Suicide, PTSD and Culture – A Deming Perspective

Headline News:  Americans are depressed and suicidal because something is wrong with our culture.  Kirsten Powers, Opinion columnist, USA Today, published 10:27 a.m. ET June 9, 2018 

Post and Discussion on LinkedIn.  As of June 19, 2018, 25,618 views, 96 likes, 48 comments, 12 reshares.

Given human nature and the fact that people are imperfect, there will likely always be suicides.  Studies indicate that there is a correlation between culture and suicide. As a Society, is our system stable, e.g.,  the number of suicides fall within a predictable range, or is it unstable?  The article by Kristen Powers identified “that suicide rates have risen nearly 30% since 1999, making it a national crisis.”  Does the 30% represent special cause variation?  A special cause identifies that based on the numbers, it is a statistically significant shift justifying the conclusion that it is a “crisis.”  If the “30%” represents common cause variation, then the number falls within a predictable range.  Stable does not mean good – just means its predictable.

The so what?  The aim of the Deming system for improvement is to take action that results in outcomes where everyone benefits or at least, are not any worse off in the long-term. This standard cannot be met without an understanding of common and special cause variation. Application of this knowledge significantly increases the probability that needed change will result in improvement – especially one that may require cultural changes.  Deming estimated that failure to understand the difference between common and special cause variation can lead to situations where 95% of action resulted in no improvement. He referred to this as “tampering.” Kristen Powers’ decision of sharing her story can certainly be considered among the positive improvement actions that can be taken.

Supporting Articles and Links

 

Center for Disease Control (CDC)  Suicide rates rising across the U.S.

CDC Vital Signs – Suicides

  • Suicide is a leading cause of death for Americans
  • Suicide is a leading cause of death in the US. Suicide rates increased in nearly every state from 1999 through 2016.
  • More than half of people (54%) who died by suicide did not have a known mental health condition.
  • Suicide rates went up more than 30% in half of the states since 1999.
  • Nearly 45,000 lives lost to suicide in 2016.

Americans are depressed and suicidal because something is wrong with our culture Kirsten Powers, Opinion columnist, USA Today, published 10:27 a.m. ET June 9, 2018 

  • Rather than pathologizing the despair and emotional suffering that is a rational response to a culture that values people based on ever escalating financial and personal achievements, we should acknowledge that something is very wrong. We should stop telling people who yearn for a deeper meaning in life that they have an illness or need therapy. Instead, we need to help people craft lives that are more meaningful and built on a firmer foundation than personal success.
  • But most Americans are depressed, anxious or suicidal because something is wrong with our culture, not because something is wrong with them.
  • Changing our culture is critical. Being honest with others about our own personal struggles and dark nights of the soul is the first step. People on the edge need to hear stories that assure them there is a way through the all-consuming pain to a meaningful life.  

New York Times, Suicides Have Increased. Is This an Existential Crisis? June 23, 2018.

As a behavioral scientist who studies basic psychological needs, including the need for meaning, I am convinced that our nation’s suicide crisis is in part a crisis of meaninglessness. Fully addressing it will require an understanding of how recent changes in American society — changes in the direction of greater detachment and a weaker sense of belonging — are increasing the risk of existential despair.

Empirical studies bear this out. A felt lack of meaning in one’s life has been linked to alcohol and drug abuse, depression, anxiety and — yes — suicide. And when people experience loss, stress or trauma, it is those who believe that their lives have a purpose who are best able to cope with and recover from distress.

Junger’s new book ‘Tribe’ is giving the public exactly the wrong idea about PTSD

BY  | 
  • Sebastian Junger’s book is doing tremendous damage to the public perception of veterans, post-traumatic stress disorder, and suicide.
  • Most horrifically, Junger claims that there is no relationship between suicide and combat. This ignores a trove of medical, academic, and journalistic evidence that clearly demonstrates that such a relationship exists.

