The gaps in-between

Is your middle missing?

You might have heard of the gap commonly referred to as the "missing middle" in mental health treatment.

It refers to people who do not meet the criteria for severe mental illness and therefore do not qualify for intensive psychiatric care — but they also don’t have mild symptoms that can be treated through their GP, or a few CBT sessions with a counsellor.

Take Brendan, a 42-year-old manager who has been depressed and drinking a lot since losing his job six months ago. Brendan is shy about getting help for his symptoms because admitting to having a problem will make him appear weak. Brendan often can’t get out of bed, and he is struggling to maintain relationships with his family, his kids, and his friends.

In this case, Brendan is experiencing the missing middle because he does not have severe symptoms that require inpatient or intensive outpatient care, but his symptoms are impacting his daily functioning, his family life, and even being able to afford his current housing.

I mention this because right now I’m working on a project to resolve a strategic question for one of my clients, who is involved in housing and psychosocial support.

They see many Brendans: ‘missing middle’ people who aren’t eligible for intensive services, nor would benefit from more universal, ‘light touch’ services where they invariably get referred. Their theory is that perhaps 10% or more of our population are on a ‘slippery slope’ of unmet need, while their everyday functioning appears, on the surface, quite functional. Until, of course, it isn’t.

Question:?“How have you defined an ‘undefinable’ target audience for your services or products?”

Napoleon’s irony

I wonder if you ever heard about this most intriguing of political paradoxes.

Napoleon Bonaparte had his eyes set on invading Britain. From 1803 to 1805, he gathered an army of 200,000 men known as the Armée des c?tes de l'Océan or the Army of England. His army was trained at camps in various French towns, and a "National Flotilla" of invasion barges was built in Channel ports.

But here's the catch: France was nearly bankrupt at the time and could not afford such an invasion.

The solution? The Louisiana Purchase. In 1803, France ceded its vast North American territories to the United States in return for a payment of 50 million French francs, which is equivalent to about $11,250,000 today.

The entire amount was spent on financing the invasion.

But this isn’t the irony.

The United States did not have the full amount needed to finance the Louisiana Purchase, so they had to borrow part of the purchase price. And where did they turn for the loan? Baring Brothers — a British bank. Yes, you read that right. The British ended up funding an invasion of themselves!

But, what did the British lose? They lost their territory, but Baring’s were repaid, with interest. The Americans gained their territory, using borrowed money, and the French, well, they lost both their territory and their money.

Question:?“What unintended consequences might arise from your organisation’s ‘do or die’ strategic decisions?”

Virtuous cycles

My sage and witty friend Sean is a filmmaker who is now head of school at a tertiary institution that teaches filmmaking.

I asked him what his measure of success was for his school, and he surprised me by not saying, “Number of students”, or “Completion rates” or, “Revenue growth”, but “Quality of output”. He explained that he takes immense pleasure in seeing the highest quality work produced, years later, by his graduates.?

And, the critical element, while they’re studying, is, “Get the highest quality feedback you can, so you can iterate”.

Be taught by people with the chops, the craft, who are capable of raising the bar for you, so you can produce beyond what you thought was possible. Iterative improvement, according to Sean, builds belief in the student and, even more powerfully, when feedback is applied, other people start noticing the quality of the work. This becomes a “conscious convincer” to the budding filmmaker that their work is good, and the surrounding talent also provides iterative feedback.

And, thus, a virtuous cycle of feedback is built, and amazing results are obtained.?

Question: “Whose performance are you improving through high-quality feedback?”

Let me know you’ve enjoyed reading by clicking the ‘like’ below. And, please pass on 5MSM to anyone you think would enjoy reading.

And, to see more strategic insights but in video form, check out?my new video channel. I’ve received plenty of great comments so, if you haven’t already done so, take a look at this one: “Do you begin your strategy process with this question?”. It’s just 40 seconds, so?click here and take a look.

In the meantime, pay attention to the gaps in-between, and I’ll see you next Friday.

Andrew