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Neoliberalism and it's impact in remote areas. 

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Neoliberalism and it's impact in remote areas. 

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Modern Liberal Theory (strengths and resources)

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Modern Liberal Theory (strengths and resources)

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From 53:30min (for about 7mins) Michael White gives a fascinating account on how societal constructs shape our language and then eventually the way we frame our emotional needs and even our identity. It makes me reflect on my use of language and how I need to be mindful of historical and societal concepts present in my cultural background.
https://vimeo.com/34671797

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Trauma and Narrative Therapy - Michael White  Part 1

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Michael White presented an all day workshop on his  narrative therapy approach to working with trauma survivors at the International Trauma Studies Program
in New York City on April 1, 2007. The videoed portion of the workshop is in five parts.

For more information on the International Trauma Studies Program, write to Jack Saul, Director, at info@itspnyc.org or visit our website at www.itspnyc.org

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One thing that stands out to me when thinking about Neoliberalism and the Western Medical model is hierarchy.  A simple example is Dr's placed above nurses.  Dr's being the 'Expert' and nurses being the Dr's helpers.  Prestige and remuneration reflect this.  I understand Dr's study for longer but what about a nurse that practices for 20yrs compared with a Dr fresh out of Uni? Who would you prefer to consult with?  What about a nurse that has a similar cultural background to a patient? who will have more insight?
Reflecting on hierarchy in relation to Indigenous people; In Victoria, public hospitals have employed an 'Indigenous Liaison Officer'. The role might have an impact in terms of health outcomes because community members can be transported, improving access. Perhaps improved communication etc. However, as an officer, the position in the hierarchy is still at the bottom, as opposed to a specialist medical practitioner, the expert. Like Koori Education Support Officers in schools, Koori students, or in hospitals Koori patients are directed toward these 'officers' without a genuine expectation for the Experts to learn from them. Perhaps if they were Cultural Specialists, remunerated accordingly, the knowledge they have might be valued by professionals in expert roles. Where the specialists see them as equals and are inclined to learn from them.

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When Bill Shorten was working so hard to create the NDIS, I think/ hope he was being as altruistic as a ‘pollie’ can be. Surely he could see how bureaucracy would ultimately absorb it as it’s own. Like so many areas of our Australian system, such as childcare, TAFE etc, smart moneymakers are never far from the trough they see as easily manipulated government money!

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Natural Therapies Review 2019–20 | Australian Government Department of Health

The medical model is completely westernised and Neoliberalism has ensured natural therapies are seen as unimportant when in fact as someone else raised above, private health have already recognized what's working and removed it from rebates. (See attachment for more info.)

We need to start looking at Natural therapies that are culturally relevant to people.

Trauma needs a lot more money invested into recognised research. We can continue to look at standardised blood test but more important than this is the person's sense of identity in the world and their ability to function- in a culturally appropriate way!

Neoliberalism only seeks to further marginalise those 'at the top'. That if anything is medicalised or 'clinically recognised' is currently quite dangerous. It's about time it was put to better use and used to recognise the absolute necessity and importance of cultural practices. Jane

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Australian Government Department of Health

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Why we're having this review

From 1 April 2019, private health insurers cannot offer cover for these natural therapies:

Since our last review in 2014-15, additional evidence on the clinical effectiveness of these therapies has been identified.

What we're reviewing

The 2019-20 review will:

look at the additional evidence

advise if private health insurance should cover any of the therapies.

How we're reviewing it

For an overview of how the Natural Therapies Review is being undertaken see the Natural Therapies Review process and governance infographic.

The Department holds regular teleconferences to provide updates for stakeholders. For more information on these teleconferences please contact the review secretariat at naturaltherapiesreview [at] health.gov.au .

Natural Therapies Review Expert Advisory Panel

The Australian Government's Chief Medical Officer set up the Natural Therapies Review Expert Advisory Panel to help with the review. The Deputy Chief Medical Officer, Professor Michael Kidd, now leads the review.

The advisory panel includes members with experience in:

researching or assessing scientific evidence of clinical effectiveness

the practice of natural therapies.

Natural Therapies Working Committee

The National Health and Medical Research Council (NHMRC) is supporting the review.

The council has set up the Natural Therapies Working Committee to oversee the evidence evaluations for the review.

