WEBVTT 1 00:00:00.001 --> 00:00:01.810 okay? 2 00:00:01.890 --> 00:00:13.349 I think that we should start. I welcome you to this session of the Research Committee 49. Sociology of Mental Health and Illness. 3 00:00:13.580 --> 00:00:18.979 And before we start with the session, maybe I, 4 00:00:19.270 --> 00:00:22.110 before I introduce the speaker. 5 00:00:22.280 --> 00:00:30.829 I would like to read this acknowledgment of the country of Australia 6 00:00:31.330 --> 00:00:34.180 the and yes. 7 00:00:34.230 --> 00:00:45.530 I'm reading this now and then. I'm starting to introduce the speakers on behalf of everyone gathered. I pay respect to the spirit of country 8 00:00:45.560 --> 00:00:47.710 here in Nagum. 9 00:00:47.890 --> 00:01:08.579 where we are meeting, I acknowledged the past and present cooperation. Gary voicemail as the sovereign people. Here the cultural knowledge holders who maintain and promote the number of aboriginal law, customs, and custodianship responsibilities for country and the people. 10 00:01:08.900 --> 00:01:26.409 That country continues to sustain generation after generation into the future. For all of us I recognized the important contribution that first nations, thinkers have made to sociology, including challenges to our dominant ways of thinking. 11 00:01:26.490 --> 00:01:31.109 We sank all first nations delegates in the room today 12 00:01:31.810 --> 00:01:36.359 for their contribution to knowledge and discipline. S. 13 00:01:37.690 --> 00:01:49.259 Now I'm asking. our 2 speakers, if you are, there is. I already saw Klt Roxbury from August. 14 00:01:49.290 --> 00:01:57.519 but I didn't hear you hear anything of Dirk. The 15 00:01:58.440 --> 00:01:59.880 yeah. 16 00:02:00.370 --> 00:02:01.090 okay. 17 00:02:02.110 --> 00:02:11.280 so I think he's recording this presentation. So I think he's at least he has recorded this. And okay, then 18 00:02:12.390 --> 00:02:16.900 oops. I would like to give to. 19 00:02:16.930 --> 00:02:20.329 or the vert is remote. 20 00:02:21.750 --> 00:02:27.799 So if the speaker would like to start screen sharing, I will jump out of screen sharing. 21 00:02:29.930 --> 00:02:32.050 If you'd like to start screen sharing 22 00:02:33.670 --> 00:02:35.899 gilt. Could you start 23 00:02:36.250 --> 00:02:43.620 screen or no? He is doing that, Kate. You have to click 24 00:02:43.720 --> 00:02:45.830 screen sharing. Yes. Okay. 25 00:02:53.500 --> 00:03:01.910 okay. I have the pleasure to introduce the professor killed Augsburg. You have also switch on your microphone. I think 26 00:03:02.410 --> 00:03:04.290 you are still mute. 27 00:03:05.420 --> 00:03:06.300 killed. 28 00:03:07.780 --> 00:03:11.189 You are still mute, could you? Yes. 29 00:03:11.290 --> 00:03:19.910 I have the pleasure to introduce Kil to Oxford, member of the R. C. 49. For a long time 30 00:03:21.550 --> 00:03:26.989 the prophes, like Hawksbury, is located in Orhog in 31 00:03:27.190 --> 00:03:38.630 Denmark, and he will give us a talk about towards the sociology of mental disease. Please count the Kyot, you have the floor. 32 00:03:38.950 --> 00:03:40.509 Kjeld Høgsbro: So thank you. 33 00:03:42.530 --> 00:03:51.390 Kjeld Høgsbro: Well, In the last session we were addressing the lots, not field of 34 00:03:51.460 --> 00:04:06.480 Kjeld Høgsbro: So you really cool models and kind of considerations, and a way where it can practice, and it was very fascinating to to listen to that. But but here I 35 00:04:06.520 --> 00:04:10.150 Kjeld Høgsbro: present a an idea 36 00:04:10.190 --> 00:04:23.689 Kjeld Høgsbro: of how to to get in a solution to to some of the theoretical problems. I say all the 37 00:04:23.870 --> 00:04:34.110 Kjeld Høgsbro: take off by, Of course, getting to back to the if 38 00:04:34.250 --> 00:04:38.769 Kjeld Høgsbro: a model for dis learning, disability. 39 00:04:38.940 --> 00:04:54.660 Kjeld Høgsbro: and combined with the bomb, vulnerability model, and all say with the premises of the disability theory, and that is the point. 40 00:04:54.990 --> 00:04:56.050 Kjeld Høgsbro: And 41 00:04:57.070 --> 00:05:10.469 Kjeld Høgsbro: the Isf model, of course, you know. and tries to to define a health conditions, disorders, or diseases 42 00:05:10.660 --> 00:05:13.410 Kjeld Høgsbro: So the result of 43 00:05:13.530 --> 00:05:16.629 Kjeld Høgsbro: of 3, the interaction between 44 00:05:16.650 --> 00:05:29.749 Kjeld Høgsbro: 3 different fields, Body functions and to personal, Activities and competences and a social participation? 45 00:05:29.930 --> 00:05:58.160 Kjeld Høgsbro: and it is all on the the influence of personal factors and environmental factors. But the arrows is, it goes both ways and all parts of the fields. So down our theory and a definite definition of the factors that is involved in this model. 46 00:05:59.380 --> 00:06:00.610 Kjeld Høgsbro: And 47 00:06:01.430 --> 00:06:15.859 Kjeld Høgsbro: as when we look at the the vulnerability model, I had to extend it. because, my, as I've presented it before. 48 00:06:16.050 --> 00:06:20.669 Kjeld Høgsbro: We don't, Meet those people 49 00:06:20.770 --> 00:06:26.200 Kjeld Høgsbro: a as, Having a certain kind of impairment. 50 00:06:26.280 --> 00:06:44.479 Kjeld Høgsbro: a link to come. A combined biological, psychological, and social world to fact is now we meet them rather later, when they have been through a different social experiences 51 00:06:44.480 --> 00:07:06.200 Kjeld Høgsbro: and different kinds of social contexts that have a given them some problems. And in the diagnostic systems, we, we, the users problems as indicators of vulnerability that is lying behind. 52 00:07:06.520 --> 00:07:08.090 Kjeld Høgsbro: But 53 00:07:08.370 --> 00:07:21.700 Kjeld Høgsbro: of course, when we are talking about a sclerosis and polio, and so on, we have exact. We. We know what the biological factors are 54 00:07:21.790 --> 00:07:37.770 Kjeld Høgsbro: it, but we don't know it. When we are talking about mental illness, we only have baked theories about it, and we don't even know what in disability research would be called impairment. 55 00:07:37.960 --> 00:07:58.740 Kjeld Høgsbro: We we see, how people with impairment experience school and grown up and social relations, and so on. In it is all put down as indicators in the in the diagnostics systems. 56 00:07:59.910 --> 00:08:07.679 Kjeld Høgsbro: So so the the whole, Theoretical discussion 57 00:08:07.760 --> 00:08:19.439 Kjeld Høgsbro: since 1990 and the year of of brain research. 58 00:08:19.770 --> 00:08:24.020 Kjeld Høgsbro: led to no specific results. 59 00:08:24.710 --> 00:08:25.950 Kjeld Høgsbro: And 60 00:08:27.010 --> 00:08:33.830 Kjeld Høgsbro: but still it the the. The important question is. 61 00:08:34.080 --> 00:09:01.610 Kjeld Høgsbro: that. What is the biological factor when talking about? And here I have chosen schizophrenia. HD. And all system, because in those in this these cases. We know that there must be a biological factor, and it must be a linked to certain genes. 62 00:09:01.630 --> 00:09:14.749 Kjeld Høgsbro: But we know don't know and we have only wake ideas about what genes that this link to, and if the Conc. And what it actually Ca characterize it. 63 00:09:14.790 --> 00:09:26.319 Kjeld Høgsbro: they've been many theories since the 1990, and and I've chosen now to to look at one later contribution 64 00:09:26.320 --> 00:09:47.449 Kjeld Høgsbro: to to this discussion, and it is Simon Baron Cones, the pattern seekers. The E. This book actually deals with autism and a bit about E. He mentioned about switch from here. But we have had a kind of presentation, following the same principles. 