Archive for April, 2011

April 18, 2011

Services Aren’t the Answer

by Richard Edwards

Recently, I read an article from the Stanford Social Innovation Review that is a must-read for anyone in or receiving human services. You can read the article here. (Some of the articles require a subscription, but this one is free. Warning: pdf file.)

Part of the reason the article struck me so was that it echoed something I’ve suspected for a long time, which is that the public human service system is essentially flawed, at a very basic level.

A few years ago, I did a pecha kucha presentation around social capital and its potential impact on the lives of people with disabilities. Social capital can be understood as the resource that exists within our relationships. One of the obstacles for people with disabilities in building social capital, as I pointed out in the presentation, is the service system itself, which wraps people in services, thereby insulating them from the community. The result is that communities abdicate their role of taking care of their members with social capital–friends and family–relying on financial capital instead. And people with disabilities and their communities become less relevant to each other.  This isn’t natural to the way members of a community live and interact.

A colleague told me today that people with schizophrenia function much better in daily life in Kenya than they do in the United States. With all the services and medications and financial capital we have available–how is this possible?

These stories illustrate for me the inherent flaw in fee-for-service supports through the public human services system, despite its good intentions. Part of what people really lacked in the institutions decried in the 60s and 70s was a network of friends and family who would watch out for them. In the 21st century, we still don’t help people make or remake these connections, relying instead on professionals to act as surrogates.

The Stanford article focuses on education–specifically dropout rates–and how the city of Cincinnati tackled poor school performance as a community. Instead of targeting individual schools or individual students, the community tackled poor school performance as a whole, yielding a much greater collective impact.

I think this point–though focused on education–is important for human services to absorb as well.

My angle is that if we pay for a service, we get a service. Paying for a service in 15″ increments means we focus on the process instead of the outcome, because 15″ of anything is unlikely to be all that useful (unless it’s an introduction). And so we perpetuate service, instead of freedom from service–which is what we all really want.  I’m not saying that we eliminate services off the bat–but at some point, we need to get beyond providing services which offset a problem, to tackling the problem itself.

But that’s just my angle…what are your thoughts?