Stein, Eric S.
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Publication The Organizational Context of Mental Health(2010-06-30) Stein, Eric S.Researchers have argued that organizational context factors in mental health services should be a focus of research and intervention. This research examines client and provider perceptions of organizational climate and client perceptions of services at community mental health organizations (CMHOs). Existing quantitative and qualitative data were gathered by the Center for Psychotherapy Research (CPR) along with primary qualitative data collected by this researcher from four Philadelphia CMHO outpatient clinics. CPR administered the Organizational Readiness for Change Scale (ORC) to 17 providers and administrators and conducted 13 semi-structured interviews at these CMHOs. Of the 13, only provider interviews (n=10) were included. Subsequently, 20 semi-structured client interviews were conducted. Grounded theory provided analysis of descriptive data. Interviews revealed providers felt negatively toward conditions of employment and everyday aspects of work, and positively toward collegiality, autonomy, flexibility, and client interactions. Differences between fee-for-service and full-time providers were notable. Clients indicated generally positive impressions of the agency and mixed ones regarding other aspects of services. Staff turnover was a negative factor overall. At CMHOs with higher scores on the ORC, providers and clients described positive perceptions of organizational climate; however, organizational climate was poor across nearly all subscales. Findings are interpreted through the concept of parallel process, systems theory, and feminist theory to illustrate replications of systemic problems at CMHOs. They reveal tensions between providers and administrators contrasted with rich relationships among providers and between providers and clients.