Sustainable Community Collaboration Building is Required to Achieve Successful and Lasting Change

 

      Sustainable Community Collaboration Building is Required to Achieve
                                                  Successful and Lasting Change

Richard C. Lumb, Ph.D.
Maine Woods Education and Training

Blog VO. 1, No. 4
07.16.21

Introduction.

We pass through life on a moment-by-moment basis, focused mostly ahead, missing the events happening on a 360-degree manifestation around us. We focus on family, work, events and appointments, and late, constant interruptions by various people and circumstances. These interruptions are an awareness of crime and violence, the philosophical rants and movements, the media's focus on nonsense. We begin to weigh out of life's chaos as it is more natural to one's health and psyche wellbeing. 

Like the frames of a movie, there is a connection, but the boundaries separate it in the film strip. Remove various frames and the totality of the movie changes, and it must, as parts of the continuum, are missing. I suspect that certain aspects of life break off and are stored in the mind that categorize and accumulate relevant and supporting information adding to the totality of that topic. 

But not all things carry the same level of importance, thus the fragmentation to which I allude.  We have borrowed from an earlier manuscript for information to adjust our thoughts, doing so as the bridging of information continues, and the value of inclusion is deemed essential to outcomes.

An Example of Collaboration Weakness.

The substance abuse problem raging across every town, city, county, state, and the entire country is perhaps the direst of examples, for it diminishes us as a people, a nation, and defies all attempts to control it. However, we never seem to ask the question of why? Instead, we spend massive amounts of money through public and private agencies, enforcement, criminal justice engagement, medical and mental health services, and the list is long and discouraging, given the lack of positive outcomes.

Some data to illustrate these points:

§ 23.5 Americans (1 in 10) are addicted to alcohol and drugs. And it continues to rise.
§ Only 11 percent of addicts receive treatment in health care facilities.

§ Of the remaining 89 percent, they live with their addiction.

§ The World Health Organization estimates that 2 billion people abuse alcohol, 185 million abuse drugs, and 1.3 billion continue to smoke.

§ Deaths are due to alcohol and drug abuse. However, prescription drugs, household cleaners, and many other substances are ingested into the body in the quest to get high.

§ Treatment facilities see approximately 41 percent for alcohol and 20 percent for heroin and opiates: Marijuana, 17 percent of admissions.

In this country, we focus on the standard drugs used are Marijuana, heroin, cocaine, methamphetamines, anabolic steroids, ecstasy, and prescription drugs. Is that not a frightening statement? Prescription drugs, one of the most regulated drugs, accounts for 45 percent of all drug-related deaths. Does that not indicate the failure of policy and the fragmentation of services to address these issues? Of course, it does! We have an estimated cost of 820 billion dollars a year for drug abuse, and I would say "hogwash," for we do not know, do not account for any breakdown of costs, and the total would run well into the billions. It is a feel-good society and a disconnected system to bring sanity back to this single problem. 

To give one example from Criminal Justice. Every police response to a service call included cost. Answering the 911 call, dispatching an officer, officer engagement, and service requested (juvenile authorities, medical, emergency response, hospitalization for the person transported, courts, and others) multiply costs that are not captured on a case-by-case issue. Yet, we take the total budget and seek to live within it, regardless of the duplication, the heavy tilt to problems A, B, or C, just the total expenditure of the budget. We, as people, are complicit and, in our absence, guilty of doing nothing of concrete outcomes.

I am not critical of these services; they do what they have done for decades. Call received, dispatch, handle the request, await the next. That is true for all other services which become part of the mix. If we were to track person "A" through the maze of public and private agencies who must deal with that individual, the total cost to taxpayers would boggle the mind and make many of you angry.

Potential Service Engagement in the Life of a Drug Addict

Addicted Individual

Issues

1.      Family issues.

2.     Physical health assistance.

3.     Substance abuse assistance.

4.     Medical or mental health care.

5.     The attention of the criminal justice system.

6.     Dependence versus contributing to society.

7.      The diversity of agencies not communicating.

Engaged Community Potential (correspond to the above issues)

1.     Division of the family unit.

2.     Loss of work, income, and increasing dissension.

3.     Public and private agencies.

4.     Public and private services.

5.     Engagement of multiple services.

6.     The contributing side bears the costs.

7.     Funding whose results are questionable.

How are we coping? We revert to fantasy, justification and hide in a mantra that says nothing of outcomes but allows expression.  The legalization of Marijuana is one of those fulfilled dreams, yet 17 percent of those thousands seeking help use it! A note on statistics, what we read is a guess, for we do not know. So, be skeptical, doubt what you read, and accept that it is but another glazing of the problem and not addressing it.

