Administration by inclusion in a large service system
Nancy Pena
Over 19,000 consumers each year receive some type
of mental health service from this large
California county public mental health system.
While anchored in principles of client-centeredness,
cultural proficiency, least restrictive care,
geographic access, best practice models,
the "system" still finds evidence of
accountability and dialogue to be illusive and transitory. Not
only among practitioners and clients,
but they are often equally absent among colleagues, and
between managers and line workers.
This presentation will focus on the challenge of establishing
accountability and dialogue at the service system level.
Just as two partners in union vow to respect and honor,
and to create the ideal, morally correct
socio-emotional environment for their new family to thrive in,
our public health and human
service systems are founded on similarly
honorable principles of healing and helping. Yet, like
so many families, how easily we find ourselves involved in subtle,
if not blatant, patterns of
inattention and neglect; even abuse and oppression.
Kids get raised, clients get served, but we all
know there was damage done along the way.
How then, from an administrative role,
are concepts of accountability and dialogue incorporated
into the management of a large organization?
The new leadership of this system has taken this
question to the heart of its organizational culture.
Utilizing concepts of 'inclusion',
'participatory leadership', and 'client-driven planning',
traditional administrative forums have
been redesigned. Clients are involved in most levels of activity.
Family members, labor organizations, advocates, and managers have
input to decisions. It hasn't been easy. Many
complain- about inefficiency, lack of authority, too much process.
Others feel valued for the first
time- mostly clients, families and line staff.
The function of administrative leadership in establishing
and developing the value of
accountability and dialogue in public mental
health delivery systems will be examined in this
presentation.