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Addressing Behavioral Health in Casper, Wyoming: A Community-Driven Approach Using PDIA 

Two people's heads, each with a string. One is tangled representing poor behavioral health.

Guest blog by Tina A. Hoebelheinrich, Anna Kinder, Sabrina Kemper

The Wyoming Business Council recently convened a diverse group of community leaders to address a pressing issue using the Problem-Driven Iterative Adaptation (PDIA) framework. This powerful approach, which empowers communities to tackle complex problems by breaking them into manageable components, was the perfect fit for our mission. Our initial team, which included key figures such as the CNCHD Executive Director, the Casper Area Chamber of Commerce CEO, the City of Mills Community Development Coordinator, an elected Mills government representative, and a top real estate producer, was confident in the potential of the PDIA framework. 

The Role of CNCHD 

Since 1954, the Casper Natrona County Health Department (CNCHD) has been a cornerstone of our community, providing crucial resources and support. In recent years, behavioral health has emerged as a critical public health issue, intertwining with mental health and various determinants of well-being. Addressing behavioral health is essential for the overall well-being of our community. Although substance use was not explicitly discussed in this project, it is recognized as a significant comorbid condition. 

Challenges and Opportunities 

Recognizing the abundance of organizations and services in our community, CNCHD acknowledges that the challenge lies in accessing these resources due to a lack of awareness. To bridge this gap, CNCHD plans to collaborate with new and established organizations to develop a comprehensive framework that engages the community in addressing our behavioral health needs. 

The Urgency of Action 

While data collection is crucial, immediate action is also necessary. Suicide prevention, for instance, needs to be integrated into our businesses, churches, organizations, and governmental entities. We can no longer avoid discussing uncomfortable topics such as suicide, bullying, and violence. Collaboration is vital, and CNCHD will leverage its resources and partnerships to create a united, cradle-to-grave approach to behavioral health. 

Learning and Progress 

Throughout this journey, our team has identified several key learning points: 

  • Time Management: Understanding the importance of time in addressing complex issues. 
  • Authority: Evaluating and effectively communicating with authority figures. 
  • Problem Deconstruction: Using methods like the “5 Whys” to address root causes. 
  • Reflection and Learning: Emphasizing the importance of reflection and continuous learning. 
  • Delegation: Recognizing that delegation is challenging but essential for progress. 
  • Trust and Crisis Communication: Building trust and effective communication during crises are crucial. 

Fishbone Diagrams and Problem Statements 

Over the last twelve weeks, we focused on mental health in our community, identifying suicide, bullying, violence, and barriers to accessing services as key issues. Initially, we considered developing an app to list resources, but the process led us to a more comprehensive and valuable resource tool. 

In May 2024, a fishbone diagram, also known as an Ishikawa diagram, was developed by Soleve, a group participating in the Harvard Kennedy School’s PDIA course. This diagram helped us identify the possible causes of the identified problems and guided our approach. 

The current fishbone diagram and problem statement: 

Fishbone diagram developed by Soleve, demonstrating the iterative process that guided their approach.

Progress and Achievements 

  • Information Gathering: We collected extensive information from the community and continuously redirected our efforts as needed. 
  • Action Steps: We moved from developing an app to identifying specific resources associated with B.A.S.E. (Behavioral, Activities of Daily Living, Social, and Emotional Services). 
  • Reassessment: We reassessed the fishbone diagram and problem statement multiple times to ensure we were on the right track. 
  • Understanding Roles: We learned to navigate the community by understanding different roles and authority levels. 
  • Application of Learning: The timely application of our learned material allowed us to avoid mistakes and develop real, sustainable solutions. 
  • Building Partnerships: We established strong partnerships across disciplines, moving beyond traditional silos. 

5 Key Takeaways 

  1. Acts of Kindness: Small acts of kindness are essential in addressing both the problem and the broader community. 
  1. Teamwork: A specific plan and teamwork are crucial to staying on track. 
  1. Diverse Teams: To effectively address community problems, a diverse team and adherence to the PDIA framework are necessary. 
  1. Perseverance: Even amidst hectic lives, we made this project work through dedication and commitment. 
  1. Celebrating Wins: Acknowledging small wins and breakthroughs is vital for sustaining momentum and motivation. 

Next Steps for Team Soleve 

As we continue our efforts to address behavioral health in Casper, Team Soleve is prepared to take the following critical next steps: 

  1. Future Collaborative Training: We will focus on ongoing collaborative training to ensure that all stakeholders are equipped with the necessary skills and knowledge to contribute effectively. 
  1. Building the B.A.S.E Solution: The B.A.S.E. (Behavioral, Activities of Daily Living, Social, and Emotional Services) solution will be treated as a living document, evolving with the needs of the community. 
  1. Inclusive Conversations: It’s essential that all industries are part of the conversation. We will actively work to ensure that diverse voices are heard and integrated into our solutions. 
  1. Developing Concrete Action Steps: The team will focus on developing the next concrete action steps to move from planning to implementation. 
  1. Impact of Acts of Kindness: We will continue to emphasize the importance of acts of kindness as a foundational element of our approach, both within our team and in the broader community. 
  1. Journaling: Team members will be encouraged to journal reflectively to document progress, insights, and learning throughout the process. 

By focusing on these areas, we aim to create a sustainable and inclusive approach to improving behavioral health in our community. 

Conclusion 

The Wyoming Business Council’s initiative highlights the power of community-driven solutions. By working together, we can create a healthier, more resilient community where behavioral health is a priority and no one is left behind. 

Three women from the Wyoming Business Council stand together, smiling

This is a blog series written by the alumni of the PDIA for Economic Development in Wyoming Program. 15 Participants successfully completed this hybrid program in August 2024. These are their learning journey stories.