Bingo!  That lady got it right!!  I’m right there with her, looking at this particular sub-culture in this society, trying to make sense of it and to figure out how it works.

What a time in history to be affiliated with mental health in whatever capacity!  We are witness to and participants in incredible change, more change than in almost any other sub-culture.  In my lifetime, effective psychiatric medications were developed.  Just since I began my career, deinstitutionalization began, community mental health centers were launched and later redefined as providers of community-based support services for people who have to cope with severe and persistent mental illness, family-blame ceased and family joined forces in an effective Alliance, consumers went public and allied as a self-help movement and as a force to acknowledge in their own treatment (--bravo!), and brain scans became effective tools for identifying altered brain structures and functioning that result in psychiatric diagnoses.  Momentous change—improvement, thank God, because change is not always the same as improvement.

Actually graduate school did a fine job preparing me to understand change.  I learned Kurt Lewin’s field theory in a social psychology course.  Lewin believes you have to see the big picture, view things in context.  That’s the “field”.  Visualize the field as an area within a frame.   Then mentally draw a line in the center.  Next, mentally draw arrows pointing toward that line, on both sides of it.  The force those various arrows (factors in the environment) exert on the line keep it stable or, depending where the force is, make it move\change.  When the forces on both sides exert the same pressure, the result is stability\ no change.  However, when the force exerted by one big arrow or several small arrows becomes different, equilibrium is lost.  Disequilibrium results in change—the line moves.  Usually, change results from multiple causes.  In any given situation, you can name those arrows, identify the pertinent factors.

So, change is hard.  It comes from disequilibrium.  Life, not Lewin, taught me that change is inevitable, so healthy organisms need to be flexible.  I remember the beautiful poster that hung in the Learning Lab I use to run at State Hospital.  It showed a closeup of a new tendril shooting up from a green plant, with the caption, “Growth is the only sign of life.”  Lose the ability to grow and you die.

We have a new facility director at Bryan.  A new state commissioner of mental health will be named soon.  Managed care is on our horizon.  Be ready to change.  At Bryan, we have stacked the deck.  We are anticipating and planning our change so that it will most likely be growth.  We work together well as a team.  Management routinely seeks feedback and suggestions from all levels of staff.  Mr. Dillihay, our Administrator, gave wonderful leadership in recent participatory budget planning.  Dr. Wood, our Director of Professional Services, was admirable in the way she organized the interview process to identify a new director—so much involvement by so many staff from so many levels.  Our Performance Improvement Program has a total commitment to seeking feedback and grassroots input—witness the August staff survey, the problem-solving task forces, the patient exit questionnaires, etc.  The very gracious Joan Underwood, our Director of Performance Improvement, consistently exhibits the perfect constructive mindset for that position.   It looks to me that our leadership is quite good, responsive.  They are doing their part.  What then is our responsibility as toilers in this vineyard when it comes to change?  --Responsibly give the best input we can.  Be flexible.  Have goodwill about the change process as we experience and adjust to it, despite any sense of disequilibrium.  Please don’t forget the goodwill.  We need to enjoy our jobs.  Let’s continue the good teamwork by taking care of each other.