Please see the NHMRC's review webpage for information on the evidence evaluations including:

descriptions of the natural therapies under review as used for the evidence evaluations; and

indicative progress of the 16 evidence evaluations.

Calls for evidence

The review included the opportunity for natural therapy organisations and members of the public to submit scientific evidence of the clinical effectiveness of the natural therapies under review.

This opportunity was provided through the:

Tranche 1 call for evidence for Western herbalism, naturopathy, Pilates, Rolfing, shiatsu, tai chi, and yoga

Tranche 2 call for evidence for Alexander technique, aromatherapy, Bowen therapy, Buteyko, Feldenkrais, homeopathy, iridology, kinesiology and reflexology.

Both calls for evidence have now closed.

Submitted evidence

These documents provide the details of the scientific research citations (excluding submitter details) submitted through both the Tranche 1 and Tranche 2 calls for evidence.

Evidence will be published progressively for those natural therapies where the National Health and Medical Research Council evidence reviewers have published the final research protocols. This will avoid potential bias in development of the research protocols.

Contact

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From 1 April 2019, private health insurers cannot offer cover for these natural therapies: Since our last review in 2014-15, additional evidence on the clinical effectiveness of these therapies has been identified. The 2019-20 review will: look at the additional evidence advise if private health insurance should cover any of the therapies.

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Sharing something that just dropped into my inbox - free online festival featuring elders, activists and educators including Resmaa Menakem - "Topics exploring the lived impact of culture AND the role of arts, creativity and the imaginal that serve liberation. We’re bringing in art, music, writing workshops, communal contact zones and integration pieces, and movement and dance in how we engage with this topic and the beautiful life force at the heart of it all."

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Sharing something that just dropped into my inbox - free online festival featuring elders, activists and educators including Resmaa Menakem - "Topics exploring the lived impact of culture AND the role of arts, creativity and the imaginal that serve liberation. We’re bringing in art, music, writing workshops, communal contact zones and integration pieces, and movement and dance in how we engage with this topic and the beautiful life force at the heart of it all."

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Tending the Roots - The Rooted Global Village

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For me it about who makes the decsions and policy's for our enviroment . Our town is classed as a service centre for the region and services pastoral properties and remote communities and relies heavy on government funding and resources.
The governement will tell you its them the elected members that make the decsions, but really it is the government heads and  advisors.
I have seen governments change but still the policys are the same, just different words or slants put on them.
Our community, town and region  have not faired well over the last few years and most of it has been due to government policy both as the Territory and Federal level.

The elected members visit, people meet and talk with them about issues and concerns,  and it seems to be just that, talk.
Pene Curtis

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These videos were amazing.
I personally have been frustrated during the pandemic with the responses from different sectors of the community. The nightly news was 'Health expert says we need to do this', business owner of XYZ says 'We can't do that cause I won't sell enough lattes'. I have worked with councils and traders groups over the years and small business is always struggling and no solution is enough or right for them, yet they are such a loud voice in our community that public health direction has been based on their need for financial survival over all of our need to live. Yes, having an income that pays for basic needs such as food and shelter is a human right, but there needs to be a stronger consideration for the collective. It's a difficult policy line to manage and so many angry voices getting airtime.
(Roberta from Melbourne/Naarm)

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The graphic may make you think about education but it applies to the medical model as well.  Think of the exam as a medical examination.  It is inevitably an examination by a western trained doctor, using evidence based techniques none of which will address your spirit, or balance.

There is very little room in the medical model for things that don't fit in their boxes.  The 2019 changes to private health that stopped claims through extras for a range of "complementary" medicines including western herbalism are an example of controls exert to reinforce the medical model.

In our current model treating a "bad" back with QiGong would not be acceptable.  Yet a work trip to China many years ago had my husband taken to a QiGong practitioner instead of the local hospital for just that reason.  The result - the practitioner balanced his Qi over two sessions and sent him home in better shape than he'd been in for years.

The current medical model, particularly in Australia is promoted and protected by groups with vested interests in collaboration with government.   An example could be seen in the requirement for private practice nurse practitioners to be supervised when administering COVID-19 vaccinations (ABC 22Mar2021).  Despite extensive qualifications and experience they were sidelined.  As many practice in remote and/or low socio-economic areas their clients were disadvantaged by distance and access to alternative services.

