Mental Health Leadership Research Articles

Reflections on Clinician Leadership and Management in Mental Health

To review the role of clinician leadership in the management of mental health services. The literature suggests that clinician leadership is increasingly regarded as an essential element in the effective introduction of innovation and improved quality of clinical care by those who manage mental health services. Psychiatrist leaders have a role to play in ensuring that service change and innovation is based on sound clinical values, is developed in partnership with clinicians and is understood and supported by psychiatrist colleagues. Clinician leaders require clear vision, commitment and courage. The support of their colleagues is essential if the psychiatric profession is to have influence on future development of mental health services.

A Broader Conceptual Approach to Clinical Practice for the 21st Century

The need for school social workers and other mental health providers to move away from specialist-oriented services to comprehensive general programmatic approaches has been gaining increasing support among leaders in education and mental health. The “clinical quadrant” highlighted in this article is offered to better conceptualize the complex and varied tasks and interventions required of school social workers and other mental health providers in the changing landscape of education reform. The proposed conceptualization takes into account ecological aspects of the complex clinical knowledge and skills necessary for effective school social work practice in the 21st century. The clinical quadrant provided here allows for a wide range of multilevel interventions and allows school social work to differentiate itself from other student support service disciplines and become a key player in school reform efforts. Several barriers and challenges that school social workers face in carrying out a broader approach to practice are discussed, and recommendations are made for school social work practice and education.

Consultant nurses in mental health: a discussion of the historical and policy context of the role.

This paper provides a platform for the discussion of the recent development of the nursing leadership role of consultant nurse. It focuses on the implementation of this role in mental health. The discussion is partially informed by evidence from personal reflections from consultant nurses obtained from semistructured interviews undertaken as part of a pilot study aimed at explaining the influences and context of nursing leadership in mental health. The authors believe that more in depth consideration needs to be given to the interpretation and implementation of such professional policy initiatives in to mental health nursing. Further thought also needs to be given to how consultant nurses in mental health can operationalize their expert clinical practice.

The Campaign for Mental Health Reform: a new advocacy partnership.

The Campaign for Mental Health Reform: a new advocacy partnership.

Walter Reed Army Medical Center's Mental Health Response to the Pentagon Attack

The September 11 terrorist attack on the Pentagon captured the attention and concern of America as well as the world. Given the extent of devastation, and the number of deaths at the Pentagon, it was believed that the uniformed mental health services would serve a pivotal role in the recovery and relief efforts. This article provides a synopsis of the complex and multidisciplinary mental health services provided by Walter Reed Army Medical Center in the wake of the September 11 attack on the Pentagon. This article offers an overview of the functions and roles of mental health team members, describes a constellation of services rendered, and describes how missions differed inside and outside of the Pentagon. Additionally, the authors provide the reader with how services were provided at the Family Assistance Center to family members of those killed during the attack. Liaison with civilian medical, mental health, and relief agencies and facilities will be discussed as well. The mental health response was an intensive and complicated experience and has yielded many lesson learned. To this end, the authors will provide the reader with an understanding of how the lessons learned during this mission may assist mental health commanders and leaders in planning and responding to similar deployments in the future.

Research ethics for mental health science involving ethnic minority children and youths.

In response to U.S. Public Health Service projects promoting attention to disparities in the outcomes of mental health treatments, in July 2001, the American Psychological Association, the National Institute of Mental Health, and the Fordham University Center for Ethics Education convened a group of national leaders in bioethics, multicultural research, and ethnic minority mental health to produce a living document to guide ethical decision making for mental health research involving ethnic minority children and youths. This report summarizes the key recommendations distilled from these discussions.

New Patterns of Community Care: Coordinated Services for Dually Diagnosed Adults in North Carolina

North Carolina has developed coordinated care systems for people dually diagnosed with both a mental retardation and a different major mental illness. In response to a class action lawsuit, the state has become a leader in treatment of this form of dual diagnosis. Systems of care for this “Thomas S class” operate in each of 41 area programs for mental health, developmental disabilities, and substance abuse. Networks of care among leaders in mental health and developmental disability promote the coordination of health, housing, social, and vocational services. A survey of 100 area program leaders finds extensive cooperation and a variety of services provided and contracted for, both within and beyond each area program, particularly among developmental disability specialists. Cooperation among leaders is associated with service variety and inter-organizational linkages. The extent of relationships among provider organizations is associated with better access to care. Best practice includes a single portal of entry and inter-agency councils.

