Addressing Fragmented Housing and Behavioral Health Systems in Santa Fe County

Guest blog by Lisa Cacari Stone, IPP ’25

One of the deepest shifts for me has been realizing, as Matt told us, that ‘policy work is about people’—not just about ideas or analysis. I came into the course often frustrated that we had good ideas in Santa Fe but struggled to implement them. I now see that the ideas themselves cannot move unless people are inspired, supported, and organized to take them forward. The implementers are the heroes, and my role as a Santa Fe County Commissioner is to mobilize and sustain them.

I learned that constructing and deconstructing the problem is leadership in action. Instead of saying ‘we need more housing for the homeless,’ I have learned to ask: why does it matter? to whom? What values are at stake? The PDIA toolkit taught me to use fishbone diagrams and ‘five whys’ to dig deeper. Iteration was another powerful learning—progress comes in small steps, not from one big leap. As Teresa Amabile taught us, ‘everyday progress—even a small win—can make all the difference’. These insights have reshaped my pracJce of governance. They have also deepened my commitment into “mindfulness in leadership, through a human-centered approach.

For my IPP, I chose a policy challenge at the heart of my work: the intersectionality of housing affordability, homelessness, and behavioral health. Santa Fe County faces a shortage of over 7,000 affordable units, rising rents, and an increase in unsheltered homelessness. More than half of those without housing face behavioral health conditions. Our jail is overburdened with individuals needing psychiatric medication. Despite tax revenues, nonprofit partners, and zoning reforms, we remain fragmented across jurisdictions and sectors. My core problem statement became: how can we overcome fragmentation and mobilize authority, acceptance, and ability to create sustainable housing and care systems to tackle the complexities of substance abuse, mental illness due to trauma among people who are homeless?

The fishbone diagram exercise was pivotal. By mapping root causes (over ½ dozen times), I was able to communicate the problem as systemic rather than blaming one sector. Structural barriers like outdated zoning codes, behavioral health workforce shortages, lack of data integration, and stigma emerged clearly (see recent Fishbone below). I found this diagram to be both an analytic tool and a relational one—a way of saying to colleagues: ‘Here are the bones of our problem. Where shall we start?’

Fishbone diagram of lac of supportive housing in Santa Fe County

From this process, I learned several insights: first, sequencing matters. Not everything can be solved at once. Second, authorization is dynamic. It is not enough to secure a formal resolution; informal legitimacy from advocates, faith leaders, and community members is equally critical. Third, progress is relational. By tracking learning and leads, I came to define success not just by outcomes, but by the new people I’ve engaged with, the trust I’ve built, and the coalitions I’ve been able to expand just through “every day conversations.” Finally, I learned to reframe failure as learning. Instead of personalizing setbacks, I ask: “what data does this give me, and how can I adapt?”. Mostly, I focus on small wins and relinquishing “ego” as a basis for moving forward, still keeping integrity and core values of my leadership intact.

PDIA has reshaped my orientation to complex challenges. I now begin with constructing the narrative: why does it matter, and to whom? This framing is critical to build coalitions. I will continue to use iterative cycles to manage uncertainty—small steps, reflection, adaptation. More recently, I have heard myself saying to “authorizers” in the county government as well as others, “let’s continue to be a learning organization and grow as we go.” I also see leadership as ‘disappointing people at a rate they can absorb,’ a phrase that will stay with me. This means pacing reform and reframing “set-backs” as information for reflection and improvement so people can stay engaged without becoming disillusioned. Rather, creating space for people to be a part of the solution.

Already, I am applying PDIA tools in Santa Fe. I framed recent working groups with city, county, state, and other community stakeholders, not simply as a housing shortage, but as a health, justice, and housing first as the model for tackling the traumas that people who are homeless face every day. I have used informal conversations to invite people to share their insights on “what they perceive as the problem” and have a chronology of written notes via my PDIA “diary.” I use learning and leads in my weekly updates: highlighting who I’ve met, what we learned (my insights for my immediate collaborators and I), and what new possibilities emerged. This way, progress is visible, even when big outcomes are not yet achieved. I am also widening the circle of authorizers by including nonprofits, chaplains, and those with lived experience as central voices. Another layer of insightful lessons learned, from this course came through the Integration of Peter Senge’s work on learning organizations and systems thinking. Senge emphasizes that deep change comes when people adopt new habits of reflection, when they are able to see themselves as part of interconnected systems, and when they cultivate what he calls ‘personal mastery.’

If I could offer words of wisdom, they would be these: start with humility, focus on small wins, and care for yourself. As the HKS teaching reminded us, ‘progress is the most important thing to keep people moving.’ Arthur Brooks emphasized the four pillars of happiness—faith, family, friends, and work—as central to sustaining leadership. For me, this means honoring my heritage, nurturing family, enjoying the hummingbirds in my yard, and finding joy even in the grind of policy. Self-care is not indulgence—it is resistance to burnout and a way to sustain justice work

This course has been transformational. It has come at a good time of my life’s journey- as I transition from a full-time faculty role in an academic institution to a local policy maker. Being a student again has been my happy place, and it’s been an honor to learn and be in a circle of global leaders. I have deep respect for the faculty including Matt, Salimah and the TA’s Santiago and Catalina, and Jessie, Alison, and others! I was a bit burnt-out from 25 years of work in government, academia, and community and policy work. The week in Boston, re-energized my spirit and motivated me due to the other students in the class to re-commit to being a student of life again! The journey from May through September, deepened my hope for the future and re-ignited the fire in my belly to keep the flames of social justice and policy leadership alive. I leave with practical tools like the PDIA method which is adaptive and deeply human. Progress is not about fixing everything at once, but about learning, leading, and building together, step by step. I continue to aspire to use policy as healing: to design trauma-informed, equity-centered reforms that restore dignity and build resilience in my community work and policy change work.


This is a blog series written by the alumni of the Implementing Public Policy Executive Education Program at the Harvard Kennedy School. 36 Participants successfully completed this 5-month hybrid program in September 2025. These are their learning journey stories.