Thursday 23 July 2009

How dumbing down kills

Over the last few days Brisbane’s Courier Mail ran a series of articles on the problems alcohol causes. During the night the streets around night spots fill with drunken revelers and violence is often the result. So much so that over a period of three months just under 112,000 were admitted to Queensland hospitals as a consequence of alcohol-fueled violence.

(By the way, the manner in which the figures were presented is interesting in itself. The article focuses on Brisbane and particularly Fortitude Valley, a suburb featuring a high concentration of bars and nightclubs. Yet the first set of figures mentions that alcohol was a factor in “25-30 percent of representations at emergency departments”, which covers the entire state. Then it says “The latest figures produced by Queensland Health showed that 373,000 people presented at its emergency departments in three months”. If we are pessimistic and accept 30 percent then there would have been 111,900 hospital admissions due to alcohol, and across Queensland as a whole. How many of those came out of Fortitude Valley is not mentioned. This is not to deny there is no issue, but the reporting does veer towards the sensational)

In any case, it helps to consider the situation in terms of human activity systems.

For a system to function on an ongoing basis it needs resources which play their part in its overall set of dynamics. The higher the complexity the system achieves, the greater the draw on resources. For the system to remain sustainable any measure that raises the level of complexity must sooner or later offer a return on the credit side of its ledger, since a debit has the effect of reducing the sustainability.

In the case of alcohol-induced damage a number of initiatives have been enacted in order to address the problem. Called the 17-point plan (Courier Mail, 21 Jul 09, “Lockout a failure”) they range from locking out patrons from re-entering a venue after 3am, to extra police in the district, to increased security at taxi ranks, to forcing hotel staff adopt various policies. They all have one thing in common: they cost money. Nor does any of those measures deal directly with the lout who throws personal responsibility to the wind and causes mayhem.

The result is an ever increasing burden to society while at the same time constructing an environment in which the irresponsible can act out their dysfunctional instincts. Rather than having to deal with their consequences even more funds are directed towards the training and protection of medicos who get attacked by drunken patients. In another article the next day we read that the emergency department of the Royal Brisbane and Women’s Hospital treats about 72,000 patients a year (around 200 per day) and “a higher proportion of patients were sicker than they were two decades ago”, and “Alcohol-related injuries had become more common in the under-25 age group, particularly among teenage girls” (Courier Mail, 22 Jul 09, “Abuse a constant threat to medicos”).

Conventional, and proven, wisdom has it that transgressions of behaviour need educational resources to prevent continuing damage being done; but that presupposes that the target represents a member of society who nevertheless remains a part of the general ameliorating and adjusting framework, a framework that in the end relates to the common standard. Remove the member from that standard and the educational process is left to perform in a social vacuum.

The experience related by the professionals in the field, be they medicos, doctors, police, or hotel staff, show the adjusting framework has been allowed to evaporate.

To force the system into a higher state of complexity through something like that 17-point plan effectively means shifting more resources towards a demographic that can now cause more damage as a consequence. The result is a spiral of dumbing down affecting society as a whole. Not only do the costs rise, the negativity spreads, leading to greater costs still, and so on.

Systems dynamics offer the solution: destructive elements require less resources, not more, for the entire system to remain within the envelope of sustainability.

The approach has been practised in the past. In frontier societies where a horse means the difference between survival and death horse thieves are not treated by an army of counsellors, they just hang them. Even more on the extreme side, indigenous cultures do not have the luxury of treating under-performers, initiation rituals decide whether a member of the tribe becomes accepted or simply abandoned.

We have advanced from those beginnings. Nevertheless, the principles still hold.