Steve Onyett and Helen Lester
Managing in mental health is a complex task, carried out at times in a climate of uncertainty. Mental health managers are moving from an environment focused on secondary care services with limited partnership working towards a future focused on integrated working practices across multiple care sectors. What is also increasingly clear from both a policy and practice perspective is that the task of working to achieve better outcomes for service users goes beyond 'care' to include a range of activities encompassing mental health promotion, social inclusion and the promotion of self-management. It also increasingly requires managers to have in mind more than just service structures, as we might traditionally understand them, and include the wider range of social supports available to all citizens.
This chapter will outline some of the key challenges that currently face those managing mental health services, focus on specific issues in managing new mental health teams, describe strategies for engaging key stakeholders across the wider system and suggest ways to address some of these challenges through effective leadership and management.
The World Health Organisation (WHO) describes mental health as 'a state of well-being in which the individual realises his or her abilities, can cope with the normal stresses of life, can work productively and fruitfully, and is able to make a contribution to his or her community' (WHO 2001). This definition introduces the theme of building on strengths and stresses the role of the individual as a contributor to the life of their local communities. It also underlines the aspiration that each individual should be socially included and able to participate effectively in community life. Mental 'ill health' includes mental health problems and strain, impaired