65 00:09:47.450 --> 00:09:57.290 Kjeld Høgsbro: at the last conference so on. I I try to elaborate on this premise. 66 00:09:57.530 --> 00:10:04.389 Kjeld Høgsbro: and and the the the premise. For for this way of thinking is 67 00:10:04.920 --> 00:10:06.990 Kjeld Høgsbro: but 68 00:10:07.000 --> 00:10:12.409 Kjeld Høgsbro: that the disability connected to autism. 69 00:10:12.700 --> 00:10:21.939 Kjeld Høgsbro: it is linked to an ability which is necessary for human beings to survive. 70 00:10:22.030 --> 00:10:24.920 Kjeld Høgsbro: The argument is that if it had 71 00:10:25.260 --> 00:10:32.230 Kjeld Høgsbro: didn't have that a connection, if we have died out as a gene 72 00:10:32.230 --> 00:11:01.230 Kjeld Høgsbro: through the evolution and the other argument is that it genetic studies shows the 2 dispositions for autism and and and the pattern recognizing is closely, connected. So if we go on with this kind of thinking we can put it into to this scene at this table 73 00:11:01.230 --> 00:11:06.249 Kjeld Høgsbro: and see what is necessary human competences. 74 00:11:06.410 --> 00:11:29.769 Kjeld Høgsbro: And what is a what turns it into a kind of disability in certain context. And with respect to autism, In a calls with a baron cone. It is the ability to identify patterns with is 75 00:11:29.770 --> 00:11:48.879 Kjeld Høgsbro: a profound ability for human beings, and what actually makes them human, and when it is exaggerated in a mental state. It turns to be an ability to ignore patterns and sold out impressions, and 76 00:11:49.210 --> 00:11:59.989 Kjeld Høgsbro: it could be an ability in specific social context. Fox, for example, able to identify complex patterns in 77 00:12:00.190 --> 00:12:14.130 Kjeld Høgsbro: it. For example, when a given unlimited time, and not distur by other impressions, so it is a kind of a concept where you can use this 78 00:12:14.130 --> 00:12:42.830 Kjeld Høgsbro: ability. in a positive way. A sketch from Veneya was at the last conference in the same way that I find defined as linked to the ability to imagine contractual scenarios, and that has and triple logically seem in necessary for human beings when they were hunters. 79 00:12:43.350 --> 00:12:58.059 Kjeld Høgsbro: but it and it, but when it is exaggerated and not controlled, it turns to it is under the influence of an ability to distinguish between factual and contra factual scenarios. 80 00:12:58.410 --> 00:13:18.460 Kjeld Høgsbro: but it can be used positively in the arts, architecture, and writing authors, and so on. If it as an ability to create artificial scenarios when being able to distinguish between different cognitive states 81 00:13:18.640 --> 00:13:32.880 Kjeld Høgsbro: and the, we know a lot of cases where people with schizophrenia have reached to a level where they are able to control that and and distinguish between 82 00:13:33.050 --> 00:13:44.160 Kjeld Høgsbro: more is exaggerated. And what is something they can can use 83 00:13:44.310 --> 00:14:00.469 Kjeld Høgsbro: as Edge HD is so only my own solution. But in the same way we can link it to the ability to register plenty of visual and auditorial inputs. 84 00:14:00.560 --> 00:14:07.679 Kjeld Høgsbro: And the acceleration of this might lead to inability to focus and concentrate. 85 00:14:07.760 --> 00:14:13.369 Kjeld Høgsbro: And it it it can still be used. For example, I 86 00:14:13.370 --> 00:14:37.389 Kjeld Høgsbro: looked at in interview with A soldier who have been in Afghanistan, and he was, had a severe severe influence of HD. But in Afghanistan on these patrols. He used it positively because he was able to to get in 87 00:14:37.390 --> 00:14:47.709 Kjeld Høgsbro: a lot of visual impressions. Look at the A movement in the bush and and the movements of birds, and so on at the same time. 88 00:14:48.380 --> 00:15:08.950 Kjeld Høgsbro: so If we put this into, we can see that there is an only early face in the socialization where it the small child 89 00:15:08.960 --> 00:15:25.870 Kjeld Høgsbro: have some kind of saturation of these abilities, and it is a met with a sanctions by the parents already, maybe already, in the first phase. 90 00:15:25.870 --> 00:15:45.680 Kjeld Høgsbro: a non verbal face where the mother reacts on. For example, a child with autism because it's difficult to get in contact with the trial. So and so already before after the first phase of socialization 91 00:15:45.680 --> 00:15:57.170 Kjeld Høgsbro: there is, it has developed some part pay a kind of impairment due to some social 92 00:15:57.360 --> 00:16:10.840 Kjeld Høgsbro: stigmatic into action with with with people other people. and later on it. It becomes a a kind of understanding 93 00:16:10.840 --> 00:16:32.770 Kjeld Høgsbro: how the person understands itself. It's a a it becomes a part of identity. I'm not a useful. I can't do this, and I can't do that, and so on. And it makes it. It gets into the social relations and has an influence on 94 00:16:32.770 --> 00:16:47.939 Kjeld Høgsbro: job security, and following certain kind of education, and so on. So, When we go on to to look at this these kinds of 95 00:16:47.970 --> 00:16:49.390 Kjeld Høgsbro: off 96 00:16:49.710 --> 00:16:58.590 Kjeld Høgsbro: into action. I made this team artificial team where I put in this originally 97 00:16:58.600 --> 00:17:15.459 Kjeld Høgsbro: in the and so out impressions. And it, The reactions from the mothers and parents might be anxious, and stress loaded. Pounds worried about strange forms of contact with the child. 98 00:17:15.460 --> 00:17:30.959 Kjeld Høgsbro: and the sociology also gives the context of the family condition. So it it develops this. A difficult is understanding the contextual influence on social interaction 99 00:17:30.960 --> 00:17:47.600 Kjeld Høgsbro: and meaning of expression. And if I'm right, we could already do something at this level by an education of parents and professionals, Dealing with the small child 100 00:17:47.910 --> 00:18:13.130 Kjeld Høgsbro: so. But the results of it will be people with a specific ability to ignore disturbing impressions and getting familiarized with changing social and convention. And when they are put into a context of complex institutional structures, stressful working home conditions, changing schools, many pupils disturbingly at learning conditions. 101 00:18:13.290 --> 00:18:16.179 Kjeld Høgsbro: Complex attention. 102 00:18:17.250 --> 00:18:33.269 Kjeld Høgsbro: a. And These things are well known from a autistic theory. So all this, a part of the model is well known as descriptions of what they have 103 00:18:33.270 --> 00:18:55.129 Kjeld Høgsbro: as problems on ability to cope with performance management to get a job on the bill, unable to get into close contacts and accept frequently trains of relations, and so on. And it is all a already described in in many articles and 104 00:18:55.130 --> 00:18:58.099 Kjeld Høgsbro: folks. But 105 00:18:58.510 --> 00:19:12.940 Kjeld Høgsbro: then it comes to the meeting with psychiatry. When people get into touch with psychiatry, what is going to happen. And then we must realize that 106 00:19:13.920 --> 00:19:14.980 Kjeld Høgsbro: and 107 00:19:15.270 --> 00:19:30.330 Kjeld Høgsbro: people get into a, a, a, 3 dimensional context they have. They are put into a kind of institutions 108 00:19:30.330 --> 00:19:59.339 Kjeld Høgsbro: together with relations to social network. And I investigated and told you about this before. I think that giving you examples and interviews, showing how institutional is settings and is social networks, that discourses and social networks and so on, gets together, and it starts as a situation one 109 00:19:59.640 --> 00:20:03.070 Kjeld Høgsbro: and then a personal development 110 00:20:03.240 --> 00:20:13.670 Kjeld Høgsbro: link to the context they're getting into now. So there's a development from situation one to situation, 2 111 00:20:13.680 --> 00:20:22.570 Kjeld Høgsbro: where they are becoming patients and getting into into the institutional capture. 