HOW PTSD BECAME A PROBLEM FAR BEYOND THE BATTLEFIELD

  • Though only 10 percent of American forces see combat, the U.S. military now has the highest rate of post-traumatic stress disorder in its history. Sebastian Junger investigates.
  • Israel is arguably the only modern country that retains a sufficient sense of community to mitigate the effects of combat on a mass scale.
  • Another Israeli researcher, Reuven Gal, found that the perceived legitimacy of a war was more important to soldiers’ general morale than was the combat readiness of the unit they were in.
  • Given the profound alienation that afflicts modern society, when combat vets say that they want to go back to war, they may be having an entirely healthy response to the perceived emptiness of modern life.
  • It might also begin to re-assemble a society that has been spiritually cannibalizing itself for generations. We keep wondering how to save the vets, but the real question is how to save ourselves. If we do that, the vets will be fine. If we don’t, it won’t matter anyway.

Repeal the Second Amendment?

 

Following is a summary of a discussion on LinkedIn discussing the NYT Op-ed submitted by retired Supreme Court Justice Stevens: John Paul Stevens: Repeal the Second Amendment , March 27, 2018.

Does the discussion reinforce the need for a new approach to help resolve controversial issues?

The debate focuses on the “meaning” and interpretation of the second amendment from a legal perspective.  A different approach is looking at the issue not from an original meaning but from the original intent.

The aim of the design of the U.S. political system was to form “a more perfect” union (original intent). Working towards this aim from a Deming perspective would equate to taking action that results in a situation where everyone gains, or at least, are not any worse off in the long-term.

The challenge becomes to identify the feedback people need to assess if a change makes things better or worse.  Deming suggests looking at things from four perspectives: Psychology (motivation), Systems (action) Variation (feedback), and Knowledge (learning).

Psychology is the study of human behavior and what motivated it.  For many, guns in America are an integral part of our history, culture, identity, strength, sense of security, and freedom. Guns are also a symbol.  Many of the comments on the post reflect this perspective.

There is also the philosophic perspective regarding the nature of man – all humans have the capability of being good and evil which reinforces an individual’s desire for self-defense and self-reliance.   And further, some have more confidence in government’s ability to protect them than do others.  For many, the 2nd amendment is an insurance policy – you may never need it, but nice to have – just in case.

A System includes laws and interpretation of the laws.  I can’t add much to the current debate on the 2nd amendment.  I think both sides have goods arguments. Unfortunately, the debate will be never ending depending on who has the most votes at the time. Conservative will vote one way and liberals the other, e.g., zero-sum that indicates a stable (predictable) system.

Variation is the gap between the ideal situation (more perfect) and actual. From an “originalist” position, repealing the 2nd Amendment is tampering – which makes things worse.  From a “living document” perspective, repeal is an improvement.

The variation principle also provides a new standard that can be applied for assessing the efficacy of gun control laws.  It also provides a new perspective on looking at all the factors that contribute to unnatural deaths from crime, accidents, disease, addictions, war, et.al.  What are the trends?  What are the priorities for improvement? What is working? What is not?

Knowledge. What are we learning?   The responses to the post identify individual views and passion on the topic.  In regard to repeal, whoever has the most votes will “win.”  Even if the votes are there to repeal, many will not accept any ruling that conflicts with their belief that they have right to keep and bear arms.  The U.S. is not Australia where the population volunteered to turn in their guns.

A way-ahead?   Start with the variation principle. Get agreement on the methodology and data e.g., the facts regarding deaths due to the misuse of guns. To provide context, I would also include comparisons with other deaths by other causes. Any successful long-term solution will need to acknowledge and address the cultural aspects (psychology) that are an inherent part of the 2nd  amendment.

Assess your knowledge of the variation principle.

More Info:

Other

Who Needs a Gun? by Gary Gutting, NYT, The Stone

 

 

Most Americans believe the management world is flat. Do you?

Imagine you lived at a time in history when it was an accepted belief that the earth was flat. Now imagine you started hearing the claims that the earth was round – that new continents were discovered. Would you have cared, or would you have wanted to learn more?”

