For around five years, early in the 21st Century, my job involved managing a set of complex service areas including Mental Health, Correctional Health, Disability and Alcohol and Drug Services. Management of a new unit was added in the form of the Complex and Exceptional Needs Unit (CEN). This included implementing the new Agency Collaboration Strategy.
The unit was resourced with a small number of people to support the function of the strategy across the very large Department of Health and Human Services including engagement of other key Government Agencies involved with complex clients such as the Education Department, Police, Department of Justice and Corrective Services.
The genesis of the strategy arose from the then Minister for Health and Human Services ( The Hon Judy Jackson) who was dismayed that her Department could not solve the needs of the most complex clients.
The group of people whose needs did not fit neatly into any one service system were repeatedly sent elsewhere and often ended up with no service at all or very costly services that did not address real needs. An example of this complexity is a homeless teenage child with a mild intellectual disability, co-morbid with substance abuse, not attending school and in contact with police and juvenile justice for lighting fires.
The Collaboration Strategy operated for a period of over five years and achieved some amazing results finding real and lasting solutions for situations that were previously deemed to be unsolvable.
It was underpinned by the vision that Collaboration is about people working together to achieve the best outcomes for clients. There was no official additional budget for service delivery allocation. Success relied instead, on tangible support from the highest levels of leadership, a small group of enthusiastic, skilled facilitators employed within CEN and some carefully developed and well articulated processes and documentation working at three different levels.
Firstly at Service Delivery level within all services across the Department utilising the vision and principles to support working together and intervening early to creatively determine solutions for clients with complex issues and their families.
Secondly, intervening with more complex cases with the assistance of Key Coordinators. Key Coordinators were about 100 designated Middle and Senior Managers/Clinicians spread across the service system. They were given the additional title and coopted as part of the Collaboration Strategy. CEN provided them with ongoing leadership training and support.
The third and highest level of intervention involved the most senior directors/managers of service areas including hospitals, mental health, housing, child protection etc meeting together as required to form a Board for Exceptional Needs (BEN) to pool resources and collective wisdom aimed at finding solutions for the most complex exceptional and even catastrophic cases.
Senior people from other Government Agencies and Non-Gov organisations were invited to attend BEN meetings as required. In effect these meetings operated as ery high level case conferences. In line with Alan Brisken’s harvesting collective wisdom work, they were underpinned with collaborative dialogue techniques including deep listening , suspension of certainty, seeing whole systems and seeking diverse perspectives, respect for others and group discernment in tandem with welcoming all that arises and retaining a sense of humor despite the seriousness of situations.
The Agency Strategy was underpinned by 5 Principles that were expressed in Plain English and disseminated widely via every means possible. This included posters that mysteriously appeared in every meeting room in the Department and small business card summaries with liberal use of easily identified artwork.
The Five Principles being:
- Work together in a spirit of cooperation: This meant everyone staying engaged with the process and the conversations until there were solutions no matter how long it took, not walking away, contributing time, energy and resources when needed.
- Intervene as early as possible: Not waiting until a small issue became an inevitably larger one and looking for system solutions that address root causes.
- Keep the client and their world at the centre: Maintaining a practical, solution-finding , creative problem-solving approach even if it meant that a few rules needed to be broken and rigid service systems bent.
- Find solutions that are fair, creative and affordable: Applying an ethical and imaginative filter and wherever possible working with available resources.
- Design understandable processes: Coming up with solutions that make sense to everyone using language that everyone can understand.
The ongoing operation of CEN and the Collaboration Strategy fell victim to organisational restructure and changes in Government direction. These collaborative methods and principles could however be easily transferable to the issue of addressing literacy in Tasmania.
