Health » Overview

Salzburg Global Seminar has long been a leading forum for the exchange of ideas on issues in health and health care affecting countries throughout the world. At these meetings agendas have been re-set affecting policy and practice in crucial areas, such as patient safety and the engagement of patients in medical decision making. In 2010, Salzburg Global Seminar launched a multi-year series of seminars to crystallize new approaches to global health and health care in the face of emerging challenges affecting us now and set to continue on through the coming generation.


Interviews and coverage from our Health programs

WIRED Health announces agenda for London 2015 event, Fellows discount
WIRED Health announces agenda for London 2015 event, Fellows discount
Stuart Milne 
WIRED Health has announced the agenda for the upcoming one-day conference in London, UK. The event, held at the Royal College of General Practitioners on Friday, April 24, brings together scientists, entrepreneurs and leading thinkers to explore the trends, challenges and solutions for 21st century healthcare. Speakers have been grouped into themed sessions throughout the day. The event begins with Consumerizing the Medical Device, featuring Clive G. Brown, Chief Technology Officer of Oxford Nanopore Technologies, and Matteo Lai, cofounder and CEO of Empatica, Inc. A wide range of experts including computer engineers, inventors, neuroscientists and prosthetic artists will present throughout the day, in sessions such as Exending Life, Humanizing the Interface and Decoding the Brain. The final session features Red Bull High Performance Director Andy Walshe, who led the performance plan for Felix Baumgartner's extraordinary jump to Earth from the stratosphere in 2012, and Geoff McGrath, vice president of McLaren Applied Technologies,who will share how McLaren is applying the real-time data processing and predictive analysis of its Formula 1 team to remote biotelemetry of patients in clinical trials. In addition to the keynote speakers leading the sessions, the Bupa Startup Stage will give a voice to emerging and established medicine and health entrepreneurs sharing their ideas for the future, with the winner of the day's competition announced at the close of proceedings. Speakers will be confirmed shortly. Read the full WIRED Health agenda here.
To register, visit the WIRED Health event website. Salzburg Global Fellows are entitled to a 10% discount off the registration fee of 995 GBP using the code WHSGLOBAL10: www.wiredevent.co.uk/wired-health-2015
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Paul Burstow: Progress happens when social movements push and politicians pull in the same direction
Paul Burstow: Progress happens when social movements push and politicians pull in the same direction
Stuart Milne & Jonathan Elbaz 
As the man who wrote the UK government’s mental health strategy, No health without mental health, Paul Burstow knows better than most how to transform ambitions to reform mental health care into reality. The Member of Parliament for Sutton and Cheam and former care services minister spoke to Salzburg Global during the session New Paradigms for Behavioral and Mental Health Care about what he learned from his time in government. “I think having the opportunity of being on the inside, you have a better idea of how it works, and therefore what the touch points are that can actually make change happen,” he said. “I think there are two things that are really important. One is the power of social movements. The second is having greater transparency and measurement of outcomes being one of the things that is a pull factor. “So you need to have political leaders who are seeing the economic and moral case and are able to act on that. The most rapid progress happens where you get both social movements pushing and political leaders pulling in the same direction.” The mental health strategy Burstow authored emphasized parity of esteem between mental and physical health, a lesson he feels developing countries would do well to follow and avoid the expensive mistakes of the West. “The biggest thing we can teach is not to follow what we have done, because what we are busily doing in Western mental health systems is deconstructing them and trying to find ways to reintegrate them into the whole health care system, so we do not have set silos. That is a very costly thing to do in a mature health system, so do not do that. Avoid those costs by never separating in the first place, making sure your training and so on never separates." Another piece of advice he has for those working to improve mental health care and service is “to challenge societal attitudes to mental health itself. Anti-stigma, anti-discrimination is a precursor to more rapid progress in terms of delivering the right sort of services,” he explains. After leaving government in 2012, Burstow chaired the Commission on Mental Health at think tank Centre Forum. Following the publication of the commission’s report in July 2014, he continues to look ahead to the future of mental health care in the UK. “I am optimistic, because I think now we have a series of well-proven innovations that are beginning to be implemented more consistently. I think we have some important reforms to payment mechanisms in the UK that are coming, not least the creation of a thing called The Better Care Fund, which is integrating health and care budgets and forcing integration between physical and mental health. Over the next four to five years that will be a very powerful driver for change.” Burstow is cautiously optimistic about the potential benefits of the increasingly connected “Big Data” society, the subject of forthcoming session The Promise of Data: Will this Bring a Revolution in Health Care? However, he recognizes the risks of sharing ever-increasing volumes of patients’ personal data must be considered carefully. “In my time as a politician, I have never found a silver bullet and I think there is no such thing. “I think Big Data has a very important part to play in informing population level commissioning of health services and enabling those that are allocating resources and arranging services to think in those big picture terms. “The issue is making sure that data is available to those people, and we are grappling with that in the UK at the moment. We have a program called Care.Data and that program is stalled because of fears of misuse of the data. So getting that right is very important.”
