(Perspective): The Importance of strengthening the management system within mental health services

Abstract

Within the civil and public service there are people appointed to managerial roles who have little or no training in management skills. Even where they have acquired the necessary skills, for example through their own initiative in attending a formal training programme, they commonly find themselves operating in a context where there are poor management processes, very patchy management tools and management role structures that are unfit for purpose. There are many problems with management structures in the health system generally and major weaknesses in all elements of the management system of the Mental Health Services (MHS) of the HSE. Managers are often not given the necessary delegated authority and, even if they are, people who are supposed to be accountable to their manager can simply refuse to accept that the manager has such authority over them, for example inappropriately citing ‘clinical independence.’ This article outlines the key management skills, tools, processes and structures that make up a coherent management system and argues that significant and sustained strengthening of the management system, will lead to a safer service, major cost savings, better service user outcomes and a higher job satisfaction among staff.