Creating pathways to innovation for autism in Quebec: why not?
As the date for the Quebec Autism Forum approaches, many of us are thinking about how Quebec can begin to address the overwhelming and growing needs of our individuals and families touched by autism spectrum disorder.
Looking across Canada and beyond, the struggles are equally vexing, though varying depending on the particular context. There is convergence on the needs across the life span and the rights of individuals to have these needs met. But it seems that addressing each need is a monumental task in terms of thought, execution and financing. In my view, what we are facing here are examples of “wicked” problems. Frances Westley, Sean Goebey and Kirsten Robinson of the Waterloo Institute of Social Innovation and Resilience (January 2012) describe wicked problems as those that seem “insoluble” or that seem to need a reconciliation between “seemingly antithetical elements” such as allowing for cost containment on one hand, while increasing the access to services for increasing numbers of people on the other. Under these conditions, human nature dictates that we tend to retreat; we do what we can and resign ourselves to that.
The knowledge that there are likely insufficient funds in the government’s coffers to do everything that needs to be done is worrisome. In the midst of transformational health system reform in Quebec, public service organizations are being told to do things differently. Yet the focus on, and burden of, constant daily cost pressures in any context are known to stifle innovation, not enable it, to de-moralize good people, and to breed turf protection versus cohesion. Furthermore, the bottom line is that in the midst of destabilizing reform among service providers, our families’ dire needs have NOT changed, nor can families be expected to « wait it out » as the public network re-calibrates.
Here are some thoughts on how we might move forward:
1. Develop a culture of innovation and collaboration for autism in this province.
We need to properly define each unmet need at every stage of life and start turning it on its head, looking at it deeply from every possible vantage point. We need to leave much-needed space for creativity; for imagining what could be. We need to focus on what the life journeys of the constituents of our province SHOULD look like and then how we can get there. Once we look at it that way, the status quo, or even improvement relative to the status quo, is no longer an option.
We need to think about whole systems problems, “metaproblems” or “messes” (Trist, 1979) and therefore come up with whole system approaches. Each of the problems we face for our autism population is multi-faceted. There are technological, administrative, clinical, social and political factors that must be combined into seamless solutions. We need to acknowledge how complex each problem is, think long- term and stop trying to attempt quick-fix solutions.
We must recognize the collective importance of all levels of government and all sectors of society in meeting the needs of our populations. Individuals, departments, organizations and sectors must re-focus on our common higher purpose and begin with enabling the development of mutual respect and common understanding. [Note that there is precedent from abroad that we can use as inspiration. Westley, Goebey and Robinson (2012) refers to the example of Denmark’s Mindlab, “a collaboration between three government ministries, members of the public and business that seeks to break down the silos between organizations and build the spaces to develop creative cross-sectoral innovations. They have developed a long-term process that involved frequent interactions and a constant reframing of the problem space so that ministry staff, business leaders, non-profit executives and citizens have an opportunity to view complex problems from each others’ perspectives. Problems the MindLab has broached include reducing government red tape, youth employment, gender equality and climate change.” (page 11)
2. Look to the glimmers of hope and replicate.
Despite the ominous cloud of concern that exists in the evolving provincial health and social services system today, so many individuals whom we have met within the public services network are dedicated and committed to improving services for our families. We need to harness that commitment and allow these individuals to both participate in finding solutions and find others to join forces with us.
We are inspired by the mobilization and partnership among sectors and organizations that have resulted from the introduction of our See Things My Way Assessment clinic that is working to reduce diagnostic wait lists for young children in Montreal. We need to appreciate this progress and all those who have contributed to it. We need to understand its levers of success and replicate these for other problems in desperate need of solution for our families. We need to make success contagious
3. Start small, go deep and learn in situ.
Our learning to-date at the Centre for Innovation in Autism and Intellectual Disabilities tells us to start small with carefully developed, well thought-out and properly resourced pilot projects for services that better respond to families’ needs. We need to bring experts and citizens from all walks of life to the table as the projects are developed. We need to ensure that projects are evaluated from day one based on worldwide best practices, with a focus on both quality and efficiency to allow for continual improvement and refinement.
The bottom line is that we need to allow ourselves to carefully and deliberately try things, and then to fail honestly if need be, in order to ultimately succeed.
Meeting the needs of our families is a long-term commitment that goes way beyond the four-year time frame of a political term in office. We need cross-sectoral leadership with steadfast determination. In this, we are inspired by Mr. Salvatore Guerrera, the Chairman of the Board of the See Things My Way Centre for Innovation and his wife Madame Diane Proulx-Gerrera, Chair of the Board of the Miriam Foundation who, despite their own life challenges, have persisted over the past 10 years to make a difference for our families. This began with their leadership role in the passing of Bill 21 in 2009 allowing psychologists to diagnose autism spectrum disorder. Their devotion continues today with the creation and development of the See Things My Way Centre for Innovation. They continue to work tirelessly for our cause, letting nothing get in their way and are but one important example of the persistence and patience needed by all of us who wish to elicit systemic change.
5. Adopt the temperament of “Why not?”
We need the temperament that Mintzberg and Avezedo (2012) refer to as “why not”, which they argue is powerful in dealing with some of the major social problems facing the world today. “Why not” people are those who are pre-disposed to the possibilities of success and willing to try something different, no matter how daunting it may seem. Their research uncovered “ordinary people extraordinarily engaged”, such as Doctors without Borders, or the successful wind turbine initiative in Denmark, as only two examples of groups that simply adopted the positive posture of “why not?”… and went for it. Then, the ideas spread.
Many examples of such social initiatives exist throughout the world, often implemented collectively by government, business and social sector organizations. We can learn from them and be inspired by them.
Let’s change the world for the better for our families.
Why not make Quebec a true leader in autism?
Malvina Klag, MBA, PhD
Chief Strategy Officer
See Things My Way Centre for Innovation in Autism and Intellectual Disabilities
For more information on the publications referred to in this blog, here are the publication source details:
Henry Mintzberg and Gui Azevedo (2012). Fostering “Why not?” Social Initiatives — beyond business and government, Development in Practice, 22: 895-908.
Eric Trist (1979). The Environment and System Response Capability: A Futures Perspective, Futures, 12: 113-127.
Frances Westley, Sean Goebey, and Kirsten Robinson (2012). Change Lab/Design Lab for Social Innovation, Waterloo Institute of Social Innovation and Resilience, sigeneration.ca/documents/PAPER_final_LabforSocialInnovation.pdf.