The Role Of The American Red Cross In Aviation Disasters

The American Red Cross is internationally recognized as the leader in disaster relief, but less well known is its role in providing psychological support services to those impacted by disasters, ranging from single family fires to mass fatality incidents. The American Red Cross Disaster Mental Health program is comprised of licensed or certified mental health professionals, trained to provide the effective, appropriate inventions in the highly chaotic, emotional charged environment that frequently surrounds a disaster. These skills are even more valued after aviation disasters. In the fall of 1996, the Congress of the United States passed the Aviation Disaster Family Assistance Act, which gave the National Transportation Safety Board (NTSB) the responsibility to oversee support services to families of passengers involved in commercial aviation disasters in the United States and its territories. The NTSB then tasked the American Red Cross with the role of coordinating emotional support services to those involved in aviation disasters. Since that time, the American Red Cross has developed a specialized Aviation Incident Response Team (AIR), with the capability and responsibility to travel anywhere in the US within four hours of an incident. A key component of the AIR Team is the Red Cross mental health leadership team which works closely with local professionals in the impacted area, as well as clergy, to ensure that appropriate support is available for affected families as well as disaster workers around the clock. Central to meeting the needs of the families is insuring they have a private area in which to grieve, while awaiting information about the crash, and identification of their loved ones. Usually family members are sequestered in a hotel near the crash site, where they can develop mutual support systems, while waiting for information. Aviation disasters are not unlike other mass casualty events, in that there is usually a tremendous outpouring of volunteers who wish to contribute their services to help those grieving. Though well meaning, these volunteers can quickly overwhelm those they are trying to help. The Red Cross has developed a system to manage this inflow of volunteers. A Staff Processing Center (SPC) is often set up in or near the relief operations headquarters. All volunteer and paid staff must process in and out of this center. Licenses and credentials are checked, volunteers are screened for appropriate assignment and availability, and all staff are given an orientation specific to the incident, including self care guidance. Once workers have been screened and given an orientation, they are assigned to specific service delivery sites, and given an ID specific to that site to ensure that security is maintained. The majority of mental health volunteers will find themselves assigned to the Family Assistance Center. Services may range from basic comfort measures, to grief counseling, education, and information about the recovery and identification process, support through the anteand post-mortem interviews, assistance arranging appropriate memorial services, and referral to support groups specific to aviation disasters. Other services for family members include child and spiritual support. These programs are provided in collaboration with Red Cross, and are comprised of specially trained child care workers and chaplains who represent a broad range of religious and spiritual backgrounds. Red Cross services may also extend to those working at the recovery site, and other locations where workers may be assigned as part of the response. The Red Cross works closely with other agencies and organizations to ensure that everyone involved has access to support services including Critical Incident Stress Debriefing as part of an overall Critical Incident Stress Management program. Red Cross mental health services are not limited to The Role Of The American Red Cross In Aviation Disasters 2 of 3 families who choose to come to the disaster site, but are provided to affected families around the country, who, for their own reasons may not choose to, or be able to travel to the crash site. Mental health volunteers from their local chapters will reach out to provide similar support, ensuring the same quality of care. These local volunteers will also provide follow up support to families returning home after the crash. The American Red Cross Disaster Mental Health program continues to expand in new directions, from support to individual families affected by single family disasters to aviation disasters, so that the same level of support is provided to people affected by traumatic events around the country and around the world. The Red Cross is ready whenever and wherever needed.

Action leadership: The development of an approach to leadership enhancement for grassroots community leaders in children's mental health

The last decade has seen the development of a number of interagency systems for children with serious emotional disturbances and their families. Many public sector agencies, however, continue to have inadequate or fragmented services. It is believed that effective systems of care for children and families will not be adequate until more parents and community residents are involved in all phases of systems development. Consequently, the need for the development of leadership models that enhance the involvement of grassroots community leaders is crucial. This article summarizes a research team's preliminary experience in developing an "action leadership" model that empowers grassroots community leaders toward action. The team discovered that leadership enhancement and development of grassroots community leaders is not a static skill attribute of an individual but rather is acquired through a dynamic process in which both the facilitator of a community leadership initiative and its natural leaders are active participants in a shared learning and change experience.

Introduction to the Mini-Series: Resilience Applied: The Promise and Pitfalls of School-Based Resilience Programs

"Introduction to the Mini-Series: Resilience Applied: The Promise and Pitfalls of School-Based Resilience Programs." School Psychology Review, 27(3), pp. 346–347 Additional informationNotes on contributorsBeth DollBeth Doll, PhD, is Director of the School Psychology Program at the University of Colorado at Denver and the leader of the Teaching for Mental Health Leadership Area of UCD's Initial Teacher Education program. Her primary interest is developing and evaluating building-wide strategies for enhancing social and emotional supports for students.Mark A. LyonMark A. Lyon, PhD, is Professor and Director of the School Psychology Program at the University of Denver. His current interests include interprofessional education and collaborative practice, university-school partnerships in urban settings, and resilience.

Developing the nursing contribution to the management of the mental health services.

The importance of management and leadership in mental health nursing has been stressed in an extensive review of the role of the profession in the mental health services. Drawing from a longitudinal study of the careers of a cohort of registered mental nurses, this paper presents data relevant to developing the management capability of the profession. The data were obtained from a questionnaire sent to the cohort at qualification, 80% of whom responded. Findings showed that 14% thought that at some stage they would definitely seek a management post and 19% thought it likely. Only 18% had received information during the course about developing a career in management. Sixty-nine per cent of those who had not received such information would have liked to have had some. Just over half (51%) felt that their course had prepared them well for aspects of ward management and 46% held this view in relation to management of other nursing staff. A statistical modelling approach as used to explore the relationships between these three aspects of management and a range of demographic and course perception variables considered as possible predictors of seeking a post in management. These analyses demonstrated that likelihood of seeking such a post was significantly associated with sex of respondent, with receipt of information about developing a career in management, and with being encouraged by the course to want to work as a psychiatric nurse. Strategies to encourage an early orientation towards management posts are considered in the light of the findings.

