Anatomy of Psychiatric Administration : The Organization in Health and Disease

When the 13 founders of the American Psychiatric Association came together in 1844, hospitals were small, and the administrative aspects of a superinten- dents job were relatively minor compared with their size and complexity today. Since the turn of the century, administration-the art and the sci- ence-has become a specialty of great importance, particularly in big business and government. Business recognizes fully that the success of organizational endeavors depends to a great extent on the talents and energies of top lead- ers. As a result, industry spends huge sums of money to train promising young executives and offers generous salaries and benefits to entice them. Anyone who wants to invest in a business first asks: "Who manages this organization, and is this management competitive in todays marketplace?" Although health is today a great industry, emphasis on the executive role has lagged behind that in the general business field. In mental health circles, the strong emphasis on one-to-one therapy has delayed a full appreciation of the influence of organization per se on patient care and treatment. Yet there 1 are now many signs of change. The popularization of behavioral science and the rise of social and community psychiatry have brought organizational con- siderations forward. We are increasingly concerned with the human side of enterprise, with worker satisfaction, group dynamics, and organizational morale. Other flags have been unfurled.