Is Change Impossible?

"No!" said skeptically, but with the belief that change is possible. Experienced pain lies within the change process.  However, the current responsibility of those not part of the problem needs to shift to those who are. The American taxpayer cannot shoulder this cost any longer, for it strips the country of money required to improve the quality of life that Washington talks about but never acts.  When we speak of the cost, it is not an either-or situation, as there is a cost for all. The loss of contribution is substantial, and in that situation, the need for contributing is also enormous. There is no magic funding; it all comes from the public in taxes and other fees.  Infrastructure, housing, health care, and many other positive life quality indicators are addressed if we enter sustainable planning and collaboration. The goal is to focus on everyday needs and stop the expectation that money expenditure is the solution. If it were, this discussion would be necessary.

Why Sustainable Community Collaboration Building?

Sustainable community collaboration building is a program that assists public and private organizations, who often respond to the same client in limited ways seeking solutions to an issue or problem, resulting in no further service requests.

Many agencies may provide services to the same client. Still, unless they collaborate and engage in steps that coordinate, have common goals, examine the outcomes, and provide a clear pathway to sustainable solutions, the repeat calls syndrome persists. In addition, few agencies track costs for individual calls, thereby not knowing the full impact of repeat calls to the same person, locations, situation, and other standard variables.

It is not inconceivable that a person, for reasons largely unknown, comes to the attention of a service agency and because of the sequence of events involves others, all expending time, resources, and personnel engagement, but the total expense unknown. Add other providers to the same case, and the costs escalate rapidly. 

Unless there is a sustainable solution, the engagements may repeat themselves many times over the years. When answers are not forthcoming, we must question the sense of multiple agency engagement, resulting in no satisfactory outcome.

We are aware that every community must engage in addressing problems and seek sustainable solutions. Therefore, we do not focus on the day-to-day efforts taken by many, resulting in the completion of the tasks at hand.

Our focus is on persistent issues, those problems of a critical nature that impact the quality of life and citizens suffer from some of the outcomes. A poignant example today is the raging substance abuse problem instigating havoc across the nation.

We address this dilemma by offering a hands-on and applied the program to guide the development of a cohesive working group charged with the careful examination of the problem. It consists of gathering data to allow a depth of drilling down into knowledge to make decisions, construct a sustainable solution plan, implement, and thoroughly evaluate it to determine outcome effectiveness.

Contributors to Inertia.

Dependence on the government to find solutions and address problems removes individual and group responsibility and transfers it to others. Within that mindset are the seeds that the issues are being taken care of and disengagement of further inquiry or determining the abandoned truthfulness. Is it trust or a willingness to surrender to others? We suspect it falls along a continuum.  

1. Individual Need to Engage.

2. Comfort knowing others are engaged.

3. Lessening of concern by a willing choice.

4. Abdication of responsibility to others.                                   

We are often dependent on the government; as the single solution to problems, we must consider avoidance. Passing the issue to someone else allows us to avoid the hard choices. Hence, the engagement, taking time preferred to be applied elsewhere and avoiding a troubling question accompanied by the desire to keep it at arm's length. However, we must also realize that governments are not funded to allow unlimited engagement in fixing issues and persistent problems. Nor do they have the employees and broadened viewpoints of many diverse people, whose experience and expertise might well be a key to the desired solution. And, while we prefer not to venture where "Angle’s fear to tread" – a misnomer – whose reality is false.

Isolation and withdrawal of engagement are the banes to sustainable fixes. It reduces input and ideas and restricts reciprocal planning required to examine all aspects of the potential solutions. The interdependence of thought and action, combined with a willingness to engage with others, has no substitute. The collective engagement of people with a focus on the issue, personal knowledge and experience, and a personal commitment is a powerful force.  What is accomplished through collaborative partnerships is unparalleled as the potential mechanism of achieving sustainable problem-solving success.

There can be no hierarchy of power represented, self-appointed by position, authority, service obligation, expertise, personal immersion, and another variable that attaches to engagement purposes. Three people bring skills, knowledge, experience, and a quest for a solution to the table; six, twelve, or twenty-four, substantially double the power behind deliberation and significance.

