Remarks by
A. Kathryn Power, M.Ed.
Director
Center for Mental Health Services
Substance Abuse and Mental Health Services Administration
U.S. Department of Health and Human Services
Closing Remarks:
Creating a Trauma Transformation
February 8, 2007
Pittsburgh, PA
Attached is the text prepared for delivery; however, some material may have been added or omitted at the time of delivery.
Thank you, _____, for that introduction. Thank you, all, for joining me as we come together to close this meeting.
I’d like to share a story I heard a few nights ago on the evening news. In a segment entitled, The American Spirit, anchor Katie Couric interviewed Dr. Donald Berwick, a physician on a personal mission…a crusade to make hospitals safer for patients. Berwick launched the “100,000 Lives Campaign”…a campaign designed to encourage hospitals to adopt standardized practices in the way they care for patients. The goal: to reduce complications and build excellence into the system. Berwick has dedicated his life to moving what might seem like an unmovable system. Having successfully recruited hospital after hospital to join him in his mission, this one committed physician is taking small, yet important steps forward. In describing his progress toward the goal, he said, “It’s in reach. It’s a matter of will…and, a matter of leadership.”
This afternoon, as we reflect on the strategies you have explored and the lessons you have learned about transforming mental health care for children and adults, I want to echo Dr. Berwick’s sentiments. A transformed system of mental health care is in our reach. And, our ability to realize this goal is a matter of will…and, of leadership.
Today, I am sending out an urgent call to action to each of you. An unprecedented window of opportunity is opening…right now. We’re moving steadily forward along the road to mental health system transformation. Transformation is happening. It is real. From California to Connecticut, promising models of transformation in behavioral health are being developed and piloted. Together with our Federal Partners, SAMHSA and CMHS are taking realistic action steps to motivate, facilitate, and compel change at the Federal, State, community, and individual levels.
But we cannot do it alone. All of us…at the local, State, and national level…must advocate for the transformed mental health system that will give American men, women, and children access to the full range of services they need to recover. It is time to deliver on our advocacy with personal action. It is time for each of us to step forward and accept our personal responsibility to lead this crusade for change.
The National Child Traumatic Stress Initiative Network is a vanguard for change. You have been on the forefront of transformation—spreading the word that addressing trauma is essential for mental health recovery…integrating a focus on trauma into evidence based practices…disseminating and training others to deliver trauma-informed care…leveraging your resources through collaborations and partnerships in order to build national awareness and momentum for this movement. From today on, these partnerships will continue to grow in magnitude and importance to the overall mental health of our nation…to the overall health of our nation.
As grantees of this network, you are natural agents of mental health transformation. Trauma is increasingly seen as an almost universal experience of public mental health and human service recipients. The impact of trauma can be very disabling. It may be misunderstood, unnoticed, or misdiagnosed if the traumatic experience is not acknowledged and addressed. Worse yet, trauma is transferable–it can be indirectly or vicariously experienced when loved ones, caregivers, service providers, and first responders feel the impact of traumatic events experienced by others. One especially troubling aspect of trauma’s transferability is its intergenerational reach, with children adversely impacted by witnessing domestic violence and parents adversely impacted by traumatic events experienced by their children.
We simply cannot build a recovery focused, transformed system of care unless we build this system on a universal presumption of trauma, recognizing that it could be part of the life experience of anyone with whom we interact. We cannot deliver truly transformed mental health care until we focus interventions on community and peer support, and on trauma-informed clinical treatment.
We need you to take the lead in building such a system. You are natural leaders. Each of you is in a prime position to empower others to become leaders. But you must identify and articulate your own leadership philosophy before you can guide and encourage others to exercise their potential for leadership. Ask yourself, “What are the qualities of leadership that resonate with who I am?” Then begin to act on these qualities. Take action to achieve your mission and take care of those you seek to lead.
Anyone can exercise the principles of leadership. You don’t necessarily have to be in a position of authority to be a leader. But, I want to make one point clear: I am not talking about ordinary, garden-variety leadership. I am calling on each of you to exercise and demonstrate transformational leadership.
What is transformational leadership?
A transformational leader is not satisfied with change around the edges. Transformational leaders take their quest for change to the core of systems…creating something where there was nothing before.
Transformational leaders must be courageous enough to take risks…and be resilient and resolute in pursuing their vision. Having a VISION is an essential quality of a transformational leader. A vision provides a purpose to focus on a shared image for the future. To quote Joel Barker, a consultant on the future of business enterprises, “Vision without action is merely a dream. Action without vision just passes the time. Vision with action can change the world.”
Another essential quality of a transformational leader is a COMMITMENT TO SOMETHING BIGGER THAN ONE’S SELF. My own belief is that true leadership emerges from a primary motivation to serve a higher purpose…a purpose of helping others find meaning in their lives…helping them find hope and connection to family and community.
Transformational leaders are ACTION ORIENTED. Transformational leaders make things happen and motivate others to do so. They relentlessly experiment and pursue the elusive.