“Men occasionally stumble over the truth but most of them pick themselves up and hurry off as if nothing happened.”—Winston Churchill

In 1924, Dr. Walther Shewart discovered a new paradigm for managing variation. Variation is a law of nature that states that no two things or people will ever be ever exactly alike – everything varies.

W. Edwards Deming was a student and colleague of Dr. Shewhart.  Deming’s contributions in developing the paradigm were recognized by U.S. News and World Report as one of the nine turning points in world history and by Fortune Magazine as among the greatest contributions to business history.

Deming concluded that failure to understand the variation paradigm resulted in a situation where ninety-five percent of changes made by management today result in no improvement. We are all managers in one role or another.

Deming further concluded that prevailing style of management resulted in devasting consequences on our economy and ability in working together in pursuit of a more perfect union.

What is the world’s most underdeveloped nation?With the storehouse of skills and knowledge contained in its millions of unemployed, and with the even more appalling underuse, misuse, and abuse of skills and knowledge in the army of employed people in all ranks in all industries, the United States may be today the most underdeveloped nation in the world.”   W. Edwards Deming

Assess your knowledge of  the variation paradigm

A way ahead?  To develop your knowledge of the variation, start with a developing and interpreting a trend chart.

Corruption: Description and Context

I generally associated the term corruption with illegality.  The Pope identifies a broader definition and context.

Pope Francis: ‘I Am Not Afraid of Sin, I Am Afraid of Corruption’,  by Thomas D. Williams  PH.D.  23 Jan 2018, Breitbart.com

“Corruption – when a person’s conscience no longer registers right and wrong.”

“There is a big difference between corruption and sin, Pope Francis contends, because the sinner can always convert but the corrupt person sees no need for conversion.”

“The corrupt person goes through life taking the shortcuts of opportunism,” said the Pope, “with an air of innocence, wearing the mask of an honest person, which he begins to believe.”

“The corrupt person cannot accept criticism, discredits anyone who criticizes him, tries to belittle any moral authority who would question him, does not value others and insults anyone who thinks differently. If the balance of power permits, he persecutes anyone who contradicts him.”

“Unfortunately, Francis said, the problem is widespread.”

Indiana High School Graduation Rates

QUESTION: Since 2010-11, have any of the increases and decreases in the graduation rate been significant or do they indicate that the system is producing results within a normal range?

Pre-Test: Assess your knowledge of variability

Indiana’s high school graduation rate slipped last year, Indianapolis Star, USA TODAY NETWORK, Jan 12, 2018

Indiana’s high school graduation rate slipped in 2017, falling nearly two points from the previous year and dropping to its lowest point in the past six years.

The decline was the largest single-year drop in the past 11 years, the time span in which state data was immediately available.

Trend Chart

Data:

  • 2010-11: 87.1
  • 2011-12: 88.7
  • 2012-13: 88.6
  • 2013-14: : 89.8
  • 2014-15: 88.9
  • 2015-16: 89.1
  • 2016-17: 87.2

Reference: (Source of Data:   School and Corporation Data Reports

More Information: Institute for Healthcare Improvement:

Not so fake news

Two recent articles on Linkedin reinforce the need for a “better system” for a national discussion on various issues.

  • Why Facts Don’t Change Our Minds. New discoveries about the human mind show the limitations of reason. New Yorker magazine, By 

Future of Brown County IN – Part 1

The following post was published in a Guest Column in the Brown County Democrat on Dec 27, 2017 titled:  The role of process in the future of Brown County

The Maple Leaf Music Venue and Performing Arts Center (MLPAC) project and the process used to fast-track approval may represent a turning point for the future of the county. This article is a first in a series that will provide a perspective on our current reality and offer additional options that may contribute to Brown County remaining a desirable place, to live, work, play and visit.

