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Leadership Competencies: A Global Perspective ACHMA, June 16, 2009


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Title: Leadership Competencies: A Global Perspective ACHMA, June 16, 2009

Leadership Competencies A Global
PerspectiveACHMA, June 16, 2009
  • Richard H. Beinecke DPA, ACSW
  • Departments of Public Management and Health
  • Suffolk University, Boston

Mental Health Is a Global Problem
  • 500 million people with some form of a mental
  • Mental illness will increase from 12 to15 of
    world population by 2020
  • Psychiatric and neurological conditions- 28 of
    years lived with disability
  • 4 of top 10 leading causes of disability (DALYs
    Disability-adjusted life years) are unipolar
    depression (1), alcohol use disorders (3),
    schizophrenia (5), bipolar disorders (7)

The Urgent Need to Train and Pass on Knowledge to
the Next Generation of Leaders
  • 40 of US workforce over age 50
  • 31 of Federal employees now eligible for
  • Up to 40 of senior public managers will retire
    within the next five years
  • Line and mid-level workers including clinicians
    are not trained in management and leadership
  • Funding for leadership training is very limited

The Project
  • Collaboration with the International Initiative
    for Mental Health Leadership (IIMHL) (Australia,
    Canada, Ireland, Northern Ireland, New Zealand,
    Scotland, UK, US)
  • Review of leadership literature
  • Identification and descriptions of mental health,
    substance use, health, public administration, and
    some business leadership training programs in the
  • Analysis of leadership program competencies and
    development of new competency model

  • Virtual agency that seeks to improve mental
    health services by supporting innovative
    leadership processes.
  • Annual leadership exchange and conference
    (2009-Australia/New Zealand 2010-Ireland)
  • Membership of 1750, free, anyone can join
  • Web site (www.iimhl.com) has reports and much
    other info.
  • The Brisbane Group (sub-group of IIMHL) focuses
    on leadership training.
  • IIMHL and Brisbane Social Networking site

  • Extensive literature review and internet search
  • Networking and report review with over 35 mental
    health leaders in the eight countries
  • Most extensive listing of these programs and
    competencies ever done
  • Content analysis and comparison of 25 mental
    health leadership training programs where good
    information was available
  • Report at www.iimhl.com

What is leadership?
  • Complex, difficult to capture, open to numerous
    definitions and interpretations... An intangible
    illusive notion, no more stable than quicksand.
    (Middlehurst, 1993)
  • ...the process of persuasion or example by which
    an individual (or leadership team) induces a
    group to pursue objectives held by the leader or
    shared by the leader and his or her followers.
    (Gardner, 1990)

Leadership is
  • Leading and managing complex adaptive systems
    that operate as a series of networks with
    multiple stakeholder interests
  • A dynamic process that emphasizes the need for
    quality, flexibility, adaptability, speed, and
  • Critical needs shared values, responsible and
    empowered members, effective communication and
    information sharing

Leadership Capabilities for Policy Change (Crosby
and Bryson, 2005)
  • Leadership in context
  • Personal leadership
  • Team leadership
  • Organizational leadership
  • Visionary leadership
  • Political leadership
  • Ethical leadership
  • Policy entrepreneurship (coordinating leadership

Three Types of Problems (Heifitz, 1994)
  • Type 1 Technical Problems Problem is definable
    and can be solved with technical knowledge and
  • Type 2 Problem is clear, but the solution is
  • Type 3 Adaptive Problems No obvious definition
    of the problem or solution.
  • Type 3 are complex, multi-framed, cross-boundary,
    and hard to solve.

Wicked Problems
  • Wicked Problems when organizations have to face
    constant change or unprecedented challenges..It
    is the social complexity of wicked problems as
    much as their technical difficulties that make
    them tough to manage. (Camillus, 2008)
  • Working in a swamp, compared to hard ground.
    (Parks, 2005)
  • No definite formulation of the problem. Each
    problem is essentially unique, often has not been
    faced before, is entwined with other problems.
    The search for solutions never stops. Solutions
    are not good or bad but are judgment calls and
    are often difficult to measure.

