Once upon a time there was a socialist system which tried to treat all citizens equally. Health care was guaranteed, but it stayed on an overall low level and could not compete with capitalism. This system encouraged consumption and growth, without any strings attached. While the first one collapsed and is history by now, the latter one is also stumbling and receives from world economists such as former German chancelor Helmut Schmidt the most inferior grades. He called it a beast. While banks and the monetary system are still unleashed and the European Union is falling in agony, voices for a third way between socialism and capitalism arise.
In concrete terms, no country spends more money on health care than the United States, but the majority of the population does not receive a fair share. Europe might be on the same track, as signs indicate. The continent’s top budget administrators met in the charming Austrian resort town Gastein (see also “Health Journalists: Go to Gastein”). In numerous sessions they virtually banged their heads against the wall how to get out of the vicious circle of decreasing funds and increasing numbers of patients.
Will higher sin taxes help, for example for cigarettes – because smokers are a heavy burden for the health system? Can a fast food chain like McDonald’s be pulled into an all-out effort to educate young people on obesity prevention strategies? Tests show that a picture of a carrot on the quarter pounder box seduces young customers to eat more vegetables. Or is the most powerful leverage Hollywood? The extremely successful movie “Untouchable” has promoted all over the world discussion about the inclusion of the handicapped. These examples, at least, are heartening and give hope that the bumpy US road is still far ahead.
One participant of the conference, the newly elected chairman of the European Health Forum Gastein, offered another remedy. “Health literacy is the corner stone”, he pronounced in a special session. This means to “empower citizens to take control over their own lives”, said Helmut Brand, expert for public health and professor at Maastricht University. He cooperates closely with patients’ groups and is very well aware of the fact that once people assume responsibility for themselves fare better in life, stay healthier and recover faster from ailments, Brand stated in an EUSJA press conference.
It was exactly this philosophy, meanwhile a well accepted formula, which created some 20 years ago a broad movement which gave birth to non-government organizations or NGOs. They have changed the world, kicked off the environmental movement, human rights campaigns and introduced more democracy and participation in community affairs. Independent NGOs, fueled by citizens’ concerns, are all over public life and contribute to something we might phrase “The Third Way”. So what do patients’ groups and self help organizations achieve in the public health sector?
There are numerous best practices throughout Europe, but one striking case has written history. Some 25 years ago, more and more people became aware of mental health issues, specifically their own depressions and anxieties, among others produced by the ever increasing pace of economy and work pressure. Today the burnout syndrome is all over the media and has become a mainstream topic. In those days however, it was a taboo to speak openly about one’s psychological condition, which many times only aggravated it and made everything worse. So the persons concerned went to look for a therapy, which sometimes worked, but many times did not produce the desired results. At the end, the patients ended up taking a lot of medication, just to make their suffering bearable and to function more or less at work.
Fortunately these were the times of change, the environmental and green movement made people aware of their own power and possibilities, far beyond of what the state and established institutions were able to provide. If psychologically unstable people pooled their own resources and knowledge, they could go places. That did not necessarily replace professional treatment and assistance, but eased significantly their situation.
These were the background and the circumstances which made three young people in Munich move into action. They founded the first self help group for patients who suffered from anxiety. The novelty was that the groups were not run by professionals but by people, who had experienced this condition which means: They were the experts. In order to empower them to run patient groups they were trained in Ruth Cohen’s theme-centered interaction TCI.
Simultaneously, some other people, more broad-based in their intentions, banded together and founded an entire self help center. Today it accommodates more than one hundred groups, which deal with a whole scope of health disorders. At the 20th anniversary of this institution, the founders recorded the history. Interestingly but not overly surprising, for Bavaria’s conservative party they were sort of rabble-rousers. They violated the rule that the important issues were tackled on the top levels of political and administrative circles. Solutions were handed down to the citizens. Also the medical field apparently did not tolerate any exceptions form this principle. At that time, only the social democrats and the green party, which had started as grassroots movements themselves and worked their way from the bottom up, supported the new health initiatives.
Munich’s anxiety self help group MASH has been highly successful in assisting people with psychological disorders. Studies have found that the organization has helped a large majority of its clients to overcome the constraints, re-integrate into work, and lead a healthy, wealthy and happy life again, cutting down on medication as well as psychiatric treatment, thus relieving substantially the health system. MASH was a role model for many other initiatives which sprung up all over Germany and beyond. The organization produces a comprehensive magazine which addresses regularly all different kinds of anxiety and how sufferers deal with them. Last but not least MASH has contributed to new funding models of self help groups. German health insurances channel a percentage of their income into financing these voluntary associations.
In short, this is the historical background of professor Brand’s health literacy initiative. In the 3rd millennium, the civil society has become a viable part of society. This rests not only on politics, economy and science, but increasingly on volunteering and citizens’ initiatives, which pave new participatory and sustainable ways. While many individual goverments of the European 27 still lag behind and are far away from compliance, the European government in Brussels has firmly understood this eminent paradigm shift and support it, especially in the medical field.
Science journalists are also grassroots people who are committed to work independently and stay away from the established powers if they want to live up to their truth-finding mission. In other words, the new health movement and modern science journalists are twins.