1. Leadership Toward Organizational Change A Core Strategy ©

2. The New York State Office of Mental Health wishes to acknowledge the contributions of the National Association of State Mental Health Program Directors (NASMHPD) and its Office of Technical Assistance formerly (NTAC) for many of the following slides.

3. The Role of Leadership Leadership can be considered the most important and fundamental resource in any project seeking culture change Leadership is the most important component in successful reduction projects. (Anthony, 2004 )

4. The Power of Leadership Used ineffectively, or not at all, it becomes the major barrier in any effective organizational change

5. “Go down there and make them laugh.”

6. Five Practices of Exemplary Leadership –Model the way –Inspire a shared vision –Challenge the process –Enable others to act –Encourage the heart (Kouzes, J & Posner B. 2002)

7. Model the way Leaders must model the behavior expected of staff People follow the person first, then the plan Leaders need to not only have strong beliefs/values; they must also openly share those values with staff Words and deeds must be consistent

8. Inspire a Shared Vision Leaders cannot command commitment, only inspire it People will follow when they accept the vision as their own Leaders forge a purpose of unity by showing how the dream is for the common good

9. Inspire Shared Vision “If you want to build a ship, don’t drum up the men to gather up the wood, divide the work and give orders. Instead, teach them to yearn for the vast and endless sea.” - Antoine de Saint-Exupéry

10. Inspire a Shared Vision Three essentials –Listen deeply to others –Discover & appeal to a common purpose –Give life to a vision by communicating expressively, so that people can see themselves in it (Kouzes, J & Posner B. 2002)

11. Challenge the Process Leaders must get clarity and consensus on the values that underlie a different culture of care From one that is rule based, institutional, impersonal, and at times coercive To one that is based on person centered care, that is respectful, never shame based, and that strives to avoid homogenous approaches and generalities (Anthony, 2004; Huckshorn, 2004)

12. Challenge the Process Processes are designed to keep the status quo Search for opportunities to change and improve Generate small wins Learn from mistakes

13. Challenge the Process Policy, procedures, treatment activities, language, and rules need to be held up to this “values threshold” and measured against it. Review your treatment values and objectively critique whether current practices are working

14. Crosswalk Values with Practices Value: Person Centered Care Practice: “Everyone goes to bed at 10:30pm and lights out” Change: A range of bedtimes that identifies and adapts to individual’s difficulty with night-time, bedrooms, and different bio-rhythms

15. When this happens, practices change… Agencies become “informed” about becoming congruent (what we say is what we do) (Anthony, 2004; Huckshorn, 2004) Challenge the Process

16. We are prisoners of our organizational vocabulary (Zuboff, S. 1988)

17. The Importance of Language The routine, consistent use of “one word” to describe groups of diverse individuals is dehumanizing, demeaning, ignores individuality, encourages a herd mentality and institutionalizes

18. The Importance of Language Needy Attention seeking Manipulative Patient Has unmet needs Needs attention Resourceful Person

19. Person First Language Chosen language to use for recovery oriented systems of care A major change/shift from usual language Is culturally competent, respectful and person centered Based on linguistic philosophy, i.e., “How we speak about something is indicative of how we value and treat it” (IAPSRS, 2003)

20. Person First Language Using terms such as “persons with a mental illness” describes what a person HAS……….., not what a person IS Reminds us those we serve are: –Mothers and Fathers –Sisters and Brothers –Sons and Daughters –Employees and Employers –Friends and Neighbors –Students and Teachers

21. Enable others to act Empower staff to negotiate and empower customers; provide choices that are win-win (Anthony, 2004; Huckshorn, 2004)

22. Enable others to act Foster collaboration & trust Empower staff to break rules Provide staff with tools/training Help staff to exceed their own expectations

23. Enable others to act Avoidance of trauma and re-traumatization becomes valued over rules, property damage and negotiation time Staff become change agents, without fear of repercussions A culture of CQI is embedded; one that understands that mistakes will be made but learning will occur (Anthony, 2004; Huckshorn, 2004)

24. Encourage the Heart Leaders build their organization around exemplary performers Best practices are recognized and rewarded Efforts are made to encourage reports of near misses and what worked Knowledge is transferred and sustained (Anthony, 2004; Huckshorn, 2004)

25. Encourage the heart Create a culture of celebration Carries staff through rough times Value exemplary performance aligned with values Individual or group