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What Works for Mental Health System Change: Evolution or Revolution?

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Abstract

The mental health system has realized significant metamorphoses in the standards and practices of quality care for people with psychiatric disability during the past decade. Now change agents are wrestling with effective strategies that help real-world systems to adopt programs reflecting these metamorphoses. Two fundamental approaches to systems change are compared and contrasted here: evolution and revolution. First, the authors compare the different ways in which evolution and revolution might approach change in the mental health system. They do this by showing how they might influence the transformation of day treatment into supported employment programs. Then, the authors present the two approaches as naturally occurring change processes that work in tandem to affect real-world adaptations. Finally, they summarize practical strategies that change agents might adopt to realize evolution and revolution. Clearly, all stakeholder groups need to become strategic about system change so that real-world practices keep up with the ideals emerging in practice guidelines and evidence-based practice reviews.

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REFERENCES

  • Ajzen, I., & Fishbein, M. (1980). Understanding attitudes and predicting social behavior. Upper Saddle River, NJ: Prentice-Hall.

    Google Scholar 

  • Barter, J.T., &Lall, K. (1992). Accreditation. In J.A. Talbott, R.E. Hales, & S.L. Keill (Eds.), Textbook of administrative psychiatry. Washington, DC: American Psychiatric Press.

    Google Scholar 

  • Bass, B.M. (1985). Leadership: Good, better, best. Organizational Dynamics, 13(3), 26–40.

    Google Scholar 

  • Bass, B.M. (1990). From transactional to transformational leadership: Learning to share the vision. Organizational Dynamics, 18(3), 19–31.

    Google Scholar 

  • Bass, B.M. (1997). From transactional to transformational leadership: Learning to share the vision. In R.P. Vecchio (Ed.), Leadership: Understanding the dynamics of power and influence in organizations (pp. 318–333). Notre Dame, IN: University of Notre Dame Press.

    Google Scholar 

  • Bass, B.M., & Avolio, B.J. (1993). Transformational leadership: A response to critiques. In M.M. Chemers & R. Ayman (Eds.), Leadership theory and research: Perspectives and directions (pp. 49–80). San Diego, CA: Academic Press.

    Google Scholar 

  • Bickman, L., & Noser, K. (1999). Meeting the challenges in the delivery of child and adolescent mental health services in the next millennium: The continuous quality improvement approach. Applied & Preventive Psychology, 8(4), 247–255.

    Google Scholar 

  • Bond, G.R. (1998). Principles of the individual placement and support model: Empirical support. Psychiatric Rehabilitation Journal, 22(1), 11–23.

    Google Scholar 

  • Bond, G., Becker, D., Drake, R., Rapp, C.A., Meisler, N., Lehman, A.F., Bell, M.D., & Blyler, C.R. (2001). Implementing supported employment as an evidence-based practice. Psychiatric Services, 52, 313–322.

    Google Scholar 

  • Bond, G.R., Becker, D.R., Drake, R.E., & Vogler, K.M. (1997). A fidelity scale for the Individual Placement and Support model of supported employment. Rehabilitation Counseling Bulletin, 40(4), 265–284.

    Google Scholar 

  • Bowditch, J.L., & Buono, A.F. (1994). A Primer on organizational behavior (3rd ed.). New York: Wiley.

    Google Scholar 

  • Breu, K., & Benwell, M. (1999). Modeling individual transition in the context of organizational transformation. Journal of Management, 18, 496–520.

    Google Scholar 

  • Brooker, C., Tarrier, N., & Barrowclough, C. (1992). Training community psychiatric nurses for psychosocial intervention: Report of a pilot study. British Journal of Psychiatry, 160, 836–844.

    Google Scholar 

  • Cameron, D. (1947). The day hospital. Modern Hospital, 69, 60–62.

    Google Scholar 

  • Corrigan, P.W. (1995). Wanted: Champions of rehabilitation for psychiatric hospitals. American Psychologist, 50, 514–521.

    Google Scholar 

  • Corrigan, P.W. (dy2001). Place-then-train: An alternative service paradigm for persons with psychiatric disabilities. Clinical Psychology—Science & Practice, 8(3), 334–349.

    Google Scholar 

  • Corrigan, P.W., & Garman, A.N. (1997). Considerations for research on consumer empowerment and psychosocial interventions. Psychiatric Services, 48(3), 347–352.

    Google Scholar 

  • Corrigan, P.W., & Garman, A.N. (1999). Transformational and transactional leadership skills for mental health teams. Community Mental Health Journal, 35(4), 301–312.

    Google Scholar 

  • Corrigan, P.W., Garman, A.N., Canar, J., & Lam, C. (1999). Characteristics of rehabilitation team leaders: A replication. Rehabilitation Counseling Bulletin, 42(3), 186–195.

