Life at the State summit: views and experiences of 18 psychiatric leaders.

In 1981 the American Psychiatric Association appointed an ad hoc committee to investigate the decline of psychiatrist leadership of public mental health programs. As part of the committee's research, the 18 psychiatrists who were then state commissioners or directors of mental health were surveyed on how they got their jobs and on their backgrounds, present responsibilities, support systems, and future plans. The results of the survey are discussed and presented in tabular format. The psychiatrists surveyed recommended that future commissioners have backgrounds similar to their own, which consisted of a great deal of previous on-the-job experience in mental health administration but little formal training or education in administration; none of the commissioners had obtained APA certification in administrative psychiatry. The commissioners felt they received the most support in their work from their subordinates; among the major groups listed as providing support, APA ranked lowest. The authors discuss the implications of the survey findings as well as issues surrounding the administration of public mental health programs by psychiatrists.