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Leaders' Role in Tough Times

April 1, 2009
by Douglas J. Edwards, Editor-in-Chief
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These certainly are tough times for behavioral healthcare organizations. In Hawaii, for example, the state said last month that it won't be able to pay mental healthcare providers for some contracted services until its new fiscal year begins-in July. “It's a devastating blow. It's really a four-month time period of trying to do without,” Tina McLaughlin, co-CEO of CARE Hawaii, told the Honolulu Advertiser. Brian Schatz, CEO of Helping Hands Hawai'i, noted, “It means that we're essentially going to be loaning money to the state.”1

The uncertainty of what's yet to come further complicates matters. As Ronald J. Hunsicker, DMin, president and CEO of the National Association of Addiction Treatment Providers, told me, the economy has been changing so much that addiction treatment providers have had difficulty plotting their next moves, and rising unemployment (and consequently fewer people with health insurance) could require some organizations to make difficult decisions in the months, if not years, ahead.

Yet even in the midst of this terrible recession, Drs. Lori Ashcraft and William A. Anthony remind leaders in this issue that now is not the time to lower expectations. Even in this difficult operating environment, they suggest leaders keep an eye out for new opportunities to transform services and be innovative. Keeping expectations high, they note, can serve as a “psychological stimulus package” for staff and clients.

Mark Mishek, Hazelden's new president and CEO, seems to share this philosophy. He not only joined the iconic addiction treatment provider just as the economy lost its legs, but he is tasked with leading an organization that has lacked a senior leadership team for much of the past year. Yet despite the many challenges Hazelden and the field face, Mishek is committed to finding ways to grow the organization and keeping staff engaged and energized (See article in this issue).

Every behavioral healthcare organization has unique financial challenges, and some are better positioned than others to survive the economy's nosedive. I am deeply concerned that many people will not have access to the treatment they need to address their mental health and/or substance use challenges, that talented staff will voluntarily or be forced to leave the field, and that some organizations will not make it through this tough time. But as history has proven again and again, strong leadership is essential to surviving hard times, and good things can emerge even when the situation looks so bleak. There are many factors that leaders of behavioral healthcare organizations can't control, but they can have a powerful influence on their staff and clients. And in this troubled time they can be important role models demonstrating careful spending, innovative thinking, and enduring hope for brighter days ahead.

Douglas J. Edwards, Editor-in-Chief


  1. Vorsino M. Pay delay ‘devastating’ to mental health services. Honolulu Advertiser. March 13, 2009.
Behavioral Healthcare 2009 April;29(4):6