    Google Scholar 

  • Corrigan, P.W., Garman, A.N., Lam, C., & Leary, M. (1998). What mental health teams want in their leaders. Administration and Policy in Mental Health, 26(2), 111–123.

    Google Scholar 

  • Corrigan, P.W., & McCracken, S.G. (1995). Psychiatric rehabilitation and staff development: Educational and organizational models. Clinical Psychology Review, 15(8), 699–719.

    Google Scholar 

  • Corrigan, P.W., & McCracken, S.G. (1997). Interactive staff training: Rehabilitation teams that work. NewYork: Plenum Press.

    Google Scholar 

  • Corrigan, P.W., & McCracken, S.G. (1998). An interactive approach to training teams and developing programs. New Directions for Mental Health Services, 79, 3–12.

    Google Scholar 

  • Corrigan, P.W., Steiner, L., McCracken, S.G., Blaser, B., & Barr, M. (2001). Strategies for disseminating evidence-based practices to staff who treat people with serious mental illness. Psychiatric Services, 52(12), 1598–1606.

    Google Scholar 

  • Deming, W.E. (1986). Out of crisis. Cambridge, MA: Institute of Technology Center for Advanced Engineering Study.

    Google Scholar 

  • Drake, R.E. (1998). A brief history of the individual placement and support model. Psychiatric Rehabilitation Journal, 22(1), 3–7.

    Google Scholar 

  • Drake, R.E., & Becker, D.R. (1996). The Individual Placement and Support (IPS) model of supported employment. Psychiatric Services, 47(5), 473–475.

    Google Scholar 

  • Erez, M., Earley, P.C., & Hulin, C.L. (1985). The impact of participation on goal acceptance and performance: A two-step model. Academy of Management Journal, 28(1), 50–66.

    Google Scholar 

  • Fauman, M.A. (1992). Quality assurance monitoring in psychiatry. In M.R. Mattson (Ed.), Manual of psychiatric quality assurance (57–67). Washington, DC: American Psychiatric Association.

    Google Scholar 

  • Fiorelli, J.S., & Margolis, H. (1993). Managing and understanding large systems change: Guidelines for executives and change agents. Organizational Development Journal, 11, 1–13.

    Google Scholar 

  • Garman, A.N., & Corrigan, P.W. (1998). Developing effective team leaders. In P.W. Corrigan & D.F. Giffort (Eds.), Building teams and programs for effective psychiatric rehabilitation. New directions for mental health services (pp. 45–54). San Francisco: Jossey-Bass.

    Google Scholar 

  • Gersick, C.J. (1989). Marking time: Predictable transitions in task groups. Academy of Management Journal, 32, 274–309.

    Google Scholar 

  • Gersick, C.J. (1991). Revolutionary change theories: A multilevel exploration of the punctuated equilibrium paradigm. Academy of Management Review, 16(1), 10–36.

    Google Scholar 

  • Griffith, B.A., & Frieden, G. (2000). Facilitating reflective thinking in counselor education. Counselor Education & Supervision, 40(2), 82–93.

    Google Scholar 

  • Harding, C.M., & Zahniser, J.H. (1994). Empirical correction of seven myths about schizophrenia with implications for treatment. Acta Psychiatrica Scandinavica, Supplementum, 90(384, Suppl.), 140–146.

    Google Scholar 

  • Harding, C.M., Zubin, J., & Strauss, J.S. (1987). Chronicity in schizophrenia: Fact, partial fact, or artifact? Hospital & Community Psychiatry, 38(5), 477–486.

    Google Scholar 

  • Hoge, M.A., Davidson, L., Hill, W.L., Turner, V.E., & Ameli, R. (1992). The promise of partial hospitalization: A reassessment. Hospital & Community Psychiatry, 43(4), 345–354.

    Google Scholar 

  • Hunter, M.E., & Love, C.C. (1996). Total quality management and the reduction of inpatient violence and costs in a forensic psychiatric hospital. Psychiatric Services, 47, 751–754.

    Google Scholar 

  • Kregel, J., Shafer, M.S., Wehman, P., & West, M. (1989). Policy development and public expenditures in supported employment: Current strategies to promote statewide systems change. Journal of the Association for Persons with Severe Handicaps, 14(4), 282–283.

    Google Scholar 

  • Lehman, A.F., Steinwachs, D.M., & the co-investigators of the PORT Project. (1998). Patterns of usual care for schizophrenia: Initial results from the schizophrenia patient outcomes research team (PORT) client survey. Schizophrenia Bulletin, 24(1), 11–19.

    Google Scholar 

  • Levinson, D.J. (1978). The seasons of a man's life. New York: Knopf.

    Google Scholar 

  • Levy, A., & Merry, U. (1986). Organizational Transformation. New York: Praeger.