When citizens, elected and appointed officials, engage in genuine collaboration, seek to identify, and find sustainable solutions to existing problems, the improvement in overall quality-of-life generally occurs. Multiple people seek information on progress, like evaluation, demand answers, and are inquisitive. That may not happen in a single public or private agency endeavor. Budget, assignment of personnel, limitations of service knowledge, problem identification, and process are constraints overcome when a larger group, particularly one with vested and personal engagement needs.

The Case for the Collaboration Model.

We seldom know the exact assignment of services applied to a situation, for those involved may not be aware or constrained by policy and rules are unable to identify them. When multiple agencies are engaged but separate from each other, no collaboration, sharing of data, engagement in determining the best practices, or course of action does not occur. Two independent agencies can be working with the same family, divided by the client and silent to others, thereby creating natural barriers to success due to the confidentiality of service. Is it about the service finding sustainable solutions or the agency utilizing a definition that protects whom? 

Separate silos of services, occasionally multiple entities assisting the same client, and the expenditure of resources without evaluation of outcomes do not bode well in any situation. We might surmise an extension of time and cost due to the voids that exist, the necessity of working in darkness to some of the processes, which may be contradictory or harmful to other actions. It is a controlled form of chaos and does not fulfill what could be a vastly improved problem-solving process. We are aware of the constrictions, the limitations that occur, and the imposed constraints requiring adherence by those in the game. It is sometimes difficult to see where they contribute to the client's wellbeing or exist for the agency's benefit!

With a coalescing of people, organizations, and stakeholders around an issue or client, determining comprehensive information of the problems, both before and after they occur, is critical. The best possible outcomes emerge from the confidentiality of sharing information, working collaboratively, an absence of distraction, any one individual or group demanding dominance, or other actions that diminish "team collaboration" and "equal status" of group members. We would also state that the client is not a passive recipient unless some condition prevents active engagement. Sharing information, developing a database, and analyzing data to expand knowledge and understanding are vital proportions. These actions will engage all parties in determining sustainable solutions. This step necessitates full disclosure of what is known, the goals we aspire to, and the measures needed to achieve positive and lasting change.

Example – A substance abuse perspective.

A true story! The outcome is a sad commentary of the division of roles and isolation of services that involve the same client.

Curtis was of high intelligence, learning not problematic, accompanied by a quiet disposition, a ready smile, and a tendency to follow others when something appealed to him. It is unknown what the originating incident was that introduced drugs to him. Nonetheless, he became addicted to both illicit and prescription substances, and his life changed.

Drug dependence diminished family engagement, academic pursuit fell away, and troublesome behaviors crept into the presence of others close to him in life. Suspended from high school, listlessness, the need to be with "friends" or other addicts surmounted the family life previously known. Friction with parents caused argument and anger, and on occasion, storming out of the house.

Parents love their children, and when experiencing this environment, they are initially at a loss of what to do, can be done, and obtain the appropriate help. Substance abuse confusion is substantial due to the changing nature of the individual's issues and behaviors. The cord is not severed initially, as the young person retains needs that are unavailable outside of familiar parental home and concern. However, the lure of drugs is powerful, and the widening gap they create is difficult to combat and overcome due to their rapidly changing nature.

Most agencies and organizations have fallen back positions if they are not directly involved, and that is a lack of hands-on assistance. Or, the rules are used to justify the action, and no compromise is possible. This expanding lack of help exacerbates the problem for those seeking assistance, as in time, they realize the dilemma is more extensive than anticipated, and they are left without options, a frightening condition.

With all manner of interventions fails, time is not a friend. As distancing and worsening conditions occur, hopelessness by those, who loved Curtis turned to frustration and fear. The pull of drugs is accompanied by the people who also share that environment; they have their "stash" of chemical substances whose deadly aspect rides the pale horse of addiction, silent and waiting. They justify their journey into the dark side by taking more of the chemicals that demand prominence. They are self-inflicted, where the outcome may result in death.

And so, it was with Curtis! Repeat offenses of a minor nature resulted in a sentence to the County Jail, punishment by a Judge for traffic offenses that held no sway for drug addiction, the foundational cause of the behavior. It was not the Judge at fault, for the limitations of the law defined his choice of action. The jail knew that incarceration deprived people of illicit drugs, and the sentence provided a period of abstinence. However, desire is not cured or results in a change of attitude, for the demand remains not in remission, but waiting for release and access to fulfillment regardless of consequence.

And so, it was with Curtis. His father asked the County jail staff if he could release so he could retrieve his son and get him home, where hope for continued abstinence would occur. But that did not happen. And Curtis was met by those with whom he associated and taken to a celebration of release from incarceration. The party consisted of alcohol and drugs; a combination of intake resulted in the loss of consciousness, a panic call to 911 by the group, and emergency transportation to a hospital. Imagine the impact on the parents and other family members to learn of these events, expecting another outcome.