112 00:20:22.780 --> 00:20:54.899 Kjeld Høgsbro: I've described this or try to figure out, How you could, Encapsulate this development and in a position to to many critical diagnostic, Discussions or discussions about diagnosis? I I realize that 113 00:20:54.940 --> 00:21:13.610 Kjeld Høgsbro: it it all begins with people who are actually excluded. If they don't suffer for anything, they will get in contact with the with the psychiatry and the diagnostic, System? And 114 00:21:13.930 --> 00:21:29.249 Kjeld Høgsbro: so so As a summary of all the interviews I made with those people, I said that the initiation of the context is that they feel, only 115 00:21:29.320 --> 00:21:34.880 Kjeld Høgsbro: they feel anxious, and they feel a kind of good question. 116 00:21:35.070 --> 00:21:42.860 Kjeld Høgsbro: and that is how the meets the patients in the first round. 117 00:21:43.580 --> 00:21:47.170 Kjeld Høgsbro: After this first contact with the psychiatry. 118 00:21:47.280 --> 00:22:06.900 Kjeld Høgsbro: because of disease and society and maybe suicide thinking. there's a period period with consultation. And in very many instances they get different diagnosis. So they are through diagnosis of anxiety. 119 00:22:06.900 --> 00:22:24.230 Kjeld Høgsbro: depression, and borderline. Until a psychiatrist, a a decide that it has nothing to do with that. The call of this is the autism Adhd or schizophrenia. 120 00:22:24.490 --> 00:22:33.979 Kjeld Høgsbro: So this face is a finally, the identification of the disease in accordance with recent diagnostic systems. 121 00:22:34.920 --> 00:22:55.470 Kjeld Høgsbro: It it it. It gives a patient a kind of belief. Now they are not just strange persons, but citizens. Will a recognize problem which demands support. And so they end up in position to, Within a 122 00:22:55.470 --> 00:23:24.930 Kjeld Høgsbro: integration in subgroups, disability organizations and specialized services. And they they feel a kind of recovery combined with socially recognized by density as a person with a personal challenge and specific social context. In my surveys it, it showed that about only 20 123 00:23:24.990 --> 00:23:34.440 Kjeld Høgsbro: percent of the patients had experienced forced medicalization 124 00:23:34.510 --> 00:23:36.460 Kjeld Høgsbro: But 125 00:23:36.979 --> 00:23:43.139 Kjeld Høgsbro: but for for half of them they have also chosen that themselves. 126 00:23:43.290 --> 00:23:53.470 Kjeld Høgsbro: It's kind, these different kinds of side country. It is achievements, or just the possibility of being locked in 127 00:23:53.470 --> 00:24:13.320 Kjeld Høgsbro: a department where you only had to where you were allowed to just sit and look into a wide wall, and there was no social demands on you. Some of my into you show that kind of of choice, too. 128 00:24:14.020 --> 00:24:16.820 Kjeld Høgsbro: So yeah. 129 00:24:17.200 --> 00:24:32.359 Kjeld Høgsbro: summing up, when we are looking at the illness narratives, we have to realize that it is a sequences of events that create experience. 130 00:24:32.470 --> 00:24:52.259 Kjeld Høgsbro: But it's this kind of experience as no meaning to people before they get into contact with discourses of illness, professional discourses, or wildly spread common discourses. 131 00:24:52.260 --> 00:25:08.859 Kjeld Høgsbro: So a. And at the same time they are also on to the influence of culture. Some had called this recently the diagnostic culture. but it all gets into illness narratives. And when you 132 00:25:08.890 --> 00:25:26.990 Kjeld Høgsbro: interview people who have been a long time within the institutions, you can find these elements in how they present themselves and how they define their illness, but in very different ways. And I think it's very important 133 00:25:26.990 --> 00:25:48.449 Kjeld Høgsbro: to listen to the patients, and be aware that there is serious experience referring to sequences of events. And this lies behind the accepted structure in the narrative which is under the influence of accept the discourses and the common culture 134 00:25:48.450 --> 00:25:53.239 Kjeld Høgsbro: of mental understanding, mental illness. So 135 00:25:53.240 --> 00:26:15.699 Kjeld Høgsbro: it is important to be aware of the way the the disability before they become patients themselves, and to notice how their relatives understand the situation. This is an important context of the stigma and getting shame they experience during the following phase of personal crisis. Last. 136 00:26:15.700 --> 00:26:29.579 Kjeld Høgsbro: the illness narrative becomes a complex product of personal experience for professional discourses and public cultural premises, for understanding unfamiliar ways of thinking and 137 00:26:29.580 --> 00:26:43.050 Kjeld Høgsbro: copy. And This unfamiliar ways, the well, the concept of unfamiliar is very important, because if you look at recognition into action 138 00:26:43.050 --> 00:27:00.379 Kjeld Høgsbro: and communication. It's a many people focus on recognition. If you only recognize people and how they think and behave. And make it acceptable. 139 00:27:00.440 --> 00:27:06.360 Kjeld Høgsbro: then you get a solution. But recognition is not that simple? 140 00:27:06.410 --> 00:27:28.409 Kjeld Høgsbro: It is based on a kind of symbolic interaction that is linked to identity. It gives you an identity, and it also, because suppose certain. in identity. So a when people meet other people with 141 00:27:28.440 --> 00:27:43.820 Kjeld Høgsbro: which who they regard as strange or odd in behavior, they have an inner idea of of a normal normality, and that creates certain expectation. 142 00:27:43.920 --> 00:27:48.790 Kjeld Høgsbro: So people don't don't just meet 143 00:27:49.040 --> 00:27:56.010 Kjeld Høgsbro: other people in the perfect to harbour us, we of communication. 144 00:27:56.160 --> 00:28:06.840 Kjeld Høgsbro: but they meet them with certain expectations, because expectations is what gives you a kind of predictability. 145 00:28:07.020 --> 00:28:08.190 Kjeld Høgsbro: Okay? 146 00:28:08.350 --> 00:28:25.610 Kjeld Høgsbro: And the the ability to predict what is going to happen, and how people are going to behave is what it gives you social trust and social security. So when you meet 147 00:28:25.760 --> 00:28:37.519 Kjeld Høgsbro: people with autism and HD. HD. Or schizophrenia, your experience that they are behaving 148 00:28:37.650 --> 00:29:01.909 Kjeld Høgsbro: a. A. In a strange way that you don't understand and contradict your expectation, and that touches your predictability and the way the ability to to predict what's happening and thereby threatening your social security and trust 149 00:29:02.180 --> 00:29:10.949 Kjeld Høgsbro: it all. So happens when you meet sub cultural traits where you that you are not familiar with. 150 00:29:12.410 --> 00:29:37.410 Kjeld Høgsbro: So the the cool thing is, if you are going to. if you are able to to, to change these expectations by some kind of education, and so on. That would open up to to to a more 151 00:29:37.410 --> 00:29:48.599 Kjeld Høgsbro: to a recognition of the the divergent ways of cognitive functioning. 