1998, Cloninger 2005, Wilkinson 2008 UN: Health, Treatment and Access to Determinants of Health A Human Right

5 Personal Health Promotion: A SeismographicCommunity Syndrome of Stress Related Morbidity and Mortality Depression Aggression, Violence Suicide Risk-taking, Self-destructive Lifestyles Abuse Cardio - Cerebro - Vascular Disorders Fabric of Society - Moral Insanity SEROTONIN???? A Basic Mechanism Gender Specificity: Example Gotland and Lithuania: Outside of existing Services, Crisis Facilities e.g. not utilized by rural Males

6 Suicides in a Transitional Europe

7 Cardiovascular Death in Transitional Societies 200 SDR(0-64), Ischaemic heart disease, per Estonia Iceland Latvia Lithuania Russian Federation Sweden

8 Focus on European populations at risk Farmers in Ireland Elderly men in Alentejo and Asturias Young men in Finland and GB Indigenious People in Greenland Immigrants in Danmark Young females in Austria, Luxembourg, Norway, Danmark and Switzerland, Kasakstan and Kyrgistan In Sweden: Adolescents, Asylum Seekers, Elderly, Psychiatric Patients (1/3 of S, 4- fold increase). Over All: Male gender a riskfactor DIVERSITY DEMANDS PERSON CENTRED APPROACHES TODAY : EMU in ECONOMICAL CRISIS A LABORATORY SITUATION

9 Personal Health Promotion Societies at Risk - in Crisis and Regression Community Mental Health and Societal Maturity: general characteristics Intolerance Scape Gouting Black and White, We and Them Marginalisation Simple Solutions Regressive Nostalgia, Strong Leaders, Law and Order Fundamentalism Totalitarian Structures Mental Health and Democracy pre-supposing each other Balkan Stability Pact (WHO EU)

10 Concretely Personcentered Health Promotion Adolescents Young Adults - Education, Professional Development Perspectives Elderly Unemployed job insecurity Young Families Depression Suicide prevention = Health Promotion Primary Care Working Places Immigrants asylum seekers indigenious populations Redistribution of Working possibilities Healthy Choices Education, Awareness

11 Ethical Sensitivity needed Not only the pharmaceutical companies... Selling our souls in order to advance within the system Mephisto Effect Accepting inacceptable economic prioritisations Diagnostical Labelling and Societal Consquences Evidence conceptualisation users, families? Evidence based Quality Control - Can the RCT really be the only Golden Standard of evidence we accept to act accordingly to???

12 World View Value Chart Survey (

13 The Societies we have created generate Mental Ill-Health Mental Ill Health - Europe`s Unseen Killer Kyprianou, f. European Commissioner for Health Medical science is a social science. and politics are nothing else than medical science applied in the greater context R. Virchow, 1848

14 Public Mental Health and Human Ecology Analysis - A Political Challenge Political Awareness and Capacity Building Environment and Health - Investment in Health - Health Accountanc - Mental Health Impact Awareness and - Assessment - Mental Environment and Mental Health Abdication of Mental Health Professions?? Professional Analysis and Advise needed Human Ecological Analysis and Signal Function in context with political and other decision making and policy changes

15 Determinants of Mental Health Liberte, Egalite, Fraternite Doing good, altruism Sense of existential cohesion Spirituality

16 OUTLOOK: Growth Fetischism Spirituality - Meaning

17 HOMO MENSURA THANK YOU!