Paul Burstow was a participant at the Salzburg Global program New Paradigms for Behavioral and Mental Health Care, which is part of the multi-year series Health and Health Care Innovation in the 21st Century. The session was hosted in partnership with the Dartmouth Center for Health Care Delivery Science. More information on the session can be found here: www.salzburgglobal.org/go/536.
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Hong Ma: "Most Chinese people think that people with mental health problems are crazy or mad"
Hong Ma: "Most Chinese people think that people with mental health problems are crazy or mad"
Stuart Milne & Jonathan Elbaz 
Hong Ma is one of just 20,000 Chinese psychiatrists serving a country of 1.4 billion. During the session New Paradigms for Behavioral and Mental Health Care, she told Salzburg Global the challenges facing mental health professionals in China and what they can learn from other countries. Educated in the aftermath of the Cultural Revolution when access to university was reopened for all, she came to specialize in psychiatry thanks to an inventive suggestion from her parents. “When I was close to finishing my five-year degree my parents, my mother working as a doctor and my father at the university, both strongly suggested I become a doctor that could work anywhere without equipment,” she explained. “The idea was very simple - if there were certain days when something happened to the equipment and it could not be used, then I would still be able to serve people.” As the first executive director of the National Center for Mental Health, China Centre for Disease Control, Ma is well aware of the difficulties of delivering quality mental health care to such a vast population. In addition to manpower shortages, Chinese health care workers must overcome the powerful stigma that still prevails in much of the country. “Most Chinese people think that people with mental health problems are crazy or mad. If you ask people what makes someone mad, they would say people who run down the stairs without any clothes on. That is what most people think is crazy. Then I ask, do you see that kind of person on the street? The response is no, but that is what we think is crazy. So, people try to avoid to be labeled as a mentally-ill patient.” However, Ma says she has learned valuable lessons from her fellow session participants that can help overcome these difficulties. She especially singles out her discussions with colleagues based in African countries, where in some cases medication is 100% free. “I am thinking about the Ugandan and Rwandan people who use more community health care services. However, I worry if such people are able to provide the right services with only two years of training, with no doctors? But they tell me, 'absolutely.' This is the first level of care for these people, and this is enough. “So, I am thinking how this idea can be applied to different provinces in China, especially in remote and rural areas where there is a lower number of doctors, nurses, and psychiatrists. China is similar to other countries, so maybe we will change this to be a more diverse model. “In the big cities, you can use a psychiatrist and nurses to provide all levels of care, but in some places we need to choose reasonable and accessible care for those regions to provide those services. We have psychiatrists there, but even the poorest need access to all health sectors. So, we are thinking about how to develop the manpower for health services in western China.”
Hong Ma was a participant at the Salzburg Global program New Paradigms for Behavioral and Mental Health Care, which is part of the multi-year series Health and Health Care Innovation in the 21st Century. The session was hosted in partnership with the Dartmouth Center for Health Care Delivery Science. More information on the session can be found here: www.salzburgglobal.org/go/536.