152 00:29:49.270 --> 00:30:00.719 Kjeld Høgsbro: And my research shows some example in the preschool phase. But they, I think I've presented that before. 153 00:30:00.860 --> 00:30:07.260 Kjeld Høgsbro: And so the questions and the challenges for social 154 00:30:07.790 --> 00:30:13.349 Kjeld Høgsbro: it is to deal with certain issues. 155 00:30:13.530 --> 00:30:41.090 Kjeld Høgsbro: The first is, what is the biological call of the disease, the impairment? And how does it influence the first phase of non verbal interaction in the family? I find that would be really great if we could make such studies. Is it possible to regulate this interaction and change the development of the specific developmental disorder? 156 00:30:41.410 --> 00:30:45.860 Kjeld Høgsbro: that would, if we could lack it, would be an enormous help 157 00:30:45.870 --> 00:31:02.919 Kjeld Høgsbro: for the the little human being later in in life. And how does specific cultural premises influence the exceptions. Control the rejection of people with specific, divergent. 158 00:31:02.950 --> 00:31:22.320 Kjeld Høgsbro: cognitive, Functions? We have to to get more more precise specific understanding of the the influence of these cultural premises, and define what it is, what the premises is about. 159 00:31:22.950 --> 00:31:29.080 Kjeld Høgsbro: and is it possible to change some premises through campaigns, decide 160 00:31:29.170 --> 00:31:33.739 Kjeld Høgsbro: education or forms of social action. 161 00:31:34.410 --> 00:31:36.100 Kjeld Høgsbro: This would be great 162 00:31:36.820 --> 00:31:44.020 Kjeld Høgsbro: to launch the accessibility. And within disability studies. 163 00:31:44.400 --> 00:32:03.600 Kjeld Høgsbro: We're not. We are now talking about a universal design not only for people with physical impairments, but also with a for people with cognitive impairments. And, after all, we all all going to get to get 164 00:32:08.110 --> 00:32:21.189 Kjeld Høgsbro: So it it would be useful to get it into a design design of software as well as the design of the physical context 165 00:32:21.190 --> 00:32:40.989 Kjeld Høgsbro: and architecture. Is it possible to make the environment and organizations more accessible for people with divergent cognitive functioning? That is a a great question. and also something which we discussed within this discussion of universal design. 166 00:32:41.670 --> 00:32:49.319 Kjeld Høgsbro: Only universal design means design that is able to to to support 167 00:32:49.420 --> 00:32:57.930 Kjeld Høgsbro: all kinds of people with also with different kinds of of in. 168 00:32:58.940 --> 00:33:12.980 Kjeld Høgsbro: And how does cultural premises influence illness, narrative, and the personal identity of people with divergent cognitive Function? And 169 00:33:13.130 --> 00:33:27.489 Kjeld Høgsbro: this is a also something that would be very nice to know all about. I could just remember this cognitive function, and they'll I don't know. But if you both. 170 00:33:27.780 --> 00:33:37.880 Kjeld Høgsbro: both for ski people with sketch from your autism and ahd the certain demands on the architecture 171 00:33:37.910 --> 00:34:03.160 Kjeld Høgsbro: it must, and not be too confusing and and distracting. people. for example, when getting into a conference too many noises, too many things that is happening will destroy their ability to concentrate and focus. 172 00:34:04.190 --> 00:34:28.350 Kjeld Høgsbro: Well, that was the end of my presentation. I have some pictures. If I have some more time. A. Here is a restaurant that is driven by people who comes right out of the psychiatric treatment. and it became very popular. 173 00:34:28.350 --> 00:34:40.900 Kjeld Høgsbro: And this is a typical way of integrating people and making a context with they can which they can manage. Yeah, thank you for having listened. 174 00:34:47.950 --> 00:34:53.729 Kjeld Høgsbro: Thanks a lot for this. very thoughtful talk 175 00:34:53.980 --> 00:34:55.340 as ever. 176 00:34:55.440 --> 00:35:01.739 and I'm sure that we have many questions from the auditorium. 177 00:35:01.960 --> 00:35:03.190 Can you hear me? 178 00:35:03.690 --> 00:35:08.539 Yes, okay, then, yeah. I will ask 179 00:35:10.140 --> 00:35:28.519 those of you who have questions to. I would ask you to come here and ask your question from this place, because because then Kiel can see you, and Cvr. Seems to have the first question, is that correct? Or you then please come up. 180 00:35:32.860 --> 00:35:42.159 Hi Kyle, thank you very much for this lovely presentation. I have a very short question, the term of illness. Narrative. 181 00:35:42.590 --> 00:35:47.060 I'm wondering if 182 00:35:47.560 --> 00:35:55.320 all people with mental health experiences would agree with this kind of identity 183 00:35:55.420 --> 00:35:59.410 construction. If you 184 00:36:01.580 --> 00:36:16.249 I mean it's a kind of identity construction which is mainly influenced by the illness. And can you give it another name, or is it? Would you really think it's good to 185 00:36:16.300 --> 00:36:19.380 so to address it as illness? 186 00:36:19.550 --> 00:36:20.650 Narrative? 187 00:36:20.820 --> 00:36:32.599 Kjeld Høgsbro: I think you misunderstand the concept. It is narrative about illness. It is not ill narratives. 188 00:36:32.950 --> 00:36:39.200 anyway, so the illness, illness, narrative, it reminds me to illness. 189 00:36:39.680 --> 00:36:54.119 as if The identity of a person with mental health experiences is mainly influenced or impacted by the illness, and is that in line with the recovery approaches? For for instance. 190 00:36:55.880 --> 00:36:59.180 Kjeld Høgsbro: I've just taken over the concept from the 191 00:37:00.100 --> 00:37:06.260 Kjeld Høgsbro: discussion, then I haven't reflected. If it if it's discriminating anything. 192 00:37:06.650 --> 00:37:09.610 Kjeld Høgsbro: yeah. 193 00:37:10.250 --> 00:37:17.219 Kjeld Høgsbro: I use it because I in an interview 194 00:37:17.400 --> 00:37:18.100 Kjeld Høgsbro: er 195 00:37:18.560 --> 00:37:28.860 Kjeld Høgsbro: in in some of my interview I have to ask people, and if there's something they define as their illness. 196 00:37:29.930 --> 00:37:37.029 Kjeld Høgsbro: And, for example, the lady told me, yes, that's when I'm losing control. 197 00:37:37.790 --> 00:37:49.510 Kjeld Høgsbro: And because my relations to to to to people who have gone away dark people 198 00:37:49.920 --> 00:37:56.550 Kjeld Høgsbro: is real although my. 199 00:37:56.590 --> 00:38:08.399 Kjeld Høgsbro: but but it is a reality. But when I'm losing control, and this communication with that person, that is what I would define 200 00:38:08.400 --> 00:38:32.089 Kjeld Høgsbro: as my illness. And she had 2 therapists. The one was the psychiatrist who gave her a medication, so she was still able to get in contact with the dead people, and another was a a person within this specific subconscious who learned how to get control with these 201 00:38:32.130 --> 00:38:35.449 Kjeld Høgsbro: Into actions. So so 202 00:38:35.480 --> 00:38:40.170 Kjeld Høgsbro: that was how she defined her illness 203 00:38:40.900 --> 00:38:42.440 Kjeld Høgsbro: and to 204 00:38:44.120 --> 00:38:46.600 Kjeld Høgsbro: there was no protest about. 205 00:38:47.160 --> 00:38:49.549 Kjeld Høgsbro: Thank you. 206 00:38:51.350 --> 00:38:54.269 Do we have other questions? 