  • To summarize, key points and issues associated with MLPAC include the following:
  • In the April 2017, owners of hotels and inns, who are also appointed to the Convention and Visitors Commission (CVC) and Convention and Visitors Bureau (CVB) decide to use the revenue collected from the innkeeper’s tax to invest in an asset that will promote tourism. The Innkeeper’s Tax is a pass-through tax paid by the party renting the overnight accommodations.
  • CVC members are appointed by the county commissioners and council. The CVB is a non-profit organization established to manage tourism related promotion on behalf of the CVC.
  • CVC/CVB members decided on a performing arts center and also determined the size, location, scope, cost (12.5 million), and overall governance plan for the facility. Given that this investment is expected to result in overnight stays, their businesses will directly benefit from the investment, and the asset values of their establishments will likely increase.
  • Initially, county citizens were told that revenue from the innkeepers tax would be used to pay the principal and interest on the mortgage for the venue. Any profits were to be used for community and county infrastructure priorities.  The final terms of the deal are that profits would be used to make the mortgage payment and the revenue from the innkeeper’s tax would only be used if profits were not sufficient to make the payment.  This arrangement provides more revenue to fund the expansion of tourism.
  • A common perception in the county that was reinforced by the president of the county council, may be that the revenue from the innkeeper’s tax is “their (CVC) money.” This inaccurate perception may have contributed to a lack of transparency over the years regarding the management and expenditure of these funds.  This revenue, per statute, is a county asset. Commissioners and Council (elected by citizens) appoint CVC members who are subordinate to the citizens and their elected officials.
  • The approval of a 12.5 million dollar loan using the revenue from the innkeeper’s tax as collateral was approved by the commissioners on Nov 15 and the county council on Nov 20. The commissioners approved another resolution approving the project on Dec 20. In case of default, the venue would become the property of the bank, and per the county council president and the county financial consultant, county taxpayers would not be obligated to assume the liability.
  • No public meetings expressly focused on this important project were scheduled by the commissioners or council before their meetings to approve the project. The League of Women Voters of Brown County offered to facilitate a public meeting to address citizen questions, concerns, and issues regarding the project. Members of the CVC, the CVB and the informal team working on the Maple Leaf project declined to participate, as did several key elected officials.
  • The editor of the only newspaper in the county – The Brown County Democrat, did recuse herself from being the primary reporter because of a conflict of interest — her husband serves on the CVC. The Democrat welcomed opposing opinions in Guest Columns and Letters to the Editor.

A government best practice for determining the optimum investment options for revenue from the innkeeper’s tax would be identified in a Comprehensive Plan or an annex to the plan that includes a strategy for tourism.  Such a plan has yet to be developed. A good “plan” includes expected outcomes, actions and milestones, and required resources.

To provide the needed objectivity regarding the feasibility of this project, it was initially suggested by the county attorneys that the County Redevelopment Commission (RDC) become involved which would have helped ensure a thorough review on the feasibility of the project.

The plan by the RDC was to involve all affected government offices to include holding several public meetings to solicit input and feedback from the citizenry.  The process would have included identifying, quantifying and acknowledging opportunity costs and the risks associated with the project  The outcome may have been the same but the public may have had more assurance that the government performed their due diligence.

Before the RDC could hold their first public meeting to discuss their plan, they were told by two of the three commissioners at their July meeting, that their involvement would no longer be needed.  Before the county council approved the project on Nov 20, a member of the council confirmed that they did not commit funding for an independent feasibility study of MLPAC.

Renowned inventor and visionary Buckminster Fuller remarked that “You never change things by fighting the existing reality. To change something, build a new model that makes the existing model obsolete.” 

My next article in this series will include two objectives:  Identify likely effects of MLPAC and identify “a new model” of citizen engagement that can result in outcomes where everyone can benefit, or at least, will not be any worse off in the long term.

More Info:  Maple Leaf Project – For the Record

Planning for project success is a choice

The following is a copy of a Guest Column that was expected to be published Nov 15, 2017, in the Brown County Democrat prior to any vote by the Commissioners (Nov 15) and Council Meeting (Nov 20) approving the Maple Leaf Music Venue project. Due to space constraints, the article was published in the Nov 23, 2017, edition which may have been better timing.
The purpose of the column was to reinforce the need for a collaborative approach when considering development projects that can have long-term impacts on the community.

