I suspect that I was asked by the same author as Terry Stawar (What’s on the Horizon, posted on 12/7/2010) to comment on the future of behavioral health leadership. Here is my response to the same question:
At almost any point during the history of community mental health, “change and challenge” would aptly describe the times. From the initial infrastructure building, to the evolution of the care continuum, to the near escapes from public policy and funding disasters, to the throes of managed care, and now to healthcare reform and beyond—the behavioral health leader has always required an expansive array of skills cemented by an abundant dose of fortitude. This has never been an endeavor for the faint of heart.
Over recent years, however, unprecedented circumstances have given birth to a “change-and-challenge-on-steroids” scenario. In our state, public policy and funding changes have required a full-blown reengineering of almost all clinical and administrative systems within the provider organizations. Healthcare reform will do the same nationwide—provided, of course, that community mental health can find a place at the healthcare table. Administrators are also challenged to optimize the benefits of technological advances while mitigating the risks and liabilities imposed by them. Electronic records, teletherapies, meaningful use, social media, and the explosion of new software applications all present opportunities for enhanced performance and service access, but at the same time are rife with legal and regulatory hazards.
We are also experiencing a “change of personality” within our industry. Those CEO’s who joined community mental health as young clinicians in the 1960’s and 70’s are retiring almost en masse. These leaders set the vision, articulated the values, shaped the cultures, and in many ways defined the organizations that they led. Entering the scene are new CEO’s who weren’t even born at the time of the 1963 enabling legislation. So, where will these new leaders take us? What leadership constructs, structures, and competencies will define future success?
I believe that executives must begin by reimagining the entire concept of organizational leadership. When we think of behavioral health leaders today, we generally think of the CEO and the executive team. Successful organizations of the future will tap the leadership potential of each employee. Every brain cell of every staff member must be engaged in managing the organization of the future. We can no longer afford to allow talent and expertise to lie dormant.
We must also reexamine our organizational structures. Community mental health centers have traditionally operated in a fairly centralized manner, often propelled forward by the vision of a longstanding leader. Organizational charts are eerily similar across the country. With few exceptions, there is generally a CEO who leads a team of clinical experts, along with individuals who manage quality/compliance, technology, finance, and other administrative functions. Several layers of management separate the front line from the chief executive.