207 00:38:55.140 --> 00:39:13.249 I would expect some other questions, and particularly, I'm looking to prove, I think, and maybe you have one, and maybe I would like to ask you. Come here, and can you help me with the chat? I I would like to close this chat window, and I can 208 00:39:13.520 --> 00:39:14.940 this, this, this 209 00:39:15.430 --> 00:39:39.990 Kjeld Høgsbro: but I I I just have one more comment to to the last question that A, when putting this into a the model. You see that she still respect her own experience. But he but she defines in it in a way. So she refer to the cultural idea. But losing control 210 00:39:40.120 --> 00:39:43.740 Kjeld Høgsbro: is something you all not to do. 211 00:39:43.760 --> 00:39:52.680 Kjeld Høgsbro: And the psychiatric discourse of splitting up people between the the the right. 212 00:39:52.730 --> 00:40:06.689 Kjeld Høgsbro: the part of the the person, and then the ill part of the person. So she make a synthesis of these different discourses, and that is the point when you're saying the model. 213 00:40:07.320 --> 00:40:15.100 Okay, thank you, kid, please, please. thanks. Good. Yeah. I appreciate the talk. So 214 00:40:15.570 --> 00:40:19.720 here were some thoughts it feels like. 215 00:40:20.110 --> 00:40:43.229 I guess some professionals might say, well, we have what you'll propose in here already, with, like the bio psycho social model of disease. and obviously you cover a great wave of of different ideas here, but this feels like some of them might contest or be kind of like a tension 216 00:40:43.230 --> 00:40:55.730 in tension with one another. For instance, the biological ideas on disease as opposed to what felt like at the other end. You're looking at medicalisation of everyday life. People who are having 217 00:40:55.840 --> 00:41:01.960 problems in school, or, you know, problems cope in these certain situations. So 218 00:41:01.990 --> 00:41:09.040 I wonder what your response was to this feeling of you. It feels like you're trying to please everybody 219 00:41:09.200 --> 00:41:11.790 in every position here. 220 00:41:13.670 --> 00:41:21.919 Kjeld Høgsbro: yeah. My intention, of course, is when I'm doing this theoretical, constant 221 00:41:22.210 --> 00:41:33.070 Kjeld Høgsbro: thinking all considerations. it is, of course, to make a censuses of how 222 00:41:33.510 --> 00:41:41.430 Kjeld Høgsbro: people already understand it. and then give it a try. a, and change some of the premises. 223 00:41:41.830 --> 00:41:48.979 Kjeld Høgsbro: so so we'll, that's a condition on the way to get into a, theoretical discussion. 224 00:41:49.220 --> 00:41:55.509 okay, thank you okay, thanks a, lot, again. 225 00:41:55.530 --> 00:41:56.720 good. 226 00:41:58.280 --> 00:41:59.540 if there are 227 00:42:00.170 --> 00:42:15.089 thanks back to her, and if there are no other questions I would like not to, as you to help me to with the another presentation of Dirk. Maybe we can have some words later. Here. 228 00:42:22.890 --> 00:42:25.369 if you could stop screen sharing. 229 00:42:25.740 --> 00:42:26.610 please. 230 00:42:30.620 --> 00:42:34.890 Could you stop the the screen sharing? Yeah. 231 00:42:36.710 --> 00:42:37.560 Hmm. 232 00:42:38.520 --> 00:42:41.459 thanks. 233 00:42:41.750 --> 00:42:42.600 No 234 00:42:55.460 --> 00:43:17.090 Hello! And welcome to this presentation on variation is the known, a multi-dimensional account of your cognitive diversity. It's unfortunate and somehow set that I can't be with you in Melbourne, but I would like to share some recent work and research that I am involved 235 00:43:17.130 --> 00:43:44.550 with. It's about the question whether we can develop a science-based and sociologically informed approach which is neutral to the question whether mental disorders do exist, and whether people with mental health issues think of themselves as being mentally ill. You know, this is one of the most discussed problems and issues within psychiatry. 236 00:43:45.230 --> 00:44:13.929 and particularly within people with mental health issues or psychos of provinces I would like to call them. and the secondary aim of this presentation is to derive tools, or to show that one can derive tools which are relevant for the support of people with psychosocial problems, and even many people who consider themselves as not being mentally ill would like to have some support, and would like to have 237 00:44:13.930 --> 00:44:24.949 some attachment to people who may be of aid to them, and I would like to show how these tools can be derived. 238 00:44:24.970 --> 00:44:40.120 From a diversity approach. And this is stem so primarily from the neurodiversity approach which is has been developed by the artistic community in recent years. 239 00:44:42.190 --> 00:45:12.370 But before I start I'd like to take a look at the current state of psychopathological and taxonomic research. There are some very interesting things going on in recent years which are against the known psychopathological classification systems, Dsm and Icd. There is, for example, one approach which is called the p-factor approach. 240 00:45:12.910 --> 00:45:27.790 Defector means the general psychopathology, and this describes that over the lifetime of an individual is vulnerable and maybe develop several different 241 00:45:27.790 --> 00:45:45.399 what we call now disorders. And these people who have developed to the p-factor approach, deny that there are specific boundaries between disorders, and they call it a general psychopathology 242 00:45:45.580 --> 00:46:07.239 which people may suffer from another one. This is the so-called high top taxonomy, hierarchy, taxonomy of psychopathology. This taxonomy suggests that there are, instead of 300 plus disorders which we 243 00:46:07.240 --> 00:46:21.250 are described in the Dsm. Or in the in the Icd. There are only 6 spectra, a Sem. How to form a spectrum and internalizing spectrum. A thought is all the spectrum 244 00:46:21.270 --> 00:46:26.490 detachment spectrum and 2 externalizing spectra. And that's it. 245 00:46:30.450 --> 00:46:45.869 The taxonomic approaches that I have just shown try to tackle a problem that is fundamental to psychiatry, namely, the question, Do we really know what a true medical disorder is? 246 00:46:45.930 --> 00:46:57.240 And the research that I have shown in the previous slides and and others suggest that, in fact, we do not really know what a metal is or is. 247 00:46:57.450 --> 00:47:24.770 and like it's it's been. said in this first quotation there is an absence of a provision of reliably the distinct boundaries, so we cannot really separate ill from well, which means there is an absence of a credible rationale for diagnostic thresholds. So at which, at what point is a a person to consider to be really ill. 248 00:47:24.890 --> 00:47:48.240 and there are also absence of specific etiologies and treatments. Currently and very interestingly, one of the most prominent people in from biomedical Psychic research in the United States. Steve Iman and former Director of the National Institute of Mental Health. He has published in 2,021 a very, very interesting article 249 00:47:48.260 --> 00:48:00.229 called Psychic Disorders, grounded in Human Biology, but not unnatural kinds. He rejects the idea that 250 00:48:00.640 --> 00:48:28.000 psychiatric for you. How also kind of deals with mental disorders is as a kind of a biological, biomedical approach. He suggests that we conduct as in the in the citation, before we cannot really separate from well. And These separations are social, cultural decisions, and he calls them policy. So when we suggest, when we see somebody as 251 00:48:28.000 --> 00:48:39.640 being mentally ill and we diagnose him, then this is a policy decision and not really a biomedical, informed decision. 