Rural mental health leaders' perceptions of stigma and community issues.

This paper provides a description of the attitudes of rural leaders toward mental health issues using data collected in two rural counties (one in Virginia and one in North Carolina). Study participants (N = 63) are individuals identified as leaders making a significant positive contribution to mental health issues in each county. While the counties were matched on a number of demographic characteristics, the counties had one difference believed important: one had a county mental health center located within the county boundary while the other had no in-county mental health center. The study found that rural leaders believed that other community members held attitudes toward mentally ill persons that were more discriminatory than their own. In addition, rural leaders expressed that mental health was a more important concern to them than it was to the community as a whole. Finally, the importance placed on issues of importance to the community and the resulting issue of priority of relevance varied in response to the occupation of respondents. The study presents an approach to understanding how occupational structures affect community issue priorities among rural leaders.

The DSM-IV-PC: a manual for diagnosing mental disorders in the primary care setting.

September 1995 marked the publication of the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, Primary Care Version (DSMIV-pC).l This manual, the result of a 5-year collaboration among leaders in mental health and primary care fields, is published by the American Psychiatric Association as an official task force report. The following organizations formally participated in the development process by recommending participants and providing resources: American Academy of Family Physicians, American Board of Family Practice, Society of Teachers of Family Medicine, Association of Departments of Family Practice, American College of Physicians, Society of General Internal Medicine, American College of Obstetrics and Gynecology, American Academy of Pediatrics, and American Psychiatric Association. The American Medical Association, acknowledging that this cooperative effort was unprecedented, also participated. We will describe the reasons for such a manual, the process whereby it was developed, its form and content, its limitations, and its intended uses. Diagnoses are fundamental to clinical conversation-they make it possible to measure the content of practice and to generalize across practices. They are an essential prerequisite to the measurement of treatment effectiveness and are indispensable to the clinician who wishes to know whether a treatment shown effective in a clinical trial is likely to help an individual patient. Mental diagnoses in the primary care setting, however, have always been problematic. Family

Leadership in practice: Developing leadership in forensic mental health nursing

Leadership in practice: Developing leadership in forensic mental health nursing

Leadership and innovation in mental health

Leadership and innovation in mental health

Mental health leadership training: a survey of state directors.

There is periodic support in the mental health literature for increased training opportunities in the area of management and leadership. The purpose of this study was to verify the need for such training as perceived by state directors of mental health and mental retardation/developmental disabilities programs and to explore related issues. The results confirmed a perception of need and provided insights into ways that such training might be successfully provided to states.

Women's mental health services: the need for women in mental health leadership.

Women's mental health services: the need for women in mental health leadership.

Leadership sought in mental health.

A new pilot scheme to develop excellence in mental health leadership has been launched, backed by the RCN, the Institute of Health Service Management and the Government.

Mental health treatment teams and leadership: a systems model.

Mental health treatment teams are living systems at the group level and comprise key productive subsystems of organizations providing mental health care. Effective treatment teams, like effective organizations, are anticipatory systems that contain subsystems that model and predict future system and environmental conditions and enable responses that increase system viability. A systems analysis of treatment teams highlights their potential instability due to their tendencies to regress toward dysfunctional partial systems and their active maintenance in nonequilibrium steady states with their organizational and external environments. Team subsystems are analyzed from the viewpoints of system processes and also with regard to individuals and their roles. Boundary processes are central to effective team functioning, assure constancy of team membership, and regulate the team's interfaces with its parent agency and with the external environment. Various causes and forms of disturbed information processing within hierarchical organizations are examined, and their effects at the treatment team level are discussed. The conclusion of the discussion focuses on team leadership and how leadership expands upon the concept of the decider subsystem to include role and personal factors to the team's leaders, and functions that are anticipatory and integrative in nature. Effective leaders must set appropriate thresholds for feedback regulation processes, and balance several pairs of seemingly opposing forces, including homeostasis and development, role differentiation and role overlap, and personal accountability and empowerment of others.

View from the bridge: reflections of a recovering staff model HMO psychiatrist.

The phenomenon of managed care is misperceived by its critics as a movement. Atheoretical in nature, and driven by spiralling health care costs, it represents the introduction of an executive function into the free-for-all (a supremely ironic term) of American medicine. Part one of this article traces the origin and development of the mental health carve-out, relating it to its antecedents, and describing its 3 overlapping phases: utilization review, discounted fees, and network development and management. Part two describes the key concept of the continuum of care and the role of the case manager in monitoring a care episode. The article concludes by anticipating seven future trends and calling for mental health leadership to recognize and ally with the need to manage resources in a more rational and efficient manner.