Along the path to where we are now, we were surprised (and sometimes overwhelmed) by all of the systemic considerations and challenges associated with systems change. There were the obvious and known barriers but there were also “hidden” and rarely discussed challenges that hindered moving forward and real change.
I have so many different experiences to share in this regard, and may, in fact, write a book about the amazing and complex process one day. In today’s blog I will discuss just one such challenge.
Years ago, as part of a “test” of Procovery, I went to a meeting attended by myself and Randy Stratt (co-founder and creator of Procovery, and my amazing and very much missed, late husband) along with the owner/operator of a residential care facility, as well as some of the local DMH staff. The DMH designees were discussing the potential of us holding a Procovery Circle at this particular residential care facility, as part of an evaluation of Procovery efficacy.
Despite the real courtesy extended to us, it felt to me, that the owner/operator was both hesitant and uncomfortable with the idea of having a Procovery Circle operate at his site, although he did not express this.
After the meeting was over, concerned about the owner/operator’s potential discomfort, I stopped back in, and asked the facility owner if I could speak with him for a moment. I shared that I felt that he was possibly a bit hesitant to hold a Procovery Circle at his site, and I wanted him to be assured that Procovery is a voluntary program. And that if, for any reason at all, he didn’t want a Circle held at his site, that we would not move forward in that regard. We would very easily select another site with no problems and no questions.
He looked very uncomfortable, shifted around a bit, and finally said slowly and softly
“I am afraid that Procovery will help people heal.”
My head began to spin, but I also respected his feelings and appreciated his genuine, blatant honesty.
He then shared, haltingly and thoughtfully, that he was trying very hard to make ends meet. That when someone first moved in to his site, they were extremely labor intensive, and therefore costly. He said that finding the right room-mate, was an often difficult and disruptive and trying process, but something critical to safety and quality of life. He said finding the right match of worker for each resident, appropriate activities for each resident, ensuring they continue to access their benefits, in part so that, quite simply, the facility got paid, could pay its bills, and so that the resident did not find him or her self, homeless. He said it was important to learn about any family involvement, and what that entailed. He shared that this took time and sensitivity to understand the often multi layer issues and hurt that were associated, and that all of this is labor intensive on the front end.
Furthermore, he said it took real focus and effort to best support any medication routine a new resident arrived with, and that in new surroundings often dosage, type and timing needed to be adjusted to best support a resident’s healing process… And that they also had to find “work arounds” to effectively deal with the “side” effect of medications, learn what food or other restrictions or requirements might exist and often deal with the hugely problematic issues that arose when people went off of their medication, not due to ineffectiveness, but due to anger or frusration, and as a result , he felt, often the individuals did not follow requirements to continue to receive benefits and then were subsequently evicted and living on the street until such time that they began receiving benefits again and moved back – the majority of the time in crisis mode.
And then, he reasoned, if once all of that expensive and labor intensive work was undertaken….if then Procovery helped people heal and move forward… and potentially away…? Well, then, he would find himself on an expensive and reasonably constant merry-go-round of getting people settled only to see them move, and leave space for the next, labor and cost intensive resident, and then the next, and the next and so on. He shared that many of his residents had been there for over a decade and they were now very cost effective, not overly taxing his staff or his budget.
The owner stated that he was committed to making his facility safe and comfortable and as inclusive and hopeful as possible, but that if Procovery did what he thought it could, he would not financially survive. And then no one would be better off, he reasoned…because he felt he was offering a truly safe, comfortable, caring residence, something that was often very hard to find.
This story is an example of just one of the hundreds and hundreds and hundreds of barriers and challenges we faced during our extended testing and revision program development stage. After further consultation, the owner of this facility selected to move forward, albeit hesitantly, with a Procovery Circle at his site. That process and lessons learned is enough to fill its own book. But in short, the owner became a huge advocate for Procovery and selected to have staff receive training, supported the Procovery Circle hugely and supported new and exciting events at the facility. I am immensely appreciative of his willingness to honestly discuss his concerns, and his interest in trying a new way of doing things. As a result of his honesty, and the honesty of hundreds of other people, across the country, Procovery changed, evolved and became a powerful vehicle for health care reform and true, sustainable systems change.
Every person involved in the system has their own unique views, considerations, concerns, needs and requirements. The starting point, the path to healing, and the desired destination, will not be the same for any two people. Nor should it be. We are all different. And there is beauty and power and strength in our differences. Yet, while we are all different, we are all interdependent. Together we can make spectacular, unprecedented changes. But one thing we need to do, along the way, is meet everyone where they are, open the lines of communication, and inspire each and every person, agency, community to move forward… We cannot live and work with only our own agenda in mind. To create truly sustainable transformational change, we must learn from each other and work (and celebrate!) together.
“If everybody is thinking alike then somebody isn’t thinking.”
-General George S. Patton
“And I think both the left and the right should celebrate people who have different opinions, and disagree with them, and argue with them, and differ with them, but don’t just try to shut them up.”