Community Engagement. Later is better.

By Anton Hart

My most memorable NIMBY experience occurred a few years ago. The fury of it all makes it seem like yesterday. I went to a meeting organized by members of my community who were aggrieved by the imminent arrival of a methadone clinic. The crowd literally spilled out onto the sidewalk of a local bar made available for the proceedings. Several doctors – clinic affiliates – were there, ostensibly to engage the community. After the chair and a local lawyer laid out the “facts,” the games began. For the next two hours or so not a rational thought surfaced, not a constructive word was spoken. The local representative on city counsel tried but was generally shouted down. The crowd went home in a highly excited mood to prepare their tar and feathers to ride the principals and politician out of town and so protect their neighbourhood. The raging battle spilled out into the kitchens, living rooms and local eateries. Even the local church found its voice a few days later when the Reverend Canon Christopher King, Senior Pastor of Little Trinity Church, wrote that “the church looks to Jesus as the one who shows us how to bring healing and transformation to hurting people and into communities. . . . He never compromised their safety by his healing, transforming work with social outcasts.” And so, the pastor reasoned, no clinic should come to his church’s back yard. Or, in this case, across the street.

On the other hand, the doctors at the meeting accused the crowd of not caring and putting their hard-earned home equity and personal welfare ahead of the dire needs of patients – who were also members of the community. The local blogger described it this way: “Tabarnouche! One would think, reading some of this, that the Gaping Gates of Hell were open and inhaling local residents in droves.”

Clearly, community engagement was not working.

This is not a new story. It is repeated often where we find the public fearful and frustrated when it has collectively determined that a cause, event or thing will destroy them. In this case, the clinic’s patients were presumed to be social outcasts who would threaten the neighbourhood and members of a church congregation. The mantra is, “build it anywhere – but not in my community.”

Let me report that this situation has since resolved itself to a dull roar, and postulate that it could now benefit from continued community engagement. These notes are a reflection of what subsequently happened and the application of some recent learnings. See what you think.

In the first place, neither the clinic nor the local politicians nor the government of the day engaged the community to ask them if and how and when they would like a methadone clinic in their community. They knew what the answer would be. Street smarts told them to stay under the radar. But the politicians also understood the need for the clinic in this community and even supported its owners in their search for a suitable building. Not fully succeeding in this limited goal they left the operators of the clinic, more or less, to their own devices. This, says journalist Malcolm Gladwell, is a process where the doing comes before engagement. And, I add, it is a demonstration that “doing” is more important to social change than any awareness campaign or pre-implementation community engagement. It is a demonstration that if you are in a position of power you can effectively begin the process of change. By doing. Consultation and awareness do not in themselves constitute change and, in fact, they accomplish nothing, says Gladwell. If anything, awareness (or community engagement) is the final stage of social change. That’s where it can have impact. Engagement is then designed specific to the goals set out. It is educational. But the doing will already have been done.

And so, in this community, the clinic went ahead. It weathered some unpleasant treatment from members of the community, a little extra attention from the media and from some vigilant cops keeping an eye on things. Today, the operators are keeping the place clean, enforcing rules to ensure a quiet operation and are going about their business without fanfare. As this was unfolding the Minister of Health (Ontario) commissioned a task force to take a close look at Methadone Maintenance Treatment across the whole province – prompted only in part by matters in his own riding. In response, the residents and business association – my neighbours – prepared and presented a thoughtful brief to the task force. Residents were given an opportunity to speak, and they gave heartfelt commentary. In the local blogger’s words, “Community residents presented their concerns in a dignified and reasonable way.” The advice was cogent, and the residents were heard. Some of the subsequent recommendations from the task force reflected the residents’ submission. In response, the provincial government set in place a province-wide program to improve communications, training, counselling, community engagement and other related services, and the city is working with the clinic to better integrate its operation with the neighbourhood. I know for a fact that the Minister made an unscheduled stop at the clinic – without fanfare.

The engagement shouldn’t stop here. It needs to be ongoing, and the mechanisms are available. Some members of the community stay in touch with the clinic owners, and the owners know where to find them. Some obvious exterior improvements have been slow to come about, hampered by city bureaucracy and some lethargy from the clinic’s operators. It’s a concern near the top of a neighbourhood’s list. Both the clinic and the city need to get on with it. (The same could be said for other businesses on the block.) The cops report little or no related crime and include the clinic in their rounds. In the meantime, new condominiums, new restaurants and new stores are all coming to the neighbourhood – unfazed by the operation of a methadone clinic with a stormy past. Real estate values are up. A few nay-sayers still want to be heard, but the neighbourhood’s silent optimists are drowning them out.

David Bornstein, who has studied social change and written about it, says that people who want to change the world are obsessively driven to succeed; they are, therefore, good listeners; they build good teams; they pay close attention to their environment; they stay focused on long-term goals but continually adapt to changing environments; and they are always looking for new opportunities to grow and innovate. By adopting this attitude, the local parliamentarian, the local councillor and the renewed rate payers’ group can improve this community, serve the sick and maybe even bring the church onside – or invite the Salvation Army to start a counselling service. The task force was strong on the need for counselling and community support. That presents an opportunity for continued community engagement.

In the end, I went back to the local blogger for a comment, and found that he had just posted a report that “research shows supportive housing has no effect on property values or crime rates. And, as in earlier studies, it showed initial community opposition disappeared once the homes opened.” Now’s the time, I add, for community engagement to ramp it up. Later is better.

Notes
Some of these thoughts come from the book, How to Change the World, by David Bornstein (Oxford University Press, 2004). They also reflect my notes taken during a debate between journalist Malcolm Gladwell and philosopher Mark Kingwell on the merits of awareness and engagement in the process of social change (May 13, 2008 on the campus of the University of Toronto).

Anton Hart is publisher of a range of healthcare publications from Longwoods Publishing Corporation, a member of a number of boards engaged in social change and the Chair of Ontario’s Methadone Maintenance Practices Task Force, which tabled its final report in March 2007. Contact: ahart@longwoods.com