Transactional and Transformative Leadership
(Burns, 1978 and others)
  • Transactional Manage and maintain the current
    system efficiency, planning, and goal setting
  • Transformative Visioning, proactive change,
    entrepreneurship, teamwork, relationships,
    creativity, communication, engagement and
  • Leader as technician or conductor (Cohen and
    Bradford, 1991)
  • Both transactional and transformative leadership
    are needed catalytic leadership (Luke, 1998),
    adaptive work (Heifitz, 1995), change masters
    (Kanter, 1985)

Is Leadership the Same As Management?
  • Are they separate functions or is management an
    essential function of leadership?

Kotter, 1990 Management Leadership
Creating an agenda Planning and Budgeting Establishing Direction
Developing a human network for achieving the agenda Organizing and Staffing Aligning People
Execution Controlling and Problem Solving Motivating and Inspiring
Outcomes Produces a degree of predictability and order and has the potential of consistently producing key results expected by stakeholders Produces change, often to a dramatic degree, and has the potential of producing extremely useful change
Problems and Competencies
  • Technical (Type 1) problems are more management
    and require more transactional skills.
  • Type 2 Adaptive (Type 3) problems are higher
    level leadership challenges and require more use
    of transformative competencies.

Can Leadership Be Learned?
  • Many dismiss the subject (development of
    leaders) with the confident assertion that
    leaders are born not made. Nonsense. Most of
    what leaders have that enables them to lead is
    learned. Leadership is not a mysterious activity.
    It is possible to describe the tasks that leaders
    perform. (Gardner, 1990)
  • Leadership can be developed...leaders can
    improve their own effectiveness across a wide
    range of situations, from those requiring change
    and innovation to those with diverse populations
    and different cultures to those in crisis.
    (Conger and Riggio, 2007)

What Are Leadership Competencies?
  • The complete competency set or model for an
    individual role identifies all the knowledge,
    skills, experiences, and attributes a person
    should display in their behaviour when they are
    doing the job well. (Mackay, 1997)
  • The combination of attributes, skills, and
    knowledge that contribute to a persons ability
    to perform a job to an appropriate standard.
    Includes personal attributes, knowledge, and
    skills (Health Research Council of New Zealand,
    July 2005)

Competency Models Developing Leadership
Performance Improvement in Health Care (New
Leadership Competency Architecture (New Zealand)
NHS Leadership Qualities Framework (UK)
SAMHSA Transformation Leadership Competencies
Wheel (US)
(No Transcript)
The Leadership and Management Skill Set (Beinecke
and Spencer, 2007)
  • Based on review of mental health, substance use,
    public administration, and business leadership
    literature and programs from eight countries
  • Full listing of competencies from theory and
  • Identification of specific competencies found in
    reviewed leadership training programs (numbers on
  • Leadership self-assessment tool

