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.