Unpublished Opinions
Axel Dorscht is the founder and head of the Institute for Human Conceptual and Mental Development (IHCMD). He has directed the Institute's work since its founding in 1990. He holds a PhD in political economy (Carleton University, Ottawa, Canada, 1988), an MA in International Relations, and a BA in Political Science (Simon Fraser University, Vancouver, Canada, 1977 and 1975).
Since 1990, he has been involved in two major studies: one to understand the mind on the inside, as the place where we consciously exist and act, where the inner mental life takes place, and where the mental self is active. Understanding the nature, elements and processes, the conditions, needs, demands and challenges of the mind, our inner mental life and the mental self, our role and responsibility in them, how to manage and deal with them, in their essence, in depth and detail, in a differentiated, but integrated, connected and related way.
The other study examines the historical path and direction of human conceptual and mental self-development. How, through the ages, human beings have made sense of their experience, the conditions of existence that lie behind them, and how to deal with them. The mental powers and abilities, mental skills and practices they developed, on which they relied, how they developed and used them, which lie behind, define and govern socio-cultural developments that have brought the human species to where we find ourselves today and the problems and difficulties we face and create. The direction of the answers and solutions, the direction we need to take in conceptual and mental development and growth, individually, as societies and as a species, to understand and manage existence and development in sustainable, equitable, secure and peaceful ways. Together, the two studies provide the conceptual foundation and framework for the Institute's work.
Starting in 1996, he has hosted a series of Online workshops, summer schools, study and training programs, and on-the-ground lecture series about sustaining existence and development in changing conditions, understanding and managing them from the ground up and from the inside out, beginning with the mind and mental existence.
Before the work with the Institute for Human Conceptual and Mental Development, he has worked as a consultant in international development (IDRC and CIDA, 1988-92), as a professor and lecturer in political science, Carleton University (Ottawa, Canada), University of Ottawa (Ottawa, Canada) and St. Francis Xavier University (Antigonish, Canada, 1983-87), as a free-lance correspondent in Germany (for the Financial Post, Canada, 1981-82), and as a researcher in political, social and economic development (in Canada and Europe, 1980-82).
Dealing with Rising Public Health Care Costs
Public health care expenditures are escalating uncontrollably across the globe, exhibiting unsustainable growth. In Canada, health care spending reached $399 billion in 2025, which constitutes 12.7% of the Gross Domestic Product (GDP). This expenditure experienced a rise of 4.2%, surpassing overall economic growth. The three predominant categories—hospitals, physicians, and pharmaceuticals—account for more than 50% of total health expenditures.
Health systems are currently confronting unprecedented pressures, including increased demand for youth and adult mental health services, clinician burnout and emotional fatigue, growing complexity in patient needs, misinformation influencing health behaviours, strained patient-provider relationships, as well as challenges in long-term care, chronic disease management, and preventive health measures.
Such pressures necessitate the development of internal mental capacities—clarity, regulation, judgment, and resilience—at levels that many patients and providers have not been adequately supported to cultivate. The Institute for Human Conceptual and Mental Development (IHCMD) perceives the rising public health care costs crisis as a manifestation of a deeper "conceptual crisis." The Institute posits that cost inflation is not solely a financial or administrative issue but is rooted in a failure to cultivate the internal mental capacities requisite for navigating modern existence.
The IHCMD presents a structural, non-clinical model aimed at enhancing these capacities across diverse populations and within the health workforce.
The IHCMD articulates its perspective on health care costs as follows:
Insufficient Mental Development: Research conducted by the IHCMD indicates that numerous health issues, particularly chronic and mental illnesses, arise from individuals’ lack of internal mental capacity to manage the pressures inherent in contemporary socio-cultural life.
The "Inside-Out" Solution: Rather than exclusively concentrating on supply-side cost reduction measures, such as expenditure caps or drug price regulation, the IHCMD advocates for mental development programs designed to instruct individuals on how to navigate their existence within natural human limits. The aim is to diminish the demand for costly medical interventions by first establishing internal order.
Institutional Overload: The Institute interprets the financial pressures faced by public health systems as an instance of "institutional overload," occurring when societies endeavour to address problems through external systems (hospitals and insurance) that ought to be managed through developed individual mental capacities.
The Cost of Mismanagement: From the IHCMD's perspective, soaring costs represent the societal price paid for neglecting to prioritize the mental development of its citizens, leading to preventable health conditions and an excessive reliance on medical infrastructure.
The advantages of mental development in health care encompass: addressing the root causes of behavioral and emotional challenges, being non-clinical and thereby alleviating pressure on clinical systems, enhancing the capacities of both patients and providers, being scalable, low-cost, and culturally adaptable, aligning with public health, prevention, and health system transformation initiatives, and establishing a unifying foundation of human capacity across health sectors. The Mental Development Framework (MDF) positions mental development as both a determinant of health and an enabler of systemic functionality.
Mental development can be seamlessly integrated into patient education and self-management initiatives, youth mental health and preventive strategies, clinician training and leadership development, community health and public health programs, digital literacy, and misinformation resilience efforts, in addition to integrated care and enhanced patient experience strategies. It is equipped for systemic application and adaptable to various health contexts.
In a singular statement, the IHCMD MDF fortifies the internal mental capacities that support patient well-being, provider resilience, and system performance—rendering it a strategic investment in sustainable, high-quality health care.
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