Following the Blackfoot Indians: Toward democratic administration of a community mental health center

A 10-year case history of one mental health center's struggle to put its own house in order to further staff morale, productivity, more egalitarian attitudes toward clients, and a sense of partnership with each other and the community is shown.

Abstract

Community mental health centers have been held back by authoritarian administrative structures, inherited from the traditional medical model, from fulfilling their original promise of innovative approaches to mental health and responsiveness to the community. This is a 10-year case history of one mental health center's struggle "to put its own house in order" to further staff morale, productivity, more egalitarian attitudes toward clients, and a sense of partnership with each other and the community. The paper shows the development of democratic structures and processes, how line staff and administrators confronted their taboo on power, the traditional hierarchy among disciplines, staff participation in administration, and their vulnerability within the wider bureaucratic system.