A transformational leader must be able to ENGAGE OTHER PEOPLE WHO CAN MOVE SYSTEMS. Leaders draw on the skills of many different people.
Transformational leaders are committed to CONTINUOUS PERSONAL DEVELOPMENT. Leaders read relevant literature, attend conferences, and talk to colleagues …building on their own trauma-sensitive environment and learning.
A transformational leader must have a strong belief in the POWER OF ONE. Now what do I mean by this?
Let me tell you a story that beautifully illustrates the POWER OF ONE.
John Woolman was an American Quaker who lived in the 1700s, when many Quakers were wealthy slave owners. He dedicated his adult life to eliminating slavery among his people.
Woolman spent more than 20 years visiting Quakers along the East Coast. He pursued his mission through the art of gentle persuasion. He did not criticize people, nor did he make them angry. He merely asked questions like, “What does it mean to be a moral person? What does it mean to own a slave?” Driven by his vision, he persisted, visiting farm after farm.
By 1770, a century before the Civil War, not one Quaker owned a slave. The Quakers were the first religious group to denounce and renounce slavery.
This story was told by Robert Greenleaf in Robert E. Quinn’s book Deep Change. Greenleaf further commented:
“One wonders what would have been the result if there had been fifty John Woolmans or even five, traveling the length and breadth of the Colonies in the 18th century persuading people, one by one, with gentle non-judgmental argument that a wrong should be righted by individual voluntary action. Perhaps we would not have had the war with its 600,000 casualties…we know now, in the perspective of history that just a slight alleviation of the tension in the 1850s might have avoided the war. A few John Woolmans, just a few, might have made the difference.”
The Power of One is so important. I am counting on each and every one of you to go back and make the difference. You have the opportunity to make a dramatic impact on the systems that we have today. When you return to your communities and actively and directly share your knowledge, thousands of others can benefit. I urge you to do your utmost to apply the leadership lessons from this meeting to collaboratively create a trauma transformation in your communities.
This will not be easy work. Nor, will this trauma transformation happen overnight. Nor will audiences and constituencies readily embrace the trauma paradigm. John Kotter, the author of Leading Change, maintains that new approaches “are fragile and vulnerable to regression until change sinks down deeply into a system”— which may take years of effective leadership.
At the same time, there is no one blueprint for what a transformational leader should do. Or, for how he or she should lead. We learned profound lessons about what we don’t yet know about leadership as we examined the effectiveness of leadership during our nation’s recent waves of disaster.
Throughout this period of disaster we learned that the quality of leadership has a dramatic correlation to the quality of life...and to survival. The effectiveness with which organizations dealt with crisis made the difference between life and death for both people and organizations.
Still a number of relevant questions have risen out of the experiences of leaders on the front lines of disaster relief. Should we rely on the traditional, “command and control” structure…where one central leader “goes it alone?” Or, should we adopt a “cultivate and coordinate” approach to leadership that relies on shared responsibility?
Should we focus our efforts on being effective managers of events…springing into action in the midst of challenges. Or, should we strive to be anticipators…who attempt to avert crises before they happen? What is the role of the leader in the days, weeks, and months after a specific crisis or event? Leadership is a process...not an event. Leadership plays out over the long run.
There is no right answer to these and countless other questions of leadership. Each one of us has to formulate our own answers to what Herman “Dutch” Leonard, from the Kennedy School executive session on Crisis Management, calls the central question: “What do we do when no one knows what to do?"
Still, I believe in the power of one. I believe in the spirit of ordinary Americans…like the single physician who launched a campaign to save 100,000 lives. And I believe in each one of you.
You can continue to build partnerships with academia, practitioners, communities, and most importantly, with States to transform mental health care into trauma-informed environments and trauma-sensitive services. You can provide the multiple levels of training and mentoring that practitioners require to properly implement these services. You can use technology to better disseminate knowledge about trauma-informed care and improve training in these techniques…especially in rural and under served areas.
You can work to spread the word that trauma-informed services are not just important in times of large-scale crises, such as 9/11 and Hurricane Katrina. You can use your power to help the field recognize and focus on the pervasive effects of trauma caused by childhood abuse and domestic violence. As transformational leaders, you have the power to do all this…and to accomplish things we have yet to imagine.
Joan Holmes, the Executive Director of The Hunger Project said it well: We often think of heroes as extraordinary people with powers and abilities far beyond those of ordinary human beings. But when we really look, we discover that heroes are ordinary men and women who dare to see and meet the call of a possibility greater than themselves—people who despite their doubts and fears commit themselves to action; people who go beyond their limits in what they think is possible. Ordinary people—daring to be heroes—are the greatest expression of human potential.
Thank you for daring to take this on…for pushing beyond what may seem possible to meet the call for evidence based practices…for family-driven and youth-guided treatment…for trauma-informed care. Thank you for planning new pathways to transformation…with yourselves as leaders. Thank you for committing yourselves to action to save lives across this nation. Thank you for having the will to be heroes.
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