| Abstract: | A national survey using a mailed questionnaire was undertaken to clarify issues of mental health district governance. CMHC, state hospital and district management and governance staff from 49 identified districts classified their districts on 20 types of decision authority and 14 measures of district effectiveness. Each respondent type thought their districts: (1) dealt with state money issues, seeking regional money, and coordinating/changing programs and services, and (2) effectively enhanced planning capabilities. Service providers did not find planning capabilities to be systematically related to specific decision authorities. CMHC management perceived less district control than district officials and, with state hospital management, perceived less effectiveness. District and CMHC officials see a direct relationship between district control and effectiveness. In a subsample of 11 districts each described by multiple respondent types, no item of authority or effectiveness was rated universally positive by all groups. District management subjectivity and legislative implications are discussed. |