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Josh Chauvin: Video testimonials can help "transcend social barriers"
Josh Chauvin: Video testimonials can help "transcend social barriers"
Stuart Milne & Jonathan Elbaz 
Josh Chauvin has a burning passion for reducing the stigma attached to mental health, and has worked to combat prejudice during his Master's and Doctoral studies at Oxford, UK, and in his native Canada. In an interview with Salzburg Global at the session New Paradigms for Behavioral and Mental Health Care, he shared his experiences of how video technology can help mental health patients share their stories and realize they are not alone. Chauvin first came to understand the potential of the film medium when making a documentary on the stigma against HIV and AIDS sufferers, which connected him to the Canadian Mental Health Association. “They got me on board to do consulting work for them, and the consulting work exposed me to the world where patients were not going out and getting the help they needed because of the tremendous social barriers,” he said. “That is when I started to become alive to that, but I did not do anything about it.” That changed when he arrived in Oxford and became involved in student activist groups. A year later he became chairman of Mind Your Head, an organization aiming to tackle discrimination surrounding mental health issues, particularly among students. It soon became clear to him that providing mental health patients with outlets to share their stories with each other and the wider world would be a key weapon in the group’s arsenal, beginning with written testimonials. “It was very important to attach faces to names associated with those testimonials, because we thought if you could feel like you knew the person … if you could see them around town cycling, at social events just like anyone else, acting like a 'normal' person ... that transcends certain social barriers. We thought a natural step beyond that was to do video testimonials.” Mind Your Head drew inspiration from the It Gets Better campaign, launched in September 2010 in response to the suicides of several American teenagers who had fallen victim to homophobic bullying. The initiative soon prompted thousands of people to share video messages of support for the LGBT community, including Barack Obama and Hillary Clinton. “The It Gets Better campaign certainly brought it to the forefront by the power of seeing someone tell their story, often times very heart-wrenching and emotionally provocative, in terms of changing people’s perception of things and really starting movements.” In January, Mind Your Head launched its own video project, It Gets Brighter, with the aim of drawing a similar response to mental health issues. Archbishop of Canterbury Justin Welby and comedienne Ruby Wax have already submitted contributions. Chauvin hopes the process of creating and sharing videos will be a therapeutic and rewarding experience for mental health sufferers. “It lets them know that they are not alone in their suffering,” he explains. “Going to the site, they will be confronted with what we hope will be thousands of videos, at some point, and that in itself will make a statement of a community that wants to embrace them. To be a part of that, and to see that, is empowering. “The effect is the cathartic feeling one gets from telling their story to someone else, and getting a response from another sharing mutual feelings. ‘My best friend suffered from this as well, my mother, brother, sister, father suffered from this too,’ all builds a sense of community and goes to some miles in terms of transcending those barriers and those stigmas associated with mental health issues.” One of the benefits Chauvin enjoyed during his time at Salzburg Global was the opportunity to network with others in the mental health sector and explore the possibilities of bringing communities together. He recalls a particularly fruitful discussion with Sally Okun, vice president of US-based data sharing platform PatientsLikeMe. “On our website the videos are only one minute of a hopeful message on how it gets brighter, but obviously there is more to a person’s story. So one thing Sally and I were talking about was directing people from It Gets Brighter to PatientsLikeMe. It would be a great way to connect people on a more personal level.” Chauvin is pleased with the work being done on mental health in his home country of Canada, but realizes there is a lot health care professionals and activists across the globe can learn from each other. “The Salzburg Global experience has allowed me to see the phenomenal variety of experiences that there is. The mental health issue in Canada is very different from the mental health issue Ghana, Uganda, or the UK. There are variety of social factors that influence the way we not only see and interpret mental health issues, but also how we respond. “I have become alive to the world of perceptions that is out there and the social factor that might be influencing our perception, I think, is a big takeaway.”


Josh Chauvin was a participant at the Salzburg Global program New Paradigms for Behavioral and Mental Health Care, which is part of the multi-year series Health and Health Care Innovation in the 21st Century. The session was hosted in partnership with the Dartmouth Center for Health Care Delivery Science. More information on the session can be found here: www.salzburgglobal.org/go/536.