    Google Scholar 

  • Locke, E. (1968). Toward a theory of task motivation and incentives. Organizational Behavior & Human Decision Processes, 3(2), 157–189.

    Google Scholar 

  • Luber, R.F. (1984). Partial hospitalization. In A.S. Bellack (Ed.), Schizophrenia: treatment, management, and rehabilitation. Orlando, FL: Grune & Stratton.

    Google Scholar 

  • Marks, M.L., Hackett, E.J., Mirvis, P.H., & Grady, J.F. (1986). Employee participation in a quality circle program: Impact on quality of work life, productivity, and absenteeism. Journal of Applied Psychology, 71, 61–69.

    Google Scholar 

  • McCarthy, D., Thompson, D, & Olson, S. (1998). Planning a statewide project to convert day treatment to supported employment. Psychiatric Rehabilitation Journal, 22(1), 30–33.

    Google Scholar 

  • National Alliance for the Mentally Ill. (1999). Accountability template: What consumers and families expect from treatment systems for persons with severe mental illness. Arlington, VA: Author.

    Google Scholar 

  • Pearlstein, R.B. (1991). Who empowers leaders? Performance Improvement Quarterly, 4(4), 12–20.

    Google Scholar 

  • Priebe, S. (2000). Ensuring and improving quality in community mental health care. International Review of Psychiatry, 12(3), 226–232.

    Google Scholar 

  • Ralph, R.O. (2000). Recovery. Psychiatric Rehabilitation Skills, 4(3), 480–517.

    Google Scholar 

  • Rosie, J.S., Azim, H.F., Piper, W.E., & Joyce, A.S. (1995). Effective psychiatric day treatment: Historical lessons. Psychiatric Services, 46(10), 1019–1026.

    Google Scholar 

  • Segal, S.P., Redman, D., & Silverman, C. (2000). Measuring clients' satisfaction with self-help agencies. Psychiatric Services, 51(9), 1148–1152.

    Google Scholar 

  • Segal, S.P., Silverman, C., & Temkin, T. (1995). On empowerment and self help. Community Mental Health Journal, 31, 215–227.

    Google Scholar 

  • Shareef, R. (1997). A Popperian view of change in innovative organizations. Human Relations, 50(6), 655–670.

    Google Scholar 

  • Sluyter, G.V. (1998). Total quality management in behavioral care. In P.W. Corrigan & D.F. Giffort (Eds.), Building teams and programs for effective psychiatric rehabilitation. New directions for mental health services (pp. 35–43). San Francisco: Jossey-Bass.

    Google Scholar 

  • Sluyter, G.V., & Mukherjee, A.K. (1993). Total quality management for mental health and mental retardation services: A paradigm for the '90s. Annandale, VA: American Network of Community Options and Resources.

    Google Scholar 

  • Stefan, S. (2001). Unequal rights: Discrimination against people with mental disabilities and the Americans With Disabilities Act. Washington, DC: American Psychological Association.

    Google Scholar 

  • Torrey, W.C., Drake, R.E., Dixon, L., Burns, B.J., Flynn, L., Rush, A.J., Clark, R.E., & Klatzker, D. (2001). Implementing evidence-based practices for persons with severe mental illnesses. Psychiatric Services, 52(1), 45–50.

    Google Scholar 

  • Torrey, W.C., Mead, S., & Ross, G. (1998). Addressing the social needs of mental health consumers when day treatment programs convert to supported employment: Can consumer-run services play a role? Psychiatric Rehabilitation Journal, 22(1), 73–75.

    Google Scholar 

  • Tushman, M.L., & Romanelli, E. (1985). Organizational evolution: A metamorphosis model of convergence and reorientation. Research in Organizational Behavior, 7, 171–222.

    Google Scholar 

  • Victor, B., Boynton, A., & Stephens-Jahng, T. (2000). The effective design of work under total quality management. Organization Science, 11(1), 102–117.

    Google Scholar 

  • Wandersman, A., Imm, P., Chinman, M., & Kaftarian, S. (2000). Getting to outcomes: A results-based approach to accountability. Evaluation & Program Planning, 23(3), 389–395.

    Google Scholar 

  • Yeager, E. (1979). Examining the quality control circle. Personnel Journal, 58, 682–708.

    Google Scholar 

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Authors and Affiliations

  1. University of Chicago Center for Psychiatric Rehabilitation, 7230 Arbor Drive, Tinley Park, IL, 60477

    Patrick W. Corrigan

  2. Behavioral Health Recovery Management, Fayette Companies, Peoria, Illinois

    Michael G. Boyle

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  1. Patrick W. Corrigan
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  2. Michael G. Boyle
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Corrigan, P.W., Boyle, M.G. What Works for Mental Health System Change: Evolution or Revolution?. Adm Policy Ment Health 30, 379–395 (2003). https://doi.org/10.1023/A:1024619913592

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