With time, the medical prognosis was grim, the body would not recover, and death was close.  The gathered family prayed, stood in silence, hoped for God's reprieve, but it was not to be. Instead, death took the son, brother, and grandson, leaving in its wake the sadness of his dying and the anger of why it had to be.

Those who loved Curtis still do; they grieve and tell stories of regular times, they wish it were different, and some blame themselves for not doing more. Therein lies the dilemma, for doing more may not be possible; the challenge is an enemy of gigantic proportions that dwarfs what most can do. The adage, "It takes a village to raise a child," is accurate, but with illegal drugs, even that may not be enough.

The resources expended, the diversity of services and the separate pathways that are often disconnected contribute to this issue, all too common every day. The message is clear, we remain fragmented in our approach to determining a sustainable solution to substance abuse, and we must ask, why?

In our book, "Substance Abuse Interventions: Catalysts for Change" (2017:5), we state:

In combination with prescription substance abuse, the invasion of illegal drugs has a crippling effect on individuals, families, friends, colleagues, the workplace, and other acts of being citizens of this country. Unfortunately, this debilitating condition is not compared with anything of a similar nature.  The extent of harm is not precisely known, but what we are aware of is disheartening. The cost of lives lost, futures shredded, and diminishing hope that wains daily, and this wave of despair seem insurmountable.

Across this nation, we find a small but determined army of people representing all manner of approaches to slowing down harm, controlling abuse, and providing recovery to the tens of thousands of individuals trapped in the grip of this devastating enigma. They provide front-line services; they see the very people who suffer from the effects of substances that control and diminish life in all its aspects. Many are visible and provide services through organized programs; others more quietly engage in numerous ways to relieve the suffering. Still, more work behind the scenes seeks change in a more personal and caring manner.

The many unsung people who toil in the world of the addicted do so from a commitment personal to them; we dedicate this book. Your example and efforts are not unnoticed; they bring renewed hope and spur engagement by others to join with you and seek sustainable solutions to the ravages of improper use of legal drugs and illegal substances.

But it is not enough as the problem far exceeds the considerable resources being applied, only not enough due to the fragmentation of approach, the gaps, and missing connection from A to B to C and onward across all local, county, state, and federal programs. There is an army of enforcement, medical, mental health, education, treatment, Criminal Justice, and other providers on the front lines daily. We are not finding fault with them, for they do what they have done for decades; yet most of which exist in separate silos of service. Therein lie the realization this may well contribute to the issues we have faced for decades.

We provide three examples of promise, where the change occurred, and it happened due to the added inclusion of people and services, combining the strengths of many for a common purpose. They are:

1. Anuvia Prevention and Recovery Center, Inc. Charlotte, North Carolina (pp 167-178).

2. Orleans County Office of the Sheriff, NY. Implementation of Primary, Secondary, & Tertiary Prevention of Substance Abuse (pages 179-187).

3. Building Community Partnerships Model. Assisting Agencies Plan for Success (pages 188-194). For example, the Charlotte-Mecklenburg Police Department's "Community Problem-Oriented Policing" program was a model for building sustainable community collaboration and problem-solving partnerships.

An Intervention Model.    

Conflict, trauma, health issues, and numerous other situational events are improved when indispensable people with skills and knowledge join to determine solutions.

We have numerous response agencies and people that provide their expertise to a situation demanding intervention. But, in the public sector, consider the number of agencies, their roles, and the services they provide. How many are collaborative in the real sense, not just temporary connection, and what is the cost of this inefficiency?

Illustration of agencies, where considerable expertise can make a difference, include:

§ Health Issues,

§ Substance Abuse,

§ Community Debt,

§ Crime and Justice,

§ Mental Health Issues,

§ Infrastructure Repairs,

§ Homelessness and Poverty,

§ Domestic and Family Violence,

§ School Safety Issues and Security,

§ Lack of Motivation by Specific Groups,

§ Theft, Damage, Disruption, and Other Labels.

Comprehensive and collaborative interventions[3] provide initiatives to address complex interactions where risk and protective factors impact a person or a group. They use the environmental effects of family violence as an illustration. They promote the use of:

1.  Service integration.

2. Comprehensive services that focus on particular problems that share common risk factors. They also allude to the collective sharing of responsibility when addressing these problems and their intervention.