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Dale Walker: "Native people need to ferret their way through the system"
Dale Walker: "Native people need to ferret their way through the system"
Stuart Milne & Jonathan Elbaz 
Roger Dale Walker had never heard of psychiatry before going to medical school, but by the end of his fourth year he had found his calling and has never looked back. A member of the Cherokee people in the United States, Walker spoke to Salzburg Global during the session New Paradigms for Behavioral and Mental Health Care to share his thoughts on the challenges and possible solutions of improving mental health care for indigenous peoples. “It has been a delightful process and a wonderful field to work in,” he said. “You are able to work with individual patients, communities, and political community issues. "I am also an addiction psychiatrist, which has been a great addition because it brings me a breath from my ordinary work and allows me to work across systems and individual communities with multiple problems.” He said the 1999 report by the US surgeon general best summed up the health care situation facing the 5.2 million Americans identifying themselves as natives. “The American Indian and Alaska native people have the same disorders, the same problems, as the general population. “However, they are much more severe: The rate of morbidity and mortality is higher, the ability to work with these populations is harder, and there is an access-to-health problem,” he explains. “The issues become shocking and very difficult to deal with because there is a lack of health care person-power in these communities.” Walker said the disparate sources of federal funding made for a complex and confusing process for those requiring access to health care resources or money.  “Native people need to ferret their way through the system. They need to figure out where to get help for what.” Walker is the founder and director of the One Sky Center, the first National Resource Center for American Indians and Alaska Natives specializing in substance abuse and mental illness in native populations. He attended the session as part of a dedicated US native team. Their final recommendations highlighted the importance of integrating mental health care at the federal level, calling for the establishment of a single agency or cabinet post to implement solutions more effectively and efficiently than they are at present. “For instance, if there is a cluster suicide or a domestic violence problem out in the community, you cannot muster the resources quickly. “They come down in pipelines, and it is very hard to move money from one pipeline to another. That is the big issue. “But now, there is also local and state funding that can be made available. We are just now able to develop these resources, and we’re hoping they will become resources for native people.” The challenges of native health care extend far beyond the borders of the US, with an estimated 370 million indigenous people living in more than 70 countries. Their needs are beginning to be addressed on a global scale, demonstrated by the convening of the first World Conference on Indigenous Peoples in New York in September 2014. However, the resolution adopted by the United Nations General Assembly as a result of the gathering did not cover health care or education in its 40 points. Walker’s team saw a chance to correct this oversight, and were encouraged by their experiences at Salzburg Global to propose a future session exploring the relationships between governments and indigenous communicates in order to improve access to health care. “I will take back with me the excitement of the people here. We have made wonderful contacts and will share information with one another. That is always the reason to have a meeting like this. “Salzburg Global Seminar lives up to its reputation, and it has been a great opportunity.”
Dale Walker was a participant at the Salzburg Global program New Paradigms for Behavioral and Mental Health Care, which is part of the multi-year series Health and Health Care Innovation in the 21st Century. The session was hosted in partnership with the Dartmouth Center for Health Care Delivery Science. More information on the session can be found here: www.salzburgglobal.org/go/536.