252 00:48:40.600 --> 00:48:55.040 So we have, in fact. a double boundary problem. When we deal with mental disorders, we cannot separate disorders from one another like W. The disorder W from this order X and this order y. 253 00:48:55.050 --> 00:49:06.049 and we cannot separate function from this this fraction. So we cannot really separate between ill from well. And how can we make sense of this 254 00:49:07.710 --> 00:49:27.950 when we first look now into genetic research? Genetic Greek shells that describes genetic profiles like in this? In this graph a variation of human characteristics which is related to a different risk. Profiles 255 00:49:27.950 --> 00:49:52.179 and these risk profiles show somehow a a shift in in some, in some genetic parts of human biology, and however these interestingly, they are shown as a variation, and somehow as a normal variation. 256 00:49:52.660 --> 00:50:12.559 And how can we make sense of this now. So so I replicate this, I've replicated this into in the next slide, where I show how what I understand as a neuro-cognitive diversity which will start again with genetics. 257 00:50:12.560 --> 00:50:27.239 We have all biological profiles, a genetic profile. We have a neuro biology profile, and these profiles are somehow related. But in a non-deterministic way. 258 00:50:27.300 --> 00:50:45.419 We also have a social environment profile. Some of us are, have been raised in more secure circumstances, others have been raised in more insecure circumstances, in poverty, for example, or in abuse of fellow relations. 259 00:50:46.400 --> 00:50:59.310 and this all culminates in our psychology. Some of us are more resilient. Some of us are more vulnerable towards external stressors. 260 00:50:59.660 --> 00:51:28.889 And in the end we may develop some kind of a psychos or a problem, and some of us may be very distressed when they experience this psychosocial problems, others are very less so distressed. And the important point now is that and this is in accordance with the neurodiversity approach. 261 00:51:28.890 --> 00:51:46.530 that we have to add an appraisal curve. And this reveals that some people who may have a psychosomal problems regard themselves as ill and others not 262 00:51:49.700 --> 00:52:14.079 so. There are many dimensions related to mental health issues. We can attribute causes to them. We have a general appraisal, likes, it have been suggested in the in the previous slide. There are consequences, maybe, for example, social exclusion of the conflict. There are phenomena like the intensity of the mood that we feel, or a positive mood. 263 00:52:14.080 --> 00:52:35.719 there are different perspectives associated with the first or second third-person perspective. The question of autonomy is touched. How how much agency we have capacity. We have the human rights that we want to. See. Then there is a support or therapy dimension which means 264 00:52:35.720 --> 00:52:48.989 with the medic that we can be supported or treated with medication psychotherapy, or, for example, with a recovery approach. And finally, we have a social environment 265 00:52:48.990 --> 00:53:08.900 that is somehow associated to stigma, to one's mental disorders, or to treatment willingness, or the psychological psychologization, namely, the question, How much do we see into ourselves? 266 00:53:11.330 --> 00:53:35.000 This can be? Then, translated into somehow assessment questions like, for example, when we talk about the mental condition. And how do you really feel today? Related to causes? What's, in your opinion has caused your current condition. How do you see yourself? How do others? How do experts see? 267 00:53:35.000 --> 00:53:48.799 your yourselves! This is the perspectives issue, and so on, and so on. And in the end we may ask the person concerned, what kind of support if any, would you like to receive? 268 00:53:48.850 --> 00:53:49.820 So 269 00:53:50.830 --> 00:54:16.759 the idea is that the person concerned is in charge of the definition of like being mentally ill or not being ill, and is in charge of the treatment preferences and the treatment that he or she will receive. So, to to give you an example, we have a mental phenomenon like hearing voices. 270 00:54:16.760 --> 00:54:29.369 These may have negative consequences. This results, then, into a psychosocial problem which may be a crisis or a viewing problem or a disability. And the person 271 00:54:29.370 --> 00:54:52.779 concerned, maybe self, declare him or herself as being mentally ill, or disorders due to biology, psychology. general vulnerability, and so on, or he or she may say, I am not methyl. Here I'm just different. I'm a voice Herea. I'm neuro divergent. My last is not pasta is not being accepted, but I'd like to have some support. 272 00:54:55.410 --> 00:55:10.150 we've get, then, further derived an algorithm from this. I I call this the preference first algorithm. So again, we start with a psychosomal problem. And we ask the person concerned? 273 00:55:10.150 --> 00:55:31.409 Which is his or her preferred support? Solution? it may be. An open dialogue in case of psychosis. For which we don't have really evidence it it may be medication for which we have evidence, and the question is whether this is whether the evidence is relevant or irrelevant. 274 00:55:31.790 --> 00:55:49.250 and we then can ask further whether the evidence is acceptable or inacceptable, for example, related to side effects, and when this person says that the evidence is irrelevant, we can start with open dialogue, and whether, when the 275 00:55:49.250 --> 00:56:02.979 evidence, the medication evidence is unacceptable, and also we can start with open dialogue, or when the evidence is really important that treatment effects are more important in side effects. 276 00:56:03.060 --> 00:56:09.300 then this person can be treated with a medication according to guidelines. 277 00:56:11.950 --> 00:56:40.680 so to summarize. the current state of psychopathological research reveals that we do not really have a better definition of mental disorders. But I think that neurodiversity model may serve as a promising starting point and approach that needs to be back out by science. And as I have hopefully demonstrated that your cognitive diversity approach is able to integrate both natural science elements and psychosocial parts. 278 00:56:40.850 --> 00:57:00.140 And from this neuro-cognitive diversity model. And again, I have probably hopefully shown that we can derive practice related tools and concepts that can be applied to people who would like to have some kind of support. 279 00:57:00.140 --> 00:57:12.179 but who want to be in charge of the the question whether they are ill or not, and which kind of support or treatment they will receive. 280 00:57:12.580 --> 00:57:24.280 So thanks very much for your intention. Best wishes from Switzerland, and I hope to see you some time somehow, soon in person again. 281 00:57:24.520 --> 00:57:25.420 Bye, bye! 282 00:57:27.090 --> 00:57:30.100 Well, I sent my 283 00:57:30.360 --> 00:57:33.770 thanks to Dirk. He cannot hear us. 284 00:57:34.210 --> 00:57:40.019 but I would try now to going back to 285 00:57:40.310 --> 00:57:47.940 gilt. Is this possible? It's the share killed. Are you still there? 286 00:57:48.160 --> 00:57:49.320 Kjeld Høgsbro: Yeah, yeah. 287 00:57:49.400 --> 00:57:53.230 I hope you had your opportunity to follow. Dioc. 288 00:57:53.310 --> 00:58:01.210 Kjeld Høgsbro: Yes, yes, I'm sure I'm sure that you see the overlap between the 2 concepts. 289 00:58:01.280 --> 00:58:03.280 Kjeld Høgsbro: Yes. 290 00:58:03.650 --> 00:58:14.900 and I would. Therefore I would like to ask you first, what do you think about? Maybe the comparability between your approach. 