Leadership

Today I watched the Minnesota Vikings solidly beat the Dallas Cowboys.  Of course as a current Midwesterner, I was thrilled.  As a mental health professional, I was intrigued as I thought about what makes these teams work.  As I have started talking to folks about this blog and about my concerns, the same things begin to pop up over and over again.  One of the biggest of those things is leadership.

An excellent football team is lead by an excellent management team.  We know that these teams only get wins when they have good leaders and when the teams work in concert with each other.  And yet, the opposite happens in our county buildings, community mental health programs and hospitals every day.  Those who know nothing about leadership are leading our staff teams, and our team members are fighting each other as a result.  I enjoy a good football game as much as the next person, but I begin to wonder what is more important to the fiber of our communities:  excellent football teams or excellent healthcare?  I would hope that most of us would say that excellent healthcare is a tad bit more important to the survival of our citizens.  And yet, we appear to be ignoring the basic good sense that every football team knows by heart.  Without good leaders, we can’t provide good services.

As one of the blog’s follower’s noted, “I too found that it was not the families who caused me the most grief, but the upper management trying to survive; paying more attention to the bottom line than workers and our families who desperately needed help”.  When did we begin to believe that these must be separate?  When did our leaders forget that quality services are the bottom line?  I believe we forgot these things when our agencies began to be lead by those who know nothing about how to lead.

When I speak about our leaders, I speak about them all.  This is about our President, Governors, legislators, Mayors, our County Administrators, Executive Directors, CFO's, and middle managers.  We regulate how one gets licenced as a professional in almost every field, but we fail to require licensure for leaders.  Instead we assume that one would not rise to a leadership position unless they were good leaders.  Wrong.

I can guarantee that it is not a requirement in my State for leaders to have any knowledge in the skill set of leadership before starting a mental health business or being promoted to a supervisory position in such a business.  This seems strange to me.  Counselors are required to attend two years of graduate school, one year of internship and, in Wisconsin, must serve under supervision for two years and then take a test before being licensed to practice.  In addition, they are required to continue their education each year in order to maintain their license.  Although I am not a nurse, I know that their standards are very similar.  And yet, any Tom, Dick or Harry can decide to start their own program and we just trust that if they aren’t a good leader, they won’t survive.

But they do.  It is about as hard to fire someone in the county, as it is to win the lottery.  Bad leaders stay forever in our healthcare system.  A person with a dream starts a non-profit or For-profit mental health agency and the community needs something so badly that the company thrives for years to come, regardless of poor quality services.  For example, an agency in Wisconsin that I shall not here name killed a child three years ago in a physical restraint.  Policy was changed, people were told to start avoiding physical holds, laws were changed and yet only two months ago that same agency had a program that was engaged in 7 physical control holds in one month with only 12 children in the program.  Still, our communities are sending children to this organization because they have nowhere else to turn.  Our most vulnerable populations are in the hands of leaders who may or may not have a clue how to lead.  And our natural born leaders are lost in the shuffle and often pushed out because of their creativity and strong commitment to what is right—not what is convenient.

And for those of you closely watching our tax dollars being whisked away into our healthcare system, I will remind you that your tax dollars are funding long term stays in these programs that are, in most cases, ineffective.  What happens then?  The Medicaid system and other third party payers begin to cut back on what they fund.  It becomes harder to get funding, and we lose more and more of our quality programming.

So, what the heck do we do?  I will venture a suggestion—to anyone who may be listening.  We must only allow individuals to start and lead our publicly funded programs if they have obtained a leadership certificate.  You may wonder, what is a leadership certificate?  It doesn’t exist yet, to my knowledge, but the resources are out there to make it happen.

Leadership consultants are widely used in larger companies to the benefit of the leadership, the staff, and the consumers.  Why, then, are they not used in this sphere?  Because companies who are looking at their bottom line can’t find it in the budget.   I believe that our healthcare agencies should only be able to hire individuals for leadership positions who have completed approved leadership training.  They must not be able to start companies without this certification either.  I also believe that they, just as counselors and nurses do, must be able to prove that they can lead before being put in those positions.  Counselors and nurses have residencies—so should our leaders.    They should be given hypothetical situations and be asked to identify ways to lead in those situations.  They should have demonstrated leadership skills before they hold the lives of our healers and our family members in their hands. Finally, they should have a budget line for leadership training every year for every leader and a leadership consultant on speed dial.

You may ask, where will we get the money for all of this?  I believe that if these programs are primarily state funded, the state should find a way to help agencies with this cost.  “But that would mean MORE tax dollars?”  I’m not sure it would.  I would challenge our state governments to begin to think proactively instead of reactively.  A program with poor leadership will spend more tax dollars to do a poorer job than one with excellent leadership.  Therefore, our tax dollars are wasted on sub-par services because of poor leadership.  Is it possible that state governments could save money if they began investing in leadership training and consulting?  Yes.  It is not only possible, I believe it is probable. 

Of course, I can’t change all of this now on my own.  But if you’re reading and thinking about this you can make your own personal commitment.  Say this one time “I will not take a supervisory position without leadership training” and “I will not start an agency where I lead staff members without a leadership consultant tucked nicely into my budget line”.  In the meantime, I’ll hope to keep getting supporters and maybe together we can convince these companies to change their ways.  And who knows, maybe we’ll even change legislation.