The recent community conversation on the status of the Salt Creek Trail reinforces that using ad-hoc teams to identify and manage projects independent of a county strategy and comprehensive planning can be problematic.

Salt Creek Trail has not been the only County project that has risks that can be eliminated or mitigated through improvements in the planning process.  Without better planning, we will continue to take a reactive “whack a mole” approach as issues bubble to the surface. Current projects include the following:

  • Salt Creek Trail Project, now 15 years in duration, has been delayed due to objections from affected property owners and elected officials opposed to the use of eminent domain by the State of Indiana.
  • Proposed Maple Leaf Music Venue.  This project is expected to be approved by the end of November. The following entities have accepted responsibility and accountability for all project results:  Council, Commissioners, Convention Visitors Commission.  Commissioners accepted the League of Women Voters request to hold a public meeting to address any questions or concerns that citizens may have with the project.
  • County Courthouse Compliance with the Americans with Disabilities Act (ADA).  This is a critical project to accommodate citizens with challenges, but approved and funded solutions have yet to be identified. Improving security is another important requirement.

Project results – be they good or bad, are determined by processes (habits, approaches) that are used in leading and managing the respective project. An improved process for identifying and managing projects can prevent problems and provide project leaders with the needed support from the community.  Successful projects that meet the expectations of the citizens make a positive contribution to our culture and quality of life.

As a certified quality auditor – now semi-retired, I have conducted and supported performance and process reviews in a wide variety of areas and industries. The scope of projects ranged from improving math skills and management issues in elementary and high schools to assessing compliance of government agencies with financial management controls required by federal and state statutes to improving national defense-related strategies.

Process reviews consist of assessing an organization’s processes (habits, approaches) and their respective capabilities in meeting the needs and expectations of the customer and other stakeholders.  Findings often supported the adage that “If you always do what you always did, on average, you will usually get what you always got” — 99.73% of the time.

In considering needed changes, the overwhelming preference – despite the risks and quality of the outcome, is often to maintain the status quo.  To break the gravitational pull of the old habits, there must be a sense of urgency that change is required to produce the desired result.

Regarding urgency, many rural counties throughout the country including Brown County, face projected declines in the population that contribute to a declining tax base. This decline may require frequent and recurring tax increases and cuts in services unless the situation can be improved.  Indiana counties are funded primarily by property and income tax. New residential and business developments that are supported by the citizenry and will result in increases in the tax base can help mitigate the projected economic decline.

Attracting investors for residential and business developments requires the formulation and updating of a comprehensive (master) plan that reinforces the community vision and values, and includes the immediate and long-range reports and plans necessary to implement the desires of the community. Elements of master planning could include strategies and plans in the following areas:  Broadband (Internet), Trail Systems, Wastewater Treatment, Residential Housing, Land Use, Thoroughfares, Tourism, and Capital Improvements.

With a master plan, community leaders can market the plan to private investors and companies can then use the plan to assess their risks and return on investment to seriously evaluate expansion and growth in Brown County.

To help develop support for the right projects, developments requiring taxpayer funding or other support must be guided by the policies and goals specified in the county comprehensive plan. The current 14-page comprehensive plan was approved in 2012 and provides general guidance concerning the future of Brown County.  Larger counties in Indiana can have more detailed plans that exceed 200 pages. Additional information on this approach is provided by The Indiana Citizens Planners Guide.  Another useful guide for developing effective project management plans and schedules is available from the Project Management Institute.

An immediate and incremental change to supplement the county comprehensive plan with the plans from current projects represents a proven strategy. This change to the status quo will help support elected leaders to maintain required project oversight, engages the citizenry, and ensures the community that actions align with the vision for the county. This change can take us a step forward in building a master plan that will convince potential new residents and investors that Brown County remains a desirable place to live, work, play and invest!

Tim Clark
Brown County

Tourism and Economic Sustainability

I serve on the County Redevelopment Commission (RDC).  The following is a copy of a Guest Column published by the Brown County Democrat on  Sept  20, 2017. The purpose of the letter was to reinforce the need for a collaborative approach when considering development projects that can have long-term impacts on the community.

