title: Who's in charge here anyway? Managing the management split in mental health organizations.
abstract: Most mental health organizations are run by chief executive officers (CEOs) who are not physicians, with medical directors reporting to the CEOs. In this article the historical and organizational origins of this arrangement are reviewed. The well known disadvantages of shared management are discussed, as are the less obvious advantages. Through case vignettes the authors illustrate how bifurcated leadership can promote productive and creative administrative decisions. Guidelines are offered for strengthening collaborations between non-medical and medical mental health program directors.
authors.affiliation: Ulster County Mental Health Department, Columbia University College of Physicians and Surgeons, Kingston, NY 12401, USA. je22@columbia.edu
authors.forename: J
authors.initials: J
authors.lastname: Eilenberg
authors.forename: E J
authors.initials: EJ
authors.lastname: Townsend
authors.forename: E
authors.initials: E
authors.lastname: Oudens
mesh_terms: D003220:Conflict, Psychological; D003659:Decision Making, Organizational; D015276:Health Care Rationing; D006270:Health Facility Administrators; D006608:Hierarchy, Social; D006801:Humans; D007400:Interprofessional Relations; D007587:Job Description; D007857:Leadership; D008605:Mental Health Services / Q000458:organization & administration*; D015279:Organizational Culture; D008486:Physician Executives; D014481:United States