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Related Experiment Videos

Modernizing mental health services: mission impossible?

Alex Berland1

  • 1Department of Health Care and Epidemiology, Faculty of Medicine, University of British Columbia, Canada. aberland@telus.net

Administration and Policy in Mental Health
|July 12, 2003
PubMed
Summary

Implementing complex organizational change in mental health services is challenging. Strategies like coalition building and stakeholder participation can overcome obstacles such as constituency conflict and agency myths.

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Area of Science:

  • Healthcare Management
  • Organizational Psychology
  • Public Health Policy

Background:

  • Complex change initiatives in public services often face significant obstacles.
  • Hargrove and Glidew's (1990) model identifies key challenges in "impossible jobs": constituency conflict, client legitimacy, professional authority, and agency myths.
  • Implementing major changes in mental health systems requires understanding these inherent difficulties.

Purpose of the Study:

  • To apply Hargrove and Glidew's "impossible jobs" model to analyze challenges in implementing change within British Columbia's community mental health system and provincial psychiatric hospital.
  • To identify and evaluate effective coping strategies for managing complex change in public mental health settings.

Main Methods:

  • Case study analysis of change implementation in British Columbia's mental health system.

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  • Application of Hargrove and Glidew's (1990) theoretical framework to real-world experiences.
  • Qualitative description of observed obstacles and implemented coping strategies.

    • Main Results:

    • The study identified constituency conflict, perceptions of client legitimacy, respect for professional authority, and the strength of the agency myth as significant obstacles.
    • Effective coping strategies included coalition building, public education, meaningful stakeholder participation, systemic feedback, mutual aid, and staff development.
    • These strategies were crucial for navigating the complexities of the change initiatives.

    Conclusions:

    • Hargrove and Glidew's model provides a valuable framework for understanding and managing complex change in mental health systems.
    • Proactive and multifaceted coping strategies are essential for successful implementation of major reforms in public healthcare.
    • Effective change management requires addressing both systemic barriers and fostering collaborative approaches among stakeholders.