Medicine is a business as well as a healing career now.  Clinics in the same town compete instead of cooperate, the economics of opening a satellite clinic in outlying towns comes before the necessity
of health care provision for a population.  All of this impacts health care - especially for those with chronic conditions, for young families and the elderly.

Basically treatments that don't fit a box, people that don't fit a box or areas that don't fit a box are like the fish, the goat and the cow in the picture. They fail the exam. Not because they aren't good enough but because the Medical Model does not, currently, accommodate them.

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Do we really want to support and care for people? By Cheryl Rosso

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Do we really want to support and care for people? By Cheryl Rosso

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I work with the most vulnerable youth.  I’d like to think that my role in helping these youth is beneficial however its clear to me in my experience, that the systems in place do not support the health and wellbeing of these youth or people in general for that matter.  Usually, by time youth come to see me for help, I’m the last port of call, their last ditch effort to obtain a different outcome. It’s very common for these youth to have been looped through several services, even time and time again, with short-term impractical support that does not actually solve the root cause of the problems being faced.  We don’t acknowledge the resilience and skills these people have to have survived time and time again.  Its rarely asked.
Due to the increasing neo-liberal ways of doing, with evidence based practices and quantitative KPI’s, it appears as though these people are being helped, on paper.  In reality, it doesn’t even scratch the surface to what these people have endured and what help they really need.  Boxes are being ticked but these people are accessing the same services for the same support, with little to no difference in their situation. Organisations don’t want to collaborate with each other, as they have to think about the bottom line - FUNDING. The ego displayed in full force, when discussions are had not about the positive impact on the person, rather which organisation did the most, who is going to receive the accolades.  Its manipulation at it best.
Vicarious trauma, a result of this wonderful assistance to these vulnerable people.  These people who have to re-tell their story, meet certain criteria, be categorised with the right label to even get their foot through the door. Some labels negates the support over other labels.  ie if you have mental health conditions however you are a drug user, you cannot access mental health support until you get off the drugs. But many I know cannot fathom getting off the drugs, because that’s they way that they have managed their mental health - its a vicious cycle.  The current medical model is like a revolving door, next one in, next one out.  A total absence of care, support and compassion and ‘no time’ to spend with these people, regardless of whether this is what a service is being funded for.  Workers on the ground resort to bending and stretching the boundaries, having to work creative and strategically to get the right support. And even then, if the person is able to come out on the other side of all of this, their experience, the impact will never be truly captured, therefore reinforcing the limitations that exists in the current model.

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The medical model.
Neoliberalism and the medical model.
It cannot be sustained indefinitely.
The trauma-informed practice is only just beginning to enter in to the mainstream of psychiatry and psychology.
Mis-diagnosis is prevalent in all communities across the globe.
A better informed medical model can only mean better outcomes for the individual and a better contribution to society community as a whole.
(Completed before reviewing medical model resources).  26/3/2022 Katerina Athanassiou

The medical model.
Neoliberalism and the medical model.
It can only get better with programs like Wurrimiyanga Health Centre.
Going for a bush walk, swimming in ocean water, going for a jog, creative arts, crotchet, connecting with family, connecting with friends.
Psychiatry and Psychology are more than just a medication.  They require a wholistic approach.
How can we move away from the standard four walled office, thirty minute chat or one hour session to being outdoors as part of mental health?  I wonder, will Wurrimiyanga lead the way globally?
Thank you Department of Social Services, Australian Government (2010).
26/3/2022 Katerina Athanassiou

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Currently, I work in paediatric private practice. In the last 2 years, I've become increasingly aware of the number of 'pop up practices' run by recently graduated students. Support and services are needed YES- however clients are not the motivator- it's financial. Under the NDIS allied health is capped at $193 dollars- almost double what it was prior to the roll out. Working under a company you don't make anymore than you previously did- but business charge the premium and receive the difference. In turn therapy price rises-> larger budgets are needed to cover services-> some people receive larger budgets/ some are not given access under the disability 'formula'-> engage services that are not meaningful. Neoliberalism is beginning to affect private practice and is truly transforming the landscape, not necessarily for the better.
Savannah Abbott

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It's just so easy to blame people from vulnerable / marginalised / isolated groups for "choosing" not to access the services, or do the things that they need to do in order to be well.  The consideration of how social and financial inequity, the decimation of culture through colonisation, the impact of trauma (both incidental and sustained) and the experience of discrimination and oppression impacts not only on a person's health, but also on their capacity to access treatment is lacking.

