Practical Implementation

From Toolkit.Socialnetwork.Health

Status:

This section is still in Alpha. This is under review by our team and not to be considered peer-reviewed or complete by any means. References have not even been added yet - that will change things quite a bit. Some commentary is present. A reader should be able to gain an understanding of what to do and what not to do when starting on their journey to improve mental health in their community.

Precautions:

These are common failure modes when pursuing a Social Network Health approach:

Partial Approach:

Partial Implementations of successful approaches to social network health have beek known to be unpredictable at best and typically harmful. Without implementing all of the key action findings in social network health, it is likely that a net negative outcome for community health will result. All of the key action findings are necessary but insufficient on their own.

For example, if a community implements a preventative mental health program that is not ecologically valid, then even with all nine other key action findings correctly implemented, the program is unlikely to see success. That would be a net negative outcome leading to lost resources and potentially cynicism that could stand in the way of future efforts.

Lack of expertise in training:

At all levels of approach implementation, it is necessary to enter in with expert knowledge of training. Without a master-level trainer in the room, it is entirely possible to incorrectly sequence approach scaffolding or an individual activity, such that a negative outcome is experienced.

A negative training cascade can also occur when an expert trainer trains a less experienced trainer, and that less experienced trainer is then allowed to train other trainers before they themselves are experts. This is a common problem often associated with "voltage drop".

Scope of Implementation:

Consistency is a key finding in Social Network Health - that and the precaution of Partial Approach are a stark reality check to anyone looking for a quick fix. Partial Approach dictates that buy in from key community members to properly prioritize preventative mental health care is essential, as that follows from a key finding.

From the implementations that members of this project have successfully participated in, it has been observed that a program can begin to have a positive effect right away. Typically, it typically takes years and dozens or sometimes hundreds of practical group sessions before a community becomes expert in it's own co-created processes - many of these might be undertaken with an expert trainer.

The advice of evidence is to find an expert who does not bend from it.

History of Implementation and Practice:

Here we will attempt to consider important historical phases of development of approaches.

It is historically interesting that a lot of Social Network Health findings are described in traditional knowledge systems. In a very real way, the history of Social Network Health goes back form millennia, and one could easily argue that oral history likely passed this knowledge on pre-history.

The pendulum is stuck

What we are seeing today is that over the last few decades modern research has provided evidence for prioritization of Social Network Health approaches, which were less formally described at the start of the 20th century. In much of the industrialized world, individual achievement became the sole focus in almost all areas of modern society, non-ironically to the detriment of aggregate individual achievement, collective health, and overall productivity.

Ignorance of community health and how it affects schools appears to change over time with government led regulatory frameworks, swinging health care systems like a pendulum from more community focused to more individual focused. Currently, the pendulum seems to be stuck hard on individual achievement.

SEL and the resource trap

SEL is a real event in sociological application to education that has, in the last 50 years, taken de-facto form without a standardization body.

In the parlance of Social Emotional Learning in US schools there Tiers - Tier 1 (prevention-based) comes before Tier 3 (isolation-based) because it is, colloquially, terrible to have to isolate people - generally, Tier 1 is the success case and Tier 3 is the last line of defense for individuals who need it. This is appropriate prioritization from the perspective of a social network health approach. In practical implementation, however, far fewer communities put as many resources into effective Tier 1 programming as Tier 3. This is often due to prioritization of individual achievement metrics, which often severely backfires, and a focus on diagnosis, isolation, and treatment as per the medical model of care, which is much closer to a Tier 3 model.

Counterexamples flourish

When the advantages of community health are unrecognized, community health is unfundable, and individual academic achievement is the only focus for administrators, then horrible community health impacts everyone. In these situations, the individuals outside the administration might call for a solution. The simplest and cheapest way for an administration to address that call is with a one-time delivery of a feel-good training. That is harmful to the community, because those trainings are ineffective, and they come at some expense in time and financial resources, and over time these repeated quick-fix solutions breed cynicism, making it more difficult to implement a long-term evidence-based approach that might actually have a chance at working.

The norm in schools appears to be quick-fix deliveries that do not require years of effort, and so those are everywhere. Typically these "programs" come with an online or single day of training, and include active learning exercises that are fun, but they don't get any further to the more meaningful and important aspects of social network health, such as deep conversations, learning shared strengths, and practicing help-seeking behaviors.

Fundamental Principles of Practice:

An ultimately successful effort will include the following fundamentals:

Expertise in Key Findings:

Expertise and Practice of the Key Findings in Social Network Health. Although from context to context, prioritization of the key findings will differ, no implementation can ignore the 14 key findings, or the Protective Factors.

Co-Creation:

The most basic level of understanding of the Key Findings in Social Network Health tell us that programs developed outside of communities are unlikely to have a positive effect. Successful approaches to preventative mental health care are ecologically valid and created and maintained by communities as part of a cultural adjustment.