1-4 The Health Model


What kind of glue do we need to construct this model?



Academically speaking…

The 'Health Model' - Any self-help group will struggle with this concept on an ongoing basis, both internally, with its own procedures, and externally, with the services it wishes to provide to its 'clientèle'. For instance: Does the health model for drug addicts mean legalising drugs, and treating addiction as a medical problem and so providing services? Or does it mean harsher penalties, longer prison sentences, for pushers and possessors? - With any services simply promoting more addiction and subsequent social problems? I have seen advocacies for both sides as recently as this week in my local newspaper (The Vancouver Sun, Vancouver, British Columbia, October 11, 1997). In these types of issues, we may/should draw guidance from programs established elsewhere in the world, and learn from their results.

You may be clear on your concept of 'health' for the issue you are addressing, but don't be surprised if vested interests or other groups challenge your assumptions and model. This debate can be vehement, as opponents battle for recognition, the higher moral ground, and ultimately funds that often mean 'survival' for their group, and vindication of their belief and value system. Who's going to fund a group that is based on false assumptions, or is 'demonstrably' unbalanced, or oppressive? And you thought you were only trying to help…

It really does become a survival issue, with all the passion and energy that may create. This conflict of opposing values and belief systems is messy, real and enervating. We may be left in the frustrating position of not being able to understand another groups 'reality', and our work may become stuck, as we are seen as opponents to their ascendant/accepted and socially/politically entrenched philosophy. Politicians are keenly aware of 'constituencies', i.e. where their political support and opposition lies, and will prefer not to upset strong vociferous groups. (In Canada, Prime Minister Chretien has declared himself to be a feminist). Saying the wrong thing can mean political suicide. The new kid on the block (you) has little influence until you can demonstrate a sizeable constituency and political 'savvy' - the willingness to understand politicians problems and limitations. Politicians are human too, they want to address urgent social issues, but not at the expense of failing to be re-elected. Thus we see few politicians providing outspoken leadership on issues of abortion, or drug-legalisation - where there are sizeable constituencies on both sides. So your 'Health Model' needs to take into account the political and social realities of the day; sometimes change may only happen over a longer period of time as we are able to educate and influence others with our perspective. Meantime, focus on balance and growth!

Another example: At one time alcoholics were considered to be bums and degenerates - these were the people you might have seen passed out in the gutter. Or they were hidden away behind closed doors, and their secret was held tightly within the family. But then some courageous people founded Alcoholic Anonymous, and created a 'health-model' for alcoholics, based squarely on the principle of self-help. Nowadays we see alcoholism as an illness, and we have more compassion for those who suffer, and provide services - such as 'drying-out' facilities, and medical options, as well as support groups. Countless thousands have been assisted by this self-help system and the vision and courage of a few individuals willing to put their ideas on the line.

The Internal 'Health Model'

What about our 'internal' Health Model? What procedures are we going to set up? Who says they are 'healthy'? What makes them healthy? How should we run this organization? Are we building from square one? Who's got some ideas? Is there a template we can use…? Hence this handbook.

A basic, obvious principle, is that to work together as a group we have to be able to make 'agreements'. Sure we may have differing visions, ideas how to do things etc., but the basis of our forward motion is the set of agreements we can make. This means being able to hear each other and understand another's perspective; being able to compromise, meet in the middle (the agreement), and follow through on your word. Ok two people, or groups, may decide they actually want different things, or use differing processes on how to get there; they decide they can't work together… so they split… try again independently. If it's not a one man show, they are still going to have to make new agreements with their current or any new allies they make. You can't get away from agreements.

So the internal health model must focus on the agreement making process, making that process clear, and getting commitment. If you find yourself shuffling from issue to crisis, and back again, consider your agreement making process… This will determine the maturity of your group (are they willing to be pinned down? - are they willing to commit to actual tasks and deliver?), and ultimately your overall effectiveness.

Sometimes 'pathology' is revealed in this process - some people are willing to sit and debate, and stay in that conflict seemingly forever, rather than actually come into agreement and make a commitment. Sometimes as you get close to an agreement, they will divert or create another issue to avoid coming to a resolution on the issue at hand. Somehow it's easier for them to sit and talk rather than do anything. Sometimes they will focus on item 'D', and not allow debate to move to items 'A', 'B' or 'C', which is the rational sequence that must be covered in order to ever resolve 'D'! Sometimes there are complex issues that necessitate this kind of sequential process - A to B to C etc. - only clarity and agreement at each level will allow you to move on to the next level. The 'pathology' seems to be about being stuck mentally/emotionally at one place and not being able to see the bigger picture, or the logical, sequential process. See the following section on 'Good Will' for a further discussion of the health model and group dynamics. Also see the concluding section.

Towards a men's health model

My particular focus is the 'Men's Health Model', but this discussion may be extended to any self-help organization. The context for this discussion is the self-help arena, of course, and also direct comparison with the many and diverse support structures available for women. If you consult your local telephone directory, or one for the nearest large city, you will find a wide range of agencies and organizations listed in the yellow pages in the section for women's organizations. Consider what is listed for men; You may not even find a section for men's organizations! If you do, there will only be a few. In my local area, one courageous individual had to battle the phone company even to get them to open a section for men's organizations!

I don't believe that there is any 'conspiracy against men'; I think rather that this situation reflects the lack of awareness about men's issues. Feminism has done a tremendous job over the years of raising awareness of women's issues, rights and opportunities, and the diversity of social agencies available to women reflects this hard work. This hard work is yet to be done for men. One unfortunate and extreme expression of feminism is that if women have been oppressed, why then, it must be the men that are responsible, and they don't deserve support, just to make it worse for women… For those that care to look a little deeper, they discovered a system, called 'Patriarchy', that essentially subjugates both men and women to prescribed roles, and places expectations and restrictions on both genders. This is revealed in the social statistics. They can be hard to look at. Feminism has said look at these statistical realities, these circumstances of women's lives. And demanded we look and respond appropriately.

Let's now look at some realities of men's lives: in Canada, the suicide rate for men is four times higher than it is for women (perhaps higher, many 'accidents' may actually be suicides). The comparative death rate for workplace fatalities is twenty men for one woman. Men's lifespan is on average 5 or 6 years less than women's. If any of these statistics were reversed, the feminists would be outraged and have proof positive of the 'oppression' of women in our society and demand action, programs and funds tailored specifically to these issues. Yet when it is men suffering in this way, we hear not a peep… no action… no programs… no funds…

One argument that is used is that there are many health structures in place for men, the doctors and mental health professionals; and we have to ask - why aren't the men using them? There are many complex factors at play here, but what is fairly plain to see, is that we need to construct a health model for men. In the same way that Alcoholics Anonymous constructed a health model for alcoholics; in the same way that feminism has constructed a model and system of support for women. Right now there is a health model gap or vacuum for men. And so we need to begin to educate ourselves, and to actually fund programs tailored for men. But first we need to have the courage to confront the current attitude that would seemingly deny men recognition of their issues and equal rights of access to support and funding for their programs.