I'm going to go back in time first with a look at Mental Health Weekly, August 2, 2004, "Mental Health Field Ushers in New Generation of Leaders" subtitled "Role of Chief Executive Has Changed Over the Years" by the New York Association of Psychiatric Rehabilitation Services. This article can be found on the NAMI SCC Website and discusses the lack of permanent leaders, for several months, for the National Council [NCCBH]; the National Alliance for the Mentally Ill [NAMI]; and the United States Psychiatric Rehabilitation Association [USPRA], formerly known as IAPSRS. For the NCCBH and NAMI, the search has ended. Linda M. Rosenberg steps into the chief executive role at the National Council [NCCBH] coming from seven years as Senior Deputy Commissioner of the New York State Office of Mental Health. She succeeds Charles G. Ray, who retired a year ago due to health reasons. NAMI made permanent, its acting Executive Director, Michael J. Kirkpatrick, who replaced Richard C. Birkel, Ph.D., on a temporary basis in January, 2004 At USPRA, the efforts to replace Ruth A. Hughes, Ph.D. are expected to take several more months.
When installed, the trio will amount to a new generation of leaders in the mental health field. Ray, Hughes and Birkel's predecessor at NAMI, Laurie Flynn, had each served at least 15 years. The article goes on to point out that Ray, Flynn and Hughes whose terms came during and after the Reagan-era retrenchment saw their share of headaches because the times were marked by a de-emphasized federal role in policy making and funding.; a shift to managed care; increasing pressure on money and other resources; health related business mergers, acquisitions and failures; and continued fierce stigma against people with mental disorders. They served during a time that was very different from the 1960s when community-based mental health services were ushered in. By the 1990s, it was clear that the challenges were quite different. The author of the article says "We have pedaled awfully hard. It's taken 40 miles of effort to get two miles down the road. I can't imagine what it's like to be a CEO and have to do that for dozens of years."
In many ways, the political, financial, scientific and cultural landscapes surrounding mental health are vastly different than they were a generation ago. Now there is greater knowledge and understanding of mental illness, grounded in research. Today, there is more stability in the lives of many people with mental disorders because of the availability of new medications. A more hopeful, recovery-oriented treatment model is taking over from the traditional maintenance model. At the same time, many people with mental illnesses have yet to live fully productive lives, partly because of inadequate supports such as housing and employment. The numbers of mentally ill people on the streets and in jails have soared. Money is still a problem and there will be renewed interest in rationing of care based on available resources.
The leaders of today's mental health organizations must be able to deal with the appropriate allocation of scarce resources and at the same time be visionaries who are able to prioritize research and treatment modalities to meet ever changing needs of society. In other words they need to be leaders of large organizations with a business focus while at the same time understanding treatment programing and how to determine the value of various treatment modalities. If that sounds confusing, that's because it can be, and often is. My conclusion is that today's leaders must be system oriented and able to understand treatment needs and methods in total system terms. Having participated in the re-definition of the state of Oregon's mental health system in the 1970s, in a way that was understandable to a fiscally conservative legislature, I am convinced that such efforts are best led by a fiscally sound leader who is system oriented, yet has a thorough understanding of treatment methodologies. Such people are difficult to find, but are well worth the effort it takes to find them. Has the National Council found such a person? You be the judge.
Linda M. Rosenberg, MSW, CSW was hired in the summer of 2004 and has now been on the job almost three years. According to the Families Together in NYS newsletter dated June 21st, Linda comes from the New York State Office of Mental Health where as Senior Deputy Commissioner she, in partnership with counties, providers, consumers and families, she led the design and implementation of community- based services for adults and children and provided operational support and oversight for New York's mental health treatment and rehabilitation system.
She is committed to enabling adults with serious mental illnesses and children with severe emotional disturbances to live, work, learn and fully participate in their communities. Her accomplishments in New York, included the expansion of supported housing, assertive community treatment and community re-entry services for individuals released from correctional
Rosenberg has said her ability to understand complex systems, see and seize opportunities, and develop and implement strategic initiatives would be critical to her leadership role at the National Council. In part 3, I'll take a look at what she's done and where her leadership is taking the National Council.
But first, a preview: In her Aril 2007 Letter from Linda, Re: Building a national service system for community mental health, she begins by referring to the April 16, 2007 tragedy at Virginia Tech. And extends condolences to the victims ' families, the students, faculty and staff at that institution and goes on to empathize with schools and communities across the country as they deal with the uncertainties that they all face. She then says: "we must also ask what we can do". She goes on to say that this month she was preparing to use her letter to update you on the National Council practice improvement initiatives. But, she goes on, it seems more timely and important to focus on what can we do to ensure that others like the gunman at Virginia Tech, who are troubled by mental illness, get the care and help they need so they can live productive lives in a community that is not threatened by the consequences of their illness. She goes on to call for a national public mental health service system, but says that right now at the national level, no one is in charge. We'll have to wait to see where she takes these thoughts.