Anatomy of Psychiatric Administration

The Organization in Health and Disease

When the 13 founders of the American Psychiatric Association came together in 1844, hospitals were small, and the administrative aspects of a superinten­ dent's job were relatively minor compared with their size and complexity today. Since the turn of the century, administration-the art and the sci­ ence-has become a specialty of great importance, particularly in big business and government. Business recognizes fully that the success of organizational endeavors depends to a great extent on the talents and energies of top lead­ ers. As a result, industry spends huge sums of money to train promising young executives and offers generous salaries and benefits to entice them. Anyone who wants to invest in a business first asks: "Who manages this organization, and is this management competitive in today's marketplace?" Although health is today a great industry, emphasis on the executive role has lagged behind that in the general business field. In mental health circles, the strong emphasis on one-to-one therapy has delayed a full appreciation of the influence of organization per se on patient care and treatment. Yet there 1 are now many signs of change. The popularization of behavioral science and the rise of social and community psychiatry have brought organizational con­ siderations forward. We are increasingly concerned with the human side of enterprise, with worker satisfaction, group dynamics, and organizational morale. Other flags have been unfurled.