mindset.

Credit: Irving Zola (1935-1994) – American activist and writer in medical sociology and disability rights.

Summary:

Upstream Thinking was inspired by the classic public health parable credited to activist, Irving Zola. The parable, often called the “River Story”, has many different versions, although the primary message remains the same. One version reads as follows:

Several community members are enjoying a picnic at the edge of a river when they hear a child scream for help. The child is caught in the current. Inspired to action the community members rescue the child and offer them comfort and support on the riverbank. Moments later they hear the cries of another child struggling in the water, and then another and another. After a short period they have saved several children. As another child is heard screaming for help, one of the community members begins to walk upstream. They are asked, “Where are you going? You are needed here, we have to save the children!”. The community member responds, “I’m going upstream to see if I can stop the children falling in the river in the first place!”

 Concept detail:

The lesson of the parable is that more can be gained by identifying and preventing what is causing the problem than seeking to cope with the exhausting consequences of that problem (see Post on Failure Demand and Avoidable Costs). The River Story inspires us to pause and reflect on the time, energy, and resources invested in managing crises, versus our efforts to address the root causes of problems.

Real world application:

Early in my career I worked in the “homelessness sector”, supporting community members who had no home, few possessions, and quite often nowhere safe to sleep that very night. Significant financial resources had been (and continue to be) invested by successive governments to resource a community sector (partially) responsive to the needs of homeless individuals and families. This complex “system” of emergency shelters, brokered pub top accommodation, case support workers, and grants is informed by the river edge “downstream perspective”. Back then, I worked full time with six peers to support scores of people every week in housing crisis in Launceston. A further 50+ staff worked across the city in various organisations, shelters and aligned crisis support services. A community service sector had been built on the river’s edge, responding to the cries for help, too busy engaging in the daily crises to look upstream (for very long) and focus (decisively) on prevention.

I note that the causes of homelessness are many and varied. It remains a “wicked” social concern and is highly complex in its resolution. Domestic and family violence, unemployment and income poverty, mental health and drug misuse, housing stock, the rental market, social housing and tax incentives for investment properties all interconnect to create a challenging social issue that has defied solution for generations. I am a strong advocate for ongoing and increased funding to the homeless sector, including crisis intervention and related river edge programs. On balance, I also believe the onus is on political leaders to lift their gaze, walk upstream and address the root causes of homelessness as promoted by peak bodies like Shelter Tasmania  and the Tasmanian Council of Social Services. The reduction in human suffering and the likely economic return on investment (see Heckman Equation) are sound reasons to stride upstream.

That said, in 2002, I helped establish the Family Homelessness Prevention Pilot (FHPP) in Launceston (see Family Matters). I was seconded from the crisis service to the inaugural team working in a Commonwealth funded pilot informed by “upstream thinking”. The goal was to identify and work with vulnerable families and support them to maintain their current secure accommodation. It worked in large part, but it was never scaled beyond the 8 pilot sites nation wide. After a decade it was quietly closed, the learnings of early intervention and prevention lost, and resources were diverted back downstream.