I've been so lucky in my career to have worked in some amazing remote Aboriginal communities.  It has given me an insight into the strengths and the challenges faced by families in these areas.

I'm horrified by the standard of living conditions for many people in these communities - disgusted that although overcrowding continues to increase risk and stressors for children and families, newly built properties are reserved for health and community services to attract a suitable workforce rather than provided to local people.

Many families I met had over 15 people living in a small home, with no alternative accommodation available unless people were prepared to leave their family and community.  Risk assessments from health and child protection services consistently undervalued the protective factors of culture and community.  Health issues, that are often caused by poverty, not because parents don't love their children continue to see children removed from families.  Infectious diseases (e.g. scabies) spread rapidly, nutritious food was limited in supply and family's capacity to store food safely was restricted as fridges / freezers etc were only available if you had the means to travel 5 hours away (and a vehicle large enough to fit the item in when you picked it up).  Electricity supply was frequently disrupted and only available through a pre-paid card.  If the value on the card ran out before payday, and nobody could help out in a hurry, it was just too bad and food spoiled, lights, stoves  and fans / air-conditioning all stopped.

Women cannot birth in their communities in some of these locations - because the health system says it's unsafe as if they need emergency care, the hospitals are ill-equipped to provide it.  The result is that pregnant women leave their families up to a month (or more) before they give birth and travel to larger regional towns where they are often without support.  Community requests to consider doulas so that women do not have to leave their families and community to give birth have not been successful, nor have requests to upgrade medical facilities.

Treatment of chronic health conditions in these communities is so hard - take diabetes for instance.  Monitoring blood glucose levels and eating the recommended diet is challenging enough when everything you need is available, but when the roads to the community are cut off for 3 months during the wet season (so the one shop has limited fresh vegetables or meat), when the one take-away sells unhealthy food for a fraction of the price of healthy food, when the only outreach health service is defunded and people had to then present at the hospital, it's easy to see how things can get significantly worse and people end up on dialysis or with limb amputation.  Even further impacted when many visiting health staff don't seem to understand the importance of cultural or community protocols or the significance of trauma experience.   For a truly heartbreaking story about the failures of the medical model in remote communities, watch "Heart Failure", the recent 4-Corners (ABC iView) story on Rheumatic Heart Disease in Doomadgee.

There's lots of great stuff that visits these communities - travelling in and out as funding permits .. but even just this week I learned that the sexual assault women's worker is only physically in town for 2 days a month, which is grossly inadequate for the level of need and the impact on women's health and family's wellbeing.  If this was happening in a different area ... well, it wouldn't be happening ..

The creative opportunities to build people's connection to health promotion activities often seems to stagnate at the "engagement" level - and even the codesign conversations with the services and community members are restricted by what the Govt funding requirements are and rarely are community or family members considered as strengths to support children and their families.

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The basics of the medical model is that, firstly, the physical health (eg Type Two Diabetes) is focused on (which it has to be initially) with appropriate medication and blood glucose monitoring, but then the socio-emotional wellbeing of the person is not intertwined with their holistic care. Secondly, health education and health promotion activities/programs to include the person's culture, family, community and country are not part of their journey to wellness and self-determination. Thirdly, the person (and their cultural expertise) is historically disempowered while the medical paternalism and control is superimposed on the person. The person is seen to be "non-compliant", "needs to be growled", "is deemed unable to manage their disease, and therefor needs it to managed for them by a clinician!". The person's power is stripped from them and the clinician expects the person to change to western medicine practices totally, rather than the clinician adopting a cultural humility, learning and understanding model.
Leanne McGill

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Rob - The business of medicine. Prevention B4 Intervention is bad for business.

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Rob - The business of medicine. Prevention B4 Intervention is bad for business.

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The current medical model is a business.  Everything in life has a financial cost and in Australia we may feel that medical support is free, however it is not because the pubic health system is funded by taxes. Most of, if not all medication and medical supplies are produced and created by private business who have profit as their primary goal outcome.

