Don’t throw the baby out with bathwater – even if it’s the baby that peed in the tub!
When we first realize that something is wrong – the water is yellow! – it’s all too easy for the next phase of chane to be a reflex reaction. Toss the water and there goes our baby. But what if we took the time to really understand the nature of the problem – and found it’s the baby that contaminated the water!
Now what – do we get rid of the baby for fresh water, or just the water leaving us without the tools to bathe, or do we just toss the whole thing? – a scary concept.
This is the place where we accept the challenge to be creative, manage difficult emotions and find a solution. Or else it is the place where we get stuck and sit staring at a crying baby and feeling awful. If we are calm enough to explore, we may just find out the baby is not at fault – we can drain the tub, start over and if it happens again, we can try a cooler temp, not feeding right before bath time – or patiently change the water.
What will my generation’s legacy be in responding to the needs of our baby that is the mental health care system? As we become aware that change is needed – we read new research, hear of a promising new method – and acknowledge the real problems, then the process of change can begin.
Embracing recovery, however, does not mean that we abandon all old ideas – or the pesky peeing babies. Such radical shifts can cause more upset than growth – dismantling the broken parts without salvaging the core strengths and moving forward with care can have a disastrous effect – a systemic detox that debilitates and divides: abandoning all use of medication without harm reduction and education, throwing away all our forms or treatment plans, losing all process boundaries, or consumers stigmatizing all mental health providers as being out to control or to do harm.
However, if we just limp along and simply acknowledge the problems without addressing them, we are left with frustration and resentments. This mirrors the personal recovery process, so why not use this same process in our system change? As anyone in recovery knows, positive change takes courage.
I was walking on the beach recently and found a bracelet that was inscribed ‘Aware Awake Alive’. This represents the process of change, becoming aware of a need, awakening to take action, and continuing to grow.
We can begin by acknowledging that we will have big feelings, including grief, loss, anticipation, hope, fear, excitement and joy! We can expect extremes and risk. A wise mentor of mine once described the process as overshooting to aggression on the road from passive to assertive.
Step one is to create a space that is safe for change to take place, where curiosity and collaboration can happen. We may get stuck in lots of meetings talking about this – however, establishing space to play, celebrate and share fun is critically important. In such environments, folks are free to examine what works, to wrestle with the things that called our attention to the need for change and we have time to be patient both with those who want to throw out the baby and those who refuse to change the water.
This is not about “my” idea or “yours” it is for the benefit of all, therefore anyone entering to the system will be welcome, an evolved system will be designed to continuously evolve regardless of who is present.
Once this space is established, systems can begin to look at what works. Acknowledge that structure without flexibility will bring stagnation and flexibility without structure will being chaos. In the systems change process, treatment plans and goals are often retained, as those can provide direction. Other modalities seem to be effective for some and are also kept, such as DBT, 12-step programs, individual therapy and joining. Other practices can be removed – such as restraints, derogatory language, forced plans, and lack of input.
I find it interesting that some peer organizations mirror elements of traditional community mental health practices. I have been told this is because some stuff just works – like confidentiality, shared values, checking in and having groups – and we learned this collectively.
We as systems and persons are gifted with golden tools, experience and practices that work and bring peace and have the opportunity to use one of the greatest – awareness – too grow.
The next step, of joining together to embrace both changing and staying the same, will drive our forward motion. A mission, a vision, and a palette of service and practice that is tailored enough to each organization but also open enough to work with others, will allow us to recover as a system and share without competing over whose is the best way. Instead we can view our practices as the unique expression of a collective desire to bring peace – with the responsibility and methods to address the situation when these principles become compromised.
I would love to hear your experiences with change as a person or system. What have you found that has worked and that hasn’t? What have you experienced, observed and hope for? Let’s hear it – lets open the space here and now!