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Anna Moore: "I needed a job that enabled me to work on a personal relationship with people"
Anna Moore: "I needed a job that enabled me to work on a personal relationship with people"
Stuart Milne & Jonathan Elbaz 
For Anna Moore, director of the AHSN Integrated Mental Health Program at UCLPartners, mental health care is a passion she has gradually grown into during her time working in medicine. In an interview during the session New Paradigms for Behavioral and Mental Health Care, held by Salzburg Global Seminar at Schloss Leopoldskron in December, she described how she came to specialize in caring for the vulnerable after starting her career as an accountant. “When I was doing accountancy, I felt like I wanted to do something that was more individually helping people,” she said. “For me, I needed a job that enabled me to work on a personal relationship with people, which is why I went to medicine. I started off with orthopedics, but as I did medicine, working as a doctor, I found myself being much more interested in the people with substance abuse problems. They were always stuffed at the end of the ward, like people who had osteomyelitis for the long-term. “I was really compelled by thinking about how we could help them.” Moore came to realize that for her orthopedic patients with substance abuse problems, it was “more helpful for them in the long-term” to treat their substance abuse than to prescribe antibiotics or conduct an operation to relieve their bone marrow inflammation. “[Their substance abuse] was the thing that was impacting on their outcomes more than anything,” she explains, and thus the patients needed to be considered in the “whole context of their life.” The program Moore now leads at UCLPartners in London, UK, prioritizes a pre-emptive approach to care, and focuses on integrating mental healthcare with the wider physical healthcare system. “We bring academics and innovators to think about how we can, not reorganize health care systems, but improve health care through identifying some of those system barriers and focusing on ways we can work with our local communities and the people in them to overcome particular problems. “For example, we have reciprocal training. We are expanding our boundaries, doing work in unusual settings like schools and the workplace, for health care to be delivered and to provide a better value of health care through better organized systems of care.” The themes of expanding mental health care into the wider health care system, and offering community support rather than pharmaceutical treatment resonated with many of the Salzburg Global Fellows participating in the session. This was deemed to be especially important in low- and middle-income countries, where providing access to mental health care at primary points of contact like GP clinics could help combat the stigma sometimes attached to many serious conditions. Action plans unveiled by Fellows at the end of the session featured examples of this integrated approach, such as the proposed Improving Mums’ Mental Health (IMum) program in the UK. This included training midwives and other perinatal care workers in recognizing the symptoms of conditions such as post-natal depression, thus maximizing the wellbeing of both mothers and infants. The cost of delivering the IMum program was estimated by the UK-based Fellows to be eight times less than the current cost of perinatal mental health problems to the UK public sector. Moore believes empowering patients to become co-decision-makers alongside the health care professionals who serve them is also important, and data sharing innovations are coming to the fore to help make this happen.
“Integrating care has the ability to sit within people rather than systems. It is important to have technologies and systems enable people to move between them – actually it is around the relationships between individuals within the system. Also, [we need to be] thinking about the care being designed around the patient rather than the individual having to interact with each parts of the system. “Things like digital [technologies] are enablers which will help us to achieve integrated care. It is not the answer, but the thing that will help us get there. We have started to see it a little bit in the linking up of electronic patient records across different health care systems, which is by no way near complete. The novel and interesting ways we can collect data at the patient level, which can be used to different care settings, are really exciting.”
Anna Moore was a participant at the Salzburg Global program New Paradigms for Behavioral and Mental Health Care, which is part of the multi-year series Health and Health Care Innovation in the 21st Century. The session was hosted in partnership with the Dartmouth Center for Health Care Delivery Science. More information on the session can be found here: www.salzburgglobal.org/go/536.
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Salzburg Global Fellows Discount for WIRED Health, London 2015
Salzburg Global Fellows Discount for WIRED Health, London 2015
Caroline Carr 
Passionate about the future of health innovation? WIRED Health, to be held in London, UK on April 24, is a showcase to explore the future of healthcare, presenting the most promising and exciting technologies set to revolutionise and improve our lives.  Extraordinary innovators will lead the conference programme to introduce, explain and predict the coming trends facing the medical and personal healthcare industries.  The 20 industry-leading main speakers include Sonia Trigueros, co-director of the Oxford Martin Programme on Nanotechnology; Marc Koska, inventor of the K1 auto-disable syringe; and neuroscientist John F. Cryan. Nigel Ackland, the "ordinary man with an extraordinary arm", will provide an alternative persepctive by sharing how his bionic prosethectic has transformed his life. Altitude physician and technologist Jack Kreindler will present a special session curated by the Singularity University/Exponential Medicine, including a presentation on a three-year project to enable world-renowned astrophysicist Stephen Hawking to continue communicating. The conference brings together an exciting selection of startups and growth-stage companies all working in the fields of medical technology, software and services.
To register, visit the WIRED Health event website. Salzburg Global Fellows are entitled to a 10% discount off the registration fee of 995 GBP using the code WHSGLOBAL10: http://www.wiredevent.co.uk/wired-health-2014
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