Psychiatric Management, Administration, and Leadership: a Continuum or Distinct Concepts?

To clarify the relationship between the concepts of management, administration, and leadership in psychiatry. The authors provide a review of the conceptual evolution of administrative psychiatry and develop operational definitions of these three domains. Based upon their experiences, they discuss relevant core competencies and personal attributes. The authors found that the terms psychiatric management, psychiatric administration, and psychiatric leadership are often used interchangeably, yet they each have a different and distinct focus. Additionally, some in the field consider the concepts overlapping, existing on a continuum, while others draw distinct conceptual boundaries between these terms. Psychiatrists in leadership positions function in all three domains. While these are distinct concepts, the authors recommend that administrative psychiatrists integrate all three in their everyday work. The authors suggest the distinctions among these concepts should inform training and identify core competencies related to these distinctions. Mentoring should focus on the practical integration of the concepts of management, administration, and leadership in administrative psychiatry. The authors present a cohesive framework for future development of a curriculum for education and research.

Career Paths and Trends: How Does One Become a Leader in Psychiatric Administration? Implications for Residency Training.

In the changing landscape of healthcare the number of psychiatrists entering leadership positions has declined steadily over the years. One factor contributing to this appears to be lack of leadership training during residency training. International competency frameworks have addressed this and some programs, both national and international, have designed innovative curricula to provide didactic and experiential learning in administration during and after residency. Despite guidelines by the Accreditation Council for Graduate Medical Education regarding competency in administrative aspects of health care delivery, most psychiatrists feel ill-equipped to assume a leadership position after residency training. Inculcating comprehensive administrative training into residency faces many challenges related to funding and saturation of existing curricula. Administrative training should be a mandatory element in the training of all residents irrespective of the setting in which they intend to practice. Accreditation Council for Graduate Medical Education should consider taking a prescriptive approach in shaping competency frameworks to address the need for residents to be fluent in administrative aspects of practice. Training psychiatrist-administrators will be crucial in the future of mental health-care, both from the perspective of consumers as well as psychiatry as a specialty.