Modernizing mental health services: mission impossible?
Managing complex change initiatives can be a risky and controversial task. Hargrove and Glidew's (1990) model of "impossible jobs" defines typical obstacles: constituency conflict, perceptions of client legitimacy, respect for professional authority, and the strength of the agency myth. The author uses this model to describe his experiences while implementing major changes within British Columbia's community mental health system and provincial psychiatric hospital. Coping strategies include coalition building, public education, meaningful stakeholder participation, systemic feedback, mutual aid, and staff development.
Berland
Alex
A
Department of Health Care and Epidemiology, Faculty of Medicine, University of British Columbia, Canada. aberland@telus.net
D000293:Adolescent; D000328:Adult; D002170:Canada; D019317:Evidence-Based Medicine; D005260:Female; D006801:Humans; D007857:Leadership; D008297:Male; D008605:Mental Health Services / Q000458:organization & administration* / Q000592:standards; D017146:Models, Organizational; D009936:Organizational Innovation; D011785:Quality Assurance, Health Care; D012922:Social Change