291 00:58:15.200 --> 00:58:21.200 which I'm finding fascinating and innovative, and also the 292 00:58:21.300 --> 00:58:41.020 to this problem, how to deal with mental illness, maybe also with diagnosis, with diagnosing people, with mental health problems, how to speak about mental health problems and how to organize a kind of support system which 293 00:58:41.130 --> 00:58:45.359 it has a basis in the concepts you are provided now. 294 00:58:46.240 --> 00:59:04.250 Kjeld Høgsbro: Yes, I I I very much agree, and I think the 2 presentation supplement each other from 2 different ankles, and I'm just a little afraid of the use of policy like duck did it. 295 00:59:04.390 --> 00:59:25.970 Kjeld Høgsbro: Because on this policy is understood in a full code in Broadway as a decentralized, a power structure, because, it is not understood it it must not be understood as political decisions. for decisions 296 00:59:26.130 --> 00:59:48.730 Kjeld Høgsbro: from about actually, this this discrimination and this no, not acceptance of A new cognitive diversity is something that is going on in the everyday life among people as a cultural premise. 297 00:59:48.750 --> 00:59:50.320 Kjeld Høgsbro: And 298 00:59:50.340 --> 01:00:18.209 Kjeld Høgsbro: our culture. And and maybe the structure of Martin society is not so tolerant, And towards neural cognitive diversity. And that is a dilemma, and that creates the exclusion of people with such problems. And maybe also also it gives them 299 01:00:19.040 --> 01:00:22.409 Kjeld Høgsbro: more problems that they actually have to. 300 01:00:22.430 --> 01:00:40.820 Kjeld Høgsbro: But anyway, a lot of those people, or maybe all of them who have serious problems in this affair is actually excluded and contact the psychiatrics system to get an explanation. And they get an explanation. 301 01:00:41.160 --> 01:00:44.780 Kjeld Høgsbro: and it forms identity. 302 01:00:44.910 --> 01:01:11.240 Kjeld Høgsbro: so that is a kind of I don't know. people in the last discussion at home here in Denmark, organizations, people from the organization of autism has been very critical about research is who says that their illness is just a construction 303 01:01:11.280 --> 01:01:27.299 Kjeld Høgsbro: and something they just think they have. they. They find it a humanistic towards the, it's humanistic interface quotation of what they find is serious problems. 304 01:01:29.110 --> 01:01:30.350 Okay. 305 01:01:32.260 --> 01:01:40.300 do we have any comments or maybe questions from the audience to to this perspective. 306 01:01:42.800 --> 01:01:49.690 Maybe I would like to ask you a a final question to you here. Maybe I'm and I'm hoping that we will get 307 01:01:49.970 --> 01:01:54.309 the opportunity to talk this, maybe in person, in 308 01:01:54.930 --> 01:02:00.210 Kjeld Høgsbro: yes, I would really like that. 309 01:02:00.380 --> 01:02:05.009 My question would be, what do you think about what 310 01:02:05.700 --> 01:02:08.540 what is required by a mental health. 311 01:02:08.960 --> 01:02:16.590 I I would like to use the old, the old term Mental health service system, mental health 312 01:02:16.690 --> 01:02:22.490 support system. How must a mental health support system be organized 313 01:02:22.870 --> 01:02:24.330 to take 314 01:02:24.670 --> 01:02:30.719 into account this perspective. You and I think also there 315 01:02:30.740 --> 01:02:35.229 provided us today. What do you think? How, what what our essential 316 01:02:35.270 --> 01:02:38.199 aspects of such a services, too. 317 01:02:40.610 --> 01:02:44.650 Kjeld Høgsbro: it is, it is, 318 01:02:45.880 --> 01:03:08.470 Kjeld Høgsbro: There's no a simple solution. But I had a great project on HD. And financed by the Social Ministry, and I came up with a kind of metrics for what the the local authorities could actually do to support these people 319 01:03:08.490 --> 01:03:11.150 Kjeld Høgsbro: on a much better way 320 01:03:11.450 --> 01:03:28.870 Kjeld Høgsbro: But but right now we are facing a clock down and psychiatric services, and so on. So a lot of those ideas that people professionals already have is not a put into practice because of this 321 01:03:28.870 --> 01:03:44.049 Kjeld Høgsbro: in the psychiatric services. But I I have worked with it. It's it would take too long time to present these metrics for for what they could build up as this support system. 322 01:03:44.560 --> 01:03:47.950 Kjeld Høgsbro: but but I have made some 323 01:03:48.410 --> 01:03:50.930 Kjeld Høgsbro: considerations. Not fair. 324 01:03:52.340 --> 01:04:08.710 Okay, that sounds a little pessimistic, and I hope maybe I I have no better idea at the moment I think I would have to some ideas. And one of one of what I think is a a very basic requirement 325 01:04:08.790 --> 01:04:12.929 or for mental health care systems is. But 326 01:04:13.330 --> 01:04:25.150 when we, when we go back to the To Dix presentation, he said that one a good solution would be that people who have these problems have the possibility to. 327 01:04:25.510 --> 01:04:34.780 to, to, to, to. to express their wish for support, if they think they need support. 328 01:04:34.860 --> 01:04:39.079 and what kind of support they 329 01:04:39.350 --> 01:04:46.879 what say in which way they would would like it. Would they like to be supported? 330 01:04:47.350 --> 01:04:49.960 And I think this is a 331 01:04:50.040 --> 01:05:00.200 very important precondition that this spectrum, because the big condition for giving people. The possibility to choose 332 01:05:00.210 --> 01:05:02.110 from services 333 01:05:02.190 --> 01:05:07.530 means that they must exist. It must be provided. And and 334 01:05:07.700 --> 01:05:16.110 if that is not the case, then it's difficult to give them some choice. If you have not nothing to choose from, then it's difficult to make choices. 335 01:05:16.490 --> 01:05:23.779 Kjeld Høgsbro: and the and and the refers to the model of open dialogue. And I really think that's a good idea. 336 01:05:23.970 --> 01:05:33.129 Kjeld Høgsbro: it's it's a perfect concept. And model would appreciate it. What if it would be implemented. 337 01:05:33.320 --> 01:05:40.819 Kjeld Høgsbro: But when I look at the resources in the system. I think it's a kind of 338 01:05:40.990 --> 01:06:08.829 Kjeld Høgsbro: well, I would like to see it practice. But in my metrics. I. It work with different levels of economic resources that the lowest level does stuff demand for the resources. And it also over there operates with a lot of models that I have worked with earlier. For example, sales, help groups and local con, the open consumption centers. 339 01:06:08.990 --> 01:06:12.719 Kjeld Høgsbro: A for people who just feel that there's something wrong. 340 01:06:13.720 --> 01:06:33.129 Kjeld Høgsbro: So in the in Norway, for example, there was in the legislation an application to offer self help, groups to to people locally. And and so that that's what I'm talking about that there's a lot of good ideas in the field that could be put together. 341 01:06:34.180 --> 01:06:35.130 Okay. 342 01:06:35.640 --> 01:06:57.650 I think now we have a little bit more pessimistic perspective for the future. And I'm glad to hear this 2 presentations today, the the opportunity and to discuss with you and the the audience, and yes, but but they have one comment or question. Please come 343 01:06:57.900 --> 01:07:00.089 and talk directly to each other. 344 01:07:00.650 --> 01:07:03.529 No, come here, then, he can see you 345 01:07:03.750 --> 01:07:04.700 sorry? 