Economic impact studies of tourism in Indiana and Brown County reinforce the benefits of sustaining a tourism industry. However, tourism, by itself, has not and cannot provide a sustainable economic future for Brown County.  Further, too much tourism can have detrimental effects on the attributes that have attracted pioneers, artists, residents, and visitors to Brown County since 1836.

The Brown County Community Readiness Initiatives, a survey and economic assessment conducted by the Ball State Economic and Research Institute concluded that Brown County’s greatest potential for economic growth is not tourism but as a bedroom community. This option is defined as attracting individuals and families that live in Brown County but can work at home or commute to the higher paying jobs outside the county.

This is not a new phenomenon.  Past economic studies have identified that the majority of citizens in Brown County commute outside the county for employment.  This strategy is among the best strategies for having positive impacts on all five of our Community Vitality Indicators (CVIs) that include:  assessed property value, per capita income, population, school enrollment and educational attainment rates.

The study also reinforced the importance of quality of place that includes good schools and amenities where people want to live.  Identifying and maintaining these attributes must be identified in the county comprehensive plan.

A May 2017 assessment by graduate students of Indiana University School of Public and Environmental Affairs (SPEA) reinforced the conclusions from the Ball State Study to include the importance of expanding the tax base to support the diversification of the business industries residing in the county.

The following chart includes data obtained from the U.S. Government Bureau of Labor Statistics.  The tourism industry is represented in the supersector identified as Leisure and Hospitality.  Comparing 2005 data with 2016 data identifies that the number of the establishments have stayed the same, jobs have decreased and wages are the lowest of the categories. Perhaps most important, the number of establishment in most categories have decreased with increases in the number of jobs in just a few areas.

U.S. Government Bureau of Labor Statistics
Brown County

In the 2014 Strategic Plan for Economic and Community Prosperity in SouthWest Central Indiana,  the Hospitality and Tourism Sector was identified as having 181 establishments in the region employing 3,506 employees with the lowest average wage ($24,477) of all the sectors.

To address the challenges within our region and with funding provided by Lilly Endowment, the Regional Opportunity Initiative (ROI) was established to: “Advance economic and community prosperity in an 11-county area that encompasses Brown, Crawford, Daviess, Dubois, Greene, Lawrence, Martin, Monroe, Orange, Owen and Washington counties.”

To prepare our students for successful careers, the Brown County Schools recently competed for and was awarded a grant from ROI to prepare our students to be qualified for the higher paying jobs.  This can lead to a business climate and a workforce that will help attract new businesses to Brown County.

A Way Ahead

The Brown County Redevelopment (RDC) commission was tasked to identify county wide strategies that would result in improvement in the CVIs.  Strategies will also need to consider courses of action if the tax base continues to decline.

The key priorities for the county include a focus on options that would provide the funding to support the capital improvements required to improve and expand the core infrastructure within the county. This infrastructure includes roads, water, sewer, broadband, police, fire and emergency services which would support the expansion of residential development and contribute to positive trends in the county CVIs.

The critical priority for the county includes broadband. Access to the internet is now considered a vital utility that is critical for leveraging the educational opportunities for our students as well as attracting businesses and new residents.

In support of this aim, the RDC has provided a proposal to the Area Plan Commission (APC) to work collaboratively in developing a comprehensive plan and economic strategy that will produce results where we will all benefit or at least, will not be any worse off.

Commissioners and Council and all their appointed commission and board members need to unite towards a common vision, plan, and strategy that has the support of the citizenry. The trend nationally has been one of polarization by wealth and political affiliation.  The challenges and opportunities facing Brown Countians cannot be successfully addressed with a divided community. The citizens of Brown County should expect the collaboration and action that will lead to a sustainable economic future.

Tim Clark
Brown County Redevelopment Commission

More info:

Survey Information:  2016 Community Readiness Initiative (CRI), Nashville, Brown County Ball State University

More Info ROI GrantGetting ready for the real world: New administrator’s job focuses on teaching workplace skills early