Jun 15, 2012

Leading Indicators of Social Change

Like many of my readers, I want to see the experience of mental illness change as a broad social phenomena in US culture and across the world.

We know that mental illness is a tough problem that is expressed in a variety of contexts. There's the issue of how the illness is experienced intimately by one person. Just beyond that are social aspects of the illness, and how it affects friends and family. Beyond that we have the issue of public policy, funding for treatment, and well beyond that the more intangible issues of social acceptance of the illness, stigma and so forth.

Given that mental illness is something that is experienced at so many levels across every society on earth, is there any way to judge the progress we are making? What is the best pace for progress on social issues that any of us can reasonably expect?

My working theory is that we should expect the pace of mental illness reform to track the pace of other historical social change movements, especially those that move away from patriarchal, hierarchical, authority-dominated, directive, and intolerant features, and move towards distributed power, permissive, diverse, supportive and tolerant features. These include women's rights, access to birth control, gay marriage, social determinants of health, civil rights, education policy, healthcare reform, and public funding for social services in general.

I think these issues cluster together as "leading indicators" of social change. They move within cultures at a certain pace. Two examples:
  • Women's suffrage, once shocking, has been reduced to a quaint backdrop for Mary Poppins (and has been so for five decades).
  • Effective birth control is legal and pretty much available to any woman in the US for $15 to $50 per month. We still have some "border skirmishes" over birth control, but we no longer jail people over it (as we did 100 years ago). 
Has the treatment of people with mental illness kept pace? To a certain extent, I think so. At least today most people know that folks with mental illness are human, not to be abused or chained up, or left naked and abandoned in basements or so-called "asylums." We know an outrage when we see one. (Not that our world's perfect by any means.)

How long will it take for us to take the experience of mental illness the rest of the way? What kind of society must we have to allow that sort of progress to take place? Are there other social issue advocates who must be our companions as we seek to make progress for our cause?

Jun 4, 2012

Where can we get some leverage to really change mental illness?

How can we use systems theory to deliver powerful innovation and change? In 1997, Donella Meadows wrote a famous article in Whole Earth Review identifying 12 key leverage points.

Here’s the list, in order of increasing power.
12    Numbers. Constants and parameters such as subsidies, taxes, and standards
11    Buffers. The sizes of stabilizing stocks relative to their flows
10    Stock-and-Flow Structures. Physical systems and their nodes of intersection
9    Delays. The lengths of time relative to the rates of system changes
8    Balancing Feedback Loops. The strength of the feedbacks relative to the impacts they are trying to correct
7    Reinforcing Feedback Loops. The strength of the gain of driving loops
6    Information Flows. The structure of who does and does not have access to information
5    Rules. Incentives, punishments, constraints
4    Self-Organization. The power to add, change, or evolve system structure
3    Goals. The purpose or function of the system
2    Paradigms. The mindset out of which the system—its goals, structure, rules, delays, parameters—arises.
1    Transcending Paradigms 
Meadows noted: “It is in the space of mastery over paradigms that people throw off addictions, live in constant joy, bring down empires, get locked up or burned at the stake or crucified or shot, and have impacts that last for millennia.”

If we really want to change the experience of mental illness, we need powerful leverage -- adding a dollar here or there, tweaking this or that will not get us all the way.

Several versions of Meadows' article exist. Here's a link to one.