346 01:07:07.380 --> 01:07:08.480 Hi. 347 01:07:08.680 --> 01:07:21.519 I I have Angelica from the Philippines. So I would just like to comment on the this conceptualization of mental health, since. I think. 348 01:07:21.640 --> 01:07:28.230 generally developing countries or low-income countries cannot relate. 349 01:07:28.250 --> 01:07:30.110 Do that. 350 01:07:31.150 --> 01:07:36.709 let's say, for example, in our country, not all communities have this concept of mental health. 351 01:07:36.840 --> 01:07:49.350 and since they don't have this concept of mental health, how then are they go? How? How then, will they ask for mental health? for help with regard to mental health 352 01:07:49.990 --> 01:07:57.390 and I think you are also aware that in some low-income countries developing countries like the Philippines 353 01:07:57.630 --> 01:08:08.640 people, there are even having the difficulty to meet even the most basic needs. Then how, then, are they going to 354 01:08:08.650 --> 01:08:12.289 meet the psychological needs 355 01:08:12.340 --> 01:08:17.959 when even the most basic living needs cannot be met. 356 01:08:18.170 --> 01:08:21.640 Kjeld Høgsbro: So I think that's 357 01:08:21.760 --> 01:08:23.660 yes. 358 01:08:23.720 --> 01:08:29.850 Kjeld Høgsbro: yes, that makes it very relevant on the global base 359 01:08:29.860 --> 01:08:47.890 Kjeld Høgsbro: perspective. To to to look at the the cultures and the different cultures around it that earlier surveys international service once concluded that in the the 360 01:08:47.890 --> 01:09:17.210 Kjeld Høgsbro: the developing countries, if people were later excluded from society, and they er earlier turned back and were included in society. So in this aspect it was friendly towards the illness, and Looking into the culture more acceptable to have divergent co cognitive functions. 361 01:09:17.210 --> 01:09:42.639 Kjeld Høgsbro: and in in some conscious you do, it is not a pretty. It is not necessary to keep control. Sometimes it's it appreciated to lose control. So so the cultural context of understanding this, these things as is problems are very different. 362 01:09:43.190 --> 01:09:51.500 Kjeld Høgsbro: so and and and the family ties sometimes 363 01:09:52.290 --> 01:10:03.069 Kjeld Høgsbro: cope with it. But I'm not romantic in in that far. Some some local communities also very 364 01:10:03.590 --> 01:10:20.110 Kjeld Høgsbro: excluding in their relation to you to to people will will mental deions. Well, But they, on an average It seems to be that mental illness. 365 01:10:20.160 --> 01:10:30.530 Kjeld Høgsbro: our pitching a to a higher level of problems. Connected to organization and modernization. 366 01:10:30.810 --> 01:10:39.060 Kjeld Høgsbro: The more you're getting into urbanization and modernization, the more you exclude people with cognitive problems. 367 01:10:40.730 --> 01:10:45.690 I think that is a final hypothesis. And 368 01:10:45.810 --> 01:10:48.549 maybe with your answer, or 369 01:10:50.480 --> 01:10:52.619 Okay, Sylvia. 370 01:10:56.330 --> 01:10:58.400 And 371 01:10:58.510 --> 01:11:14.859 it's in Georgia's presentation. And this model which which is on theoretical phase, is really amazing, and including that, as we said, we have the resources, and we have all those services which we know from evidence that they are 372 01:11:15.060 --> 01:11:16.720 some of these events. 373 01:11:18.140 --> 01:11:43.279 Sorry. Did you? Did you hear it, Kil? So far? No, no. Sorry I got to mark the mic. It was just a comment that when I listen to Dx presentation and the model he had which is really convincing. And let's say we? We do have all the resources, psychosocial interventions, and a very rich system. 374 01:11:43.280 --> 01:11:54.360 still it sounds to me As a very rational approach to mental health issues. 375 01:11:54.650 --> 01:12:00.799 So if you have the right services and appropriate services. 376 01:12:00.890 --> 01:12:08.760 mental health issues are going to be, I don't know. It's it's a solution. But what if 377 01:12:08.760 --> 01:12:22.300 this rational approach does not work, and I speak concretely about, maybe it's just a minority of people with severe mental disorders who are. 378 01:12:22.300 --> 01:12:45.069 I think, a bit of forgotten and such systems, because they do not have such a rational approach that you just have to propose, or just to introduce To good or 3 solutions, and they can choose it, and everything is going to be good. And this is what I mentioned before, that there is a risk 379 01:12:45.070 --> 01:13:08.540 that all those things we do not like to talk about, and we do not like to handle with, which is concretely violence. Violence is a human condition, and it has to do with severe mental disorders. And what about this group? What happens with these people? Very vulnerable and severe, with severe mental illness? 380 01:13:08.540 --> 01:13:21.499 What happens? And do we really think in those models who are rational and very convincing? I like it. But is there a risk that we might forget about these people. 381 01:13:21.740 --> 01:13:25.730 And what is the answer to to this question? 382 01:13:28.910 --> 01:13:46.030 Kjeld Høgsbro: yeah, I think you're right. But but maybe you could could define it more specifically. I just came to think that that this possibility of choosing 383 01:13:46.200 --> 01:14:01.479 Kjeld Høgsbro: and getting influence on the the treatment and the services through an open dialogue. it seems a it seems rationally a great 384 01:14:01.720 --> 01:14:14.339 Kjeld Høgsbro: but went on to my experience. these consultations, where there is dominance of professionals 385 01:14:14.410 --> 01:14:15.520 Kjeld Høgsbro: and 386 01:14:15.750 --> 01:14:38.990 Kjeld Høgsbro: supporting professionals they like, but they still link to certain professional discourses. And it it it. It gives a lot of pressure on the people to understand it. They have problems in a professional way, and that is what we in our society call rational. 387 01:14:39.660 --> 01:14:49.029 Kjeld Høgsbro: So rationality. I'm really inspired by focal rational. It's rationality is a kind of discourse. 388 01:14:49.580 --> 01:14:57.909 Kjeld Høgsbro: and we have several kinds of rationalities. And that's why I also have this element of self help groups. 389 01:14:58.420 --> 01:15:00.650 Kjeld Høgsbro: And then 5 series, centers 390 01:15:01.240 --> 01:15:11.809 Kjeld Høgsbro: and services is that include earlier patients and so on. I've seen and study the most. Serve these kinds of dynamics. 391 01:15:14.280 --> 01:15:20.490 I would take this as a good closing word, and 392 01:15:20.840 --> 01:15:26.949 I'm seeing people getting hungry here and thirsty particularly. 393 01:15:27.930 --> 01:15:35.730 Kjeld Høgsbro: I don't understand you. I just have one final remark, and that was so what you said. 394 01:15:35.750 --> 01:15:44.540 Kjeld Høgsbro: this is a kind of invitation. So I could really look forward. If someone is forming a group. 395 01:15:45.500 --> 01:15:57.490 Kjeld Høgsbro: we in this research committee to try to further elaborate and and discuss those possibilities. 396 01:15:57.530 --> 01:16:16.109 I'm sure we will discuss this tonight when we going out to eat and drink with the colleagues here. You cannot. Okay. I would like to thank you and Dirk for this inspiration 397 01:16:16.150 --> 01:16:32.290 and for yes, motivating us to discuss. Only a few of us are here now, but I think the discussion I I liked it very much. Thanks a lot to all work, and also to burn. And yes, see you next time. 398 01:16:32.790 --> 01:16:33.860 Really.