Modernizing Mental Health Services: Mission Impossible?

  • Alex Berland

Abstract

Managing complex change initiatives can be a risky and controversial task. Hargrove and Glidew's (1990) model of “impossible jobs” defines typical obstacles: constituency conflict, perceptions of client legitimacy, respect for professional authority, and the strength of the agency myth. The author uses this model to describe his experiences while implementing major changes within British Columbia's community mental health system and provincial psychiatric hospital. Coping strategies include coalition building, public education, meaningful stakeholder participation, systemic feedback, mutual aid, and staff development.

mental health systems Canada change leadership evidence-based practice 

Preview

Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.

REFERENCES

  1. Andrews, G. (2000, June). Planning without tears: Disease management instead of case management. Paper presented at Innovations in Health Care, Vancouver BC.Google Scholar
  2. Bachrach, L.L. (1999). The state of the state mental hospital at the turn of the century. New Directions for Mental Health Services 84, 7-24.Google Scholar
  3. Berland, A. (2001). Mental health reform in British Columbia. Administration and Policy in Mental Health 29(1), 89-93.Google Scholar
  4. Birleson, P. (1998). Learning organizations: A suitable model for improving mental health services? Australia and New Zealand Journal of Psychiatry, 32, 214-222.Google Scholar
  5. Davis, L.J. (1997, February). The encyclopedia of insanity. Harper's Magazine (pp. 61-66).Google Scholar
  6. Ferlie, E., Fitzgerald, L., & Wood, M. (2000). Getting research into clinical practice: An organizational behaviour perspective. Journal of Health Services Research and Policy 5, 96-102.Google Scholar
  7. Government of British Columbia, Ministry of Health (2000). Evaluation of amendments to the Mental Health Act. Victoria BC: Adult Mental Health Division.Google Scholar
  8. Hargrove, E., & Glidew, J. (1990). Impossible jobs in public management. Lawrence, KS: University Press of Kansas.Google Scholar
  9. Kotter, J.P. (1995, March-April). Leading change: Why transformation efforts fail. Harvard Business Review, 59-67.Google Scholar
  10. Macfarlane, D. (1999, June). The status of deinstitutionalization in two provinces. Lecture in Vancouver BC.Google Scholar
  11. Marshall, M. (1999). Modernizing mental health services. British Medical Journal, 318, 4-5.Google Scholar
  12. Millar, G.E., & Iscoe, I. (1990). A state mental health commissioner and the politics of mental illness. In E. Hargrove & J. Glidew (Eds.), Impossible jobs in public management (pp. 103-132). Lawrence, KS: University Press of Kansas.Google Scholar
  13. Reinharz, D., Contandriopoulos, A.-P., & Lesage, A.D. (2000). Organizational analysis of deinstitutionalization in a psychiatric hospital. Canadian Journal of Psychiatry 45, 539-543.Google Scholar
  14. Senge, P.M. (1990). The fifth discipline. New York: Currency Doubleday.Google Scholar
  15. Thornicroft, G., Becker, T., Holloway, F., Johnson, S., Leese, M., McCrone, P., Szmukler, G., Taylor, R., & Wykes, T. (1999). Community mental health teams: Evidence or belief? British Journal of Psychiatry, 175, 508-513.Google Scholar
  16. Wenger, E.C., & Snyder, W.M. (2000, January). Communities of practice. Harvard Business Review (pp. 139-145).Google Scholar

Copyright information

© Human Sciences Press, Inc. 2003

Authors and Affiliations

  • Alex Berland
    • 1
  1. 1.Department of Health Care and Epidemiology, Faculty of MedicineUniversity of British Columbia. Strategic Resource GroupVancouverCanada

Personalised recommendations