Written by: Center for Care Innovations

Substance use disorder demands a willingness to think outside the box. SafeRx Santa Cruz County, a coalition of social service, government, and health care organizations dedicated to supporting and expanding existing efforts around safety, awareness, and best practices for prescription pain medication, has long been open to exploring a range of opportunities to address substance use disorder in its community. Could “systems thinking” be another tool in the toolkit of this addiction treatment coalition searching for solutions to this widespread problem?

The short answer: Yes. But it took a long conversation that began May 2019, when SafeRx Santa Cruz County and three other coalitions started to immerse themselves in the approach of systems thinking — in particular an exercise called “systems mapping” — as part of a 16-month Center for Care Innovations learning collaborative, Addiction Treatment Starts Here: Community Partnerships. The collaborative’s goal was to help uncover potential approaches to addressing substance use disorder in California communities in consultation with local stakeholders.

Systems what? Systems thinking is a relatively new practice intended to help bring clarity to thorny, intractable, multi-level challenges in a way that can facilitate lasting change without a so-called end goal or finish line in sight but rather a focus on helping systems heal and thrive. Systems mapping — which includes actor mapping, iceberg mapping, and forces mapping — are exercises that help an individual or group discover patterns of behavior, supporting structures, and mental models that underlie a particularly vexing concern with all its interconnected and interwoven factors. The goal here is to act strategically to find new pathways while also being willing to adapt to constant change to ensure the continual health of a system.

“Systems mapping is helpful because it honors the complexity of many problems and allows groups of people to come together to see news paths forward,” says Shelly Barker, SafeRx Santa Cruz County’s project manager and the co-project leader on this collaboration. “The paths forward may not be dramatically different than things previously tried, but they’re viewed through the prism of multiple entry points, with each entry point representing a different stakeholder. That’s an invaluable lens from which to see things.”