3. The engagement of community-exchange interventions that target social attitudes, behaviors, and networks.

While the overall goals and characteristics of the agencies addressing the same issue are similar in purpose, each has its own set of strategies, rules, policy, service approaches, and other agency-specific resolutions. When more than one agency is involved (known and unknown to others), the crossover of services is confusing. The expenditure of different resources may not bring about the desired outcome. Change in the process makes sense and should be the topic of agency outcomes, not as a separate organization but in the collective imagination.

It is not a complicated process; it merely needs commitment, definition, policy, and formal M.O.U.s that spell out how agencies and staff will work collectively when finding themselves in those situations.

Effecting change is complex, and with our example of substance abuse substantial.  Breaking down agency territoriality, causing collaboration models, using resources differently, establishing database systems, proper analysis staff, and coordinated efforts seem daunting. Still, if so, it would beat what is currently the model of chaos.

We offered a model, a comprehensive focus on the problem and issues identified, to include:

A.    Other stakeholders.

B.    Additional expertise.

C.    Professional services.

D.   Citizens in the focus area.

E.    Government officials (elected and appointed).

Success includes coordination, participation, and a focus on strengths, skills, knowledge, expertise, abilities, and experience into a sole focus and sharing information, collaborating, planning, and executing what is deemed a sustainable solution. This concept is simple but challenging to implement for reasons we all understand.

Problem-solving is an exact science, and there are many models in existence. For example, in Charlotte, North Carolina, we utilized Goldstein's S.A.R.A. Model. It expertly met the demands and provided the information and analysis used to reduce crime, disorder, violence and improve the quality of life for thousands of citizens. Other models also have utility; the key is determining what will be used, incorporate it, and utilize in the efforts undertaken.

Summary.

Society seems dysfunctional beyond a few people, with illustrations abounding of groups desirous and demanding of being allowed to live as they choose, which is just fine until they require the rest of us to comply with their view of the world and lifestyle. No, I live my life as I see fit and want to avoid the cynical and caustic rhetoric that dominates the news, media, and other things. But, unfortunately, common sense and loyalty to rights have evaporated, and we are in the turmoil of rant and rave by seemingly everyone.

Why mention this? Well, it dominates and takes the oxygen out of the discussion for all other matters, which are dangerous, harmful, and devastating our society to limits not previously reached. Our illustration of the chaos of substance abuse illustrates our point. When we argue about political philosophy, polarization, and total lack of value to millions of Americans, we must focus on solving persistent problems. Failure to do so lead to a worsening of issues and concerns, leading to higher cost. 

Statistics of the cost of illegal drugs and requisite enforcement, treatment, prevention, lost wages, and the big industries that have appeared are mostly years old. That speaks to the interest in being cost-effective. However, here is a smattering of costs [5]:

1. Enforcement of the drug control system costs at least $100 billion a year. How well is that working?

2. Federal spending is 'around' $15 billion. Remember that it was five years ago.

3. State and local drug-related criminal justice expenditures amount to $25.7 billion.

4. The massive spending accomplishes little, and law enforcement's action, the group we demand action from, does not impact illegal drug sales and accompanying issues. So, if this is true, are we not spending time and money that should be applied to problems where positive change might occur. Unfortunately, we do not know because we do not collaborate in enough depth, nor do we evaluate to determine where we could substantially improve.

5. We incarcerate more than 500,000 in the past four decades. The net loss from productivity, estimated in 2004 (old data), was $40 billion annually. Today, it must be staggering.

6. What of the dozens upon dozens of public and private agencies who are involved in the worn War on Drugs, where the cost seemingly has made no difference. That is based on the continuing rise in use, legalization, and deaths — three measures of many.

Recommendation.

As with Charlotte in 1996, the "big picture" must reduce to "what can we manage"? The focus includes:

§ Utilizing local stakeholders and paid staff to focus on the problem.

§ Identify stakeholders who have the expertise to step up and form collaborative partnerships.

§ Demand full participation by others who have familiarity with the situation.

§ Engage in sustainable problem-solving efforts.

§ Highlight the goal of engagement in sustainable community collaboration building to reduce and eliminate persistent problems. 

We cannot afford the cost in dollars, the harm to people, the disjointed focus away from the purpose of some agencies corrupted on emotional issues of serious problems where no change occurs, indicative of our not practical efforts.

Community collaboration is an answer. Working locally with people supported by expertise, experience brings the right individuals to the table to determine the focus and engage in a problem-solving model of proven outcomes. Local people addressing local problems and connecting with others will result in sustainable problem-solving.