Becoming an administrator: the vicissitudes of middle management in mental health organizations

Middle management has been a conceptually neglected and operationally abused position in the administrative hierarchy of mental health organizations. The position is viewed as a preparatory exercise for executive responsibility, and frequent changes disrupt service delivery. The author describes the responsibilities, hierarchical role relationships, rewards, and constraints of middle management positions. Health care professionals must actively seek and retain these positions if they wish to maintain their place in directing the work of mental health institutions.