With profit as the goal, the business of medicine has the vested interest in the population being sick and there are many facets of society that could be contributing to a population of sick people feeding the machine of medicine.  Therefore, if we do not focus on our health and wellbeing we will become sick and need to get medical assistance.

Creative therapies has the potential to contribute to participants connectedness to ‘self’; being comfortable and content with their existence and less judgmental of who they feel they are (identity) or should be.  Through a regular practice, or ritual, a participant will allocate time to the ‘self’ respecting their individual need and right to believe they have control over their governing system; their brain and body integrated, for use within space…..

There will always be a need for medical intervention, however if there was less focus on profit and more focus and individual wellbeing & community wellbeing there will be less isolation and more connectedness providing more opportunity for individuals to share their thoughts and feelings, releasing them, resulting in free flowing energy within the human system which may mean, less stressful thoughts causing blockages in the complex intuitive human system which can cause illness.

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What does this mean for Creative Therapy?

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What does this mean for Creative Therapy?

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This week's topic is a really big area that warrants extensive exploration in order to ensure that creative therapies are effectively designed to genuinely assist people to build their mental and spiritual well-being in a structured way, that can have physical health outcomes. It seems that the focus of the health care system is largely on medical responses where health is considered to be the "absence of disease" and issues with health are treated with medical "intervention and procedures". This approach of course has its place, say if you break your arm you are pretty open to the medical model. But if you find that you are not being fulfilled or are not happy in your daily experience the medical model may not offer you much, and more creative options can be of greater value, despite them often being less well understood and practiced.

It is not yet clear the link between neoliberalism and the medical model. If we assume that neoliberalism is basically the idea that private corporation should be able to do whatever they like, not pay much tax, and be protected from government 'interference', because this will be better for everyone, despite this clearly not being the case, then perhaps the link is that, particularly in the USA, medical insurance and services are typically provided by private companies at a high cost using the medical model and are often based on ongoing medicine provision, with creative or alternative options overlooked or at least less supported. The emerging field of creative therapy has a critical role to play in providing structure and consistent practice to allow creative endeavours to be part of healing and well-being. However it will be very important that practitioners of "creative therapies" are as good at the 'therapy' part as they are at the 'creative' part, as although most creative endeavour is therapeutic it needs to be explicit.

So if the medical model is focused on selling medicine and medical procedures regardless of the state of mind and wellbeing of the patent, and even perhaps doing so intentionally to provide the greatest market for such ongoing sales, where does creative therapy fit? Looking online it seems that the alternative to the "Medical Model" is a "Therapeutic Model", or a "Social Model", or a "Psychosocial/Behavioural Model". Perhaps both models are needed. When we have a medical condition we need the medical model to respond, however this is not all we need as it is clear that our psychological conditions affect the health of our body and this also needs to be addressed. Perhaps the unnecessary pressure placed on the body due to psychological states of fear, anxiety, or anticipation that cause diminished health outcomes can't be treated by focusing on the symptoms of the pressure but rather but initially addressing these symptoms and then addressing the root physiological causes. Perhaps also the field of psychology which is based around dialog and sharing can be enhanced by including creative endeavour in a structured and rigorous way?

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Economy over health: Neoliberalism is destroying lives

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Throughout the pandemic, the Australian Government has been heavily focused on the economy, leaving Australians to fend for themselves, writes Lakeisha Watkins. DESPITE THE TIME that has passed, Australia is still unable to manage this pandemic as it puts its focus into the wrong places.

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This is a great explanation of Neo liberalism, just be aware dude pops the balloon after filling it with air (scared the fritzers out of me)

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Gabor Mate  - Beyond the Medical Model - AARM

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Indigenous Australian Knowing and western ways (post by Nadia Di Martino)

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Indigenous Australian Knowing and western ways (post by Nadia Di Martino)

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"Whereas in Western culture the world can be manipulated and controlled through ‘doing’ in our worldview we see ourselves fed by quality of relationships. Because you will hear the white professors say that my people will whack it out cheaply. The therapy is about restoration of pride and ‘stirring’ up of the spiritual things so that these people believe in their inner self. It is coming from the inner source, with a story attached to it and it is not a dollar thing. There has to be a belief that they are taking part in creation itself." (Lawson, Woods & McKenna, 2019, p. 99)

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Share your thoughts about the  medical model 

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Share your thoughts about the  medical model 

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Shar your thoughts about the  medical model 