ii Comparison and Contrasting the Meikirch Model and Hodges' model

Meikirch Model

Quite some time has passed since June 1st and part 1. I don't think this post can wait 18 years like that preceding! It is good to see '(Biologically given) potential' emphasized in the Meikirch Model; and the arrows which refer to:

'Whenever the five components and the ten complex interactions (double arrows) cooperate in a purposeful way, health may result. More specifically, a person is healthy, if by the two potentials she or he is in a position to respond satisfactorily to the demands of life.'

The interactions are explained in more detail. Mental health (illness) is there in 'personally acquired potential', but I wonder if it needs to be more explicit? Although, is this a welcome 'break' from the mind-BODY Cartesian divide and its legacy? A shift that enables a more constructive (less stigmatizing) formulation?

Given the climate crisis and experience of COVID, we can hopefully retain a sense of our individual proximity to the environment and green spaces. The importance of access to 'green spaces' seems to be sustained, even if action on air quality (and plastics in the environment) is still playing catch up with WHO air quality recommendations. The interdependence of nations and geography crystallizes more each month. The need for international cooperation apparent in cities, such as Lahore (1). Pollution and smog in Pakistan depends on what happens in India. Water flows, the how, when and whether is noted as a potential trigger for future conflicts.

Both models, the Meikirch, and Hodges' are of course idealizations. As such there are inevitable limitations, assumptions, pros and cons. Like many concepts, environment is a compound or expansive term. Simultaneously, from a primary meaning, we can proceed from the physical environment, to the social, political and the mental environment that these invoke or foster. 

In the SCIENCES domain of Hodges' model we are in 'a' - the environment. Physical reality presents itself in raw and fundamental terms. Across the world climate change is threatening many homes and places a stress the importance of 'shelter' and the homeless. Natural disasters, and acute local weather events which are now repetitive disrupt life and population. Conflicts continue to displace people, climate refugees will follow: (https://www.unhcr.org/refugee-statistics). Contrast this with the ideals of housing design that is sustainable and also enables occupants and communities to feel the environment. 

'Ecosystem' is being applied in ways beyond its original articulation. This past N. summer-autumn reading and reviewing -

Capra and Luisi's (2014) The Systems View of Life - A Unifying Vision.

(i) https://hodges-model.blogspot.com/2024/09/i-systems-view-life.html

- there was much emphasis on complexity, ecosystems, emergence, education, and obviously systems.

In their model, Bircher and Hahn incorporate Complex Adaptive Systems (CAS).

https://meikirch-modell.ch/wp-content/uploads/2017/12/Health-and-diease-as-CAS.pdf

This is helpful as the ecosystem is transformed, before our eyes. Clearly, there isn't one ecosystem, but several and they are all dynami: even if, outdoor clothing and car manufacturers want us to believe that we can create our own private ecosystem that is trans-portable. Systems are like the whirls in moving water, they come and go. Ironically there are now more opportunities to study them - if we so choose. Now weather events reveal the risks of people trying to sustain these mindsets when a local catastrophe strikes. The website for the Meikirch Model includes the table below. 

Theories Concerning
Health and Disease

Type of thinking	Epistemology	Means for comprehension
Prescientific	Personal experience	Intuition
Scientific: Meikirch-Model	Scientific argumentation	Rational mind

This is constructive as models should encompass what can be presented as 'knowledge' and from there: data, information, facts, myth, wisdom and folk theory. Intuition is listed as a prescientific 'means for comprehension'. Intuition is highly subjective, in contrast to the (supposed) objectivity of the sciences. Intuition is nonetheless significant in mental health care - psychotherapy, and in truth more generally (interpersonal skills); even if it remains 'unscientific' and an enigmatic phenomena. 

On twi/X and here on W2tQ, I've suggested that the bio-medical, and the biopsychosocial models are inadequate as conceptualisations for healthcare and education. We need to fully encompass the subjective and humanistic dimensions of health care and lived experience, giving more attention, if not credence to 'personal experience'. In England and Wales these past months and to follow our parliament has been debating assisted dying for people with terminal illness. Both sides acknowledge the sorry state of palliative care. Policy and ethics - hence the politics of health needs to be explicit in a model of/for healthcare.

Working in mental health you quickly understand how critical it is being able to relate to others, and  develop therapeutic relationships. Get this wrong, and problems may follow. If interpersonal - communication are essential to a health professional's knowledge then awareness and competence in relational skills are also key. In the past two years or so, I've realised the importance of this for Hodges' model and trying to develop a theory to underpin Hodges' model. I believe that this is a strength of Hodges' model. So we need to extend the table above. 

Individual
   |

      INTERPERSONAL    :     SCIENCES               

HUMANISTIC  --------------------------------------  MECHANISTIC      

 SOCIOLOGY  :   POLITICAL 

|

Group

choice - life style reasoning - rationality my literacy - responsibility mental illness - fear of stigma intuition / subjectivity	geography - environment air pollution - smog & plastics traffic regulation - metrics Planetary health 'truth' objectivity
community - relationships culture social systems family social (all) determinants	international cooperation transparency / accountability policies - funding determinants of health reporting - citizen science

As part 1 started, I will finish with the title of the paper that prompted these reflections:

Bircher J. und Hahn E. G., (2017). Will the Meikirch Model, a New Framework for Health, Induce a Paradigm Shift in Healthcare? Cureus 9(3): e1081. DOI 10.7759/cureus.1081 

The Meikrich model is not alone in seeking to facilitate and deliver a paradigm shift in healthcare; and, at individual, collective, planetary levels, across social care and education and the disciplines - old and new.

 

(1) https://www.independent.co.uk/climate-change/news/pakistan-lahore-air-pollution-schools-shut-aqi-b2640783.html

i Comparison and contrasting the Meikirch Model and Hodges' model