The Model
Emotional intelligence (self-awareness, personal reflection, personal style, conscious use of self) 11
Leaders values and beliefs (honesty/integrity, respect for others, courage, humility/generosity/empathy/caring, showing genuine concern) 9
Ethics, morality, respect for human rights 8
Adaptability, creativity, flexibility, situational awareness 5
Intelligence, knowledge, competence 5
Being responsible 5
Confidence 4
Reflective thinking and practicing, challenging thinking 4
Critical thinking 4
Being decisive, taking responsibility, determination 3
Customer orientation 3
Self-care, work-life balance, stress management 3
Personal development plan 3
Being accessible, collegial, open-minded 2
Passion 2
Conceptual thinking 2
Perseverance 2
Recovery orientation 2
Professionalism 2
Listening 2
Communicating (written, verbal including listening, presenting) 16
Teamwork and small group skills, collaboration, meeting management 15
Coaching, mentoring, development, personal growth, enabling and building leadership skills in others 15
Negotiating, resolving conflict, facilitating, agreement building, mediation 12
Working with people of other cultures, promoting diversity 9
Motivating, inspiring, energizing, empowering others 8
Supporting recovery, working with stakeholders, inclusion and empowerment of stakeholders including consumers, families, and providers 7
Managing others, holding others accountable, disciplining and supervision 6
Networking 5
Building trust 5
Trusting others, delegating and sharing tasks 4
Ability to lead teams 2
Affirming and regenerating values 1
Quality management (CQI), accountability, measuring, monitoring and reporting, evaluation, outcomes, performance assessment, data use, evidence-based practices 15
Human resource management, staffing, recruiting 12
Finance, budgeting, and funding, health economics 11
Organizational theory and design 9
Information systems and technology, software and data base management, applying technology 9
Project planning and management 8
Planning and priority setting, agenda setting, decision making 6
Problem solving and decision making, analytical models and skills, task management 6
Business acumen business plan development, business-to-business models 6
Marketing 6
Service and systems design and improvement, operations management, managing service improvements and patient care 5
Keeping the system functioning, maintaining the institution, building the organization 4
Contracting management, performance contracting 3
Legal 3
Working with the media 3
Process improvement 2
Risk management 2
Resource management 2
Governance 1
Research methods and data collection 1
Developing partnerships 1
Visioning and setting shared strategic vision and mission, strategic thinking and planning, innovative strategic thinking, broad scanning, anticipating trends, future thinking and positioning, systems thinking 20
Managing of complex organizational change, renewing, leading innovation, being a catalyst 14
Goal setting, setting direction, alignment, driving for results, leading through influence 10
Mobilizing support, influencing, inspiring and motivating others, creating energizing environments, being a conductor 7
Working across complex inter-organizational systems, external relationships, working collaboratively 7
Political astuteness and awareness, skills, and management 5
Creating and empowering the organizational culture 4
Role modeling, leading by example 4
Policy development 3
Community development, capacity building 3
Support of lifelong and continuous learning 2
Local, state, and Federal government and policies political knowledge 5
Recovery principles and experience and, in health, patient centered care 3
The policy formation process/policy development 2
History, organization, funding, policies, and legislation of the mental health, substance use, and health systems in ones country and globally 2
Discrimination, stigma, racism, social inclusion, users rights 2
Clinical and service areas 1
Issues in medical ethics 1
Community services and resources 0
Characteristics of Effective Leaders in
Behavioral Health
  • While core competencies are similar for all
    leaders, behavioral health leaders need to be
    particularly skilled in
  • Personal and interpersonal skills including
    verbal communication.
  • Need better business acumen (transactional
  • Given behavioral healths stigma and low position
    on the health priority, need creativity,
    evaluation, marketing, mobilizing support,

Changing Knowledge in 5-10 Years
  • Continued battle for recognition and resources,
    e.g. universal health care, any attention and
    services in developing countries transformation
  • CQI, evidence based practice implementation,
    outcomes measurement
  • Information technologies
  • Knowledge of medical and primary care as well as
  • Training of consumers as well as professionals

Developing Needed Knowledge
  • More comprehensive leadership and management
    training in behavioral health professional
    schools and association sponsored continuing
    education programs at all levels and for
    professionals, consumers, and families.
  • Web based directories of training programs
    including those in health, public administration,
    and business.
  • Case studies of behavioral health leadership
    development, and change in action lessons
  • What can ACMHA do?

Current Brisbane Group Projects
  • Article comparing three types of effective
    leadership training projects in three countries.
  • 2010 conference on global behavioral health
    leadership training.
  • Book of case studies of effective global mental
    health interventions and leadership competencies,
    strategies, and lessons learned from them.

References and Other IIMHL Related Readings
  • Annapolis Coalition (2007). An Action Plan for
    Behavioral Health Workforce Development A
    Framework for Discussion Executive Summary.
  • McDaid, D., Raja, S., Knapp, M. (2008). Barriers
    in the Mind Promoting an Economic Case for
    Mental Health in Low- and Middle-Income
    Countries. World Psychiatry 7, 79-86
  • Patel, V., Garrison, P., de Jesus Mari, J.,
    Minas, H., Prince, M., Saxena, S. (2008). The
    Lancets Series on Global Mental Health 1 Year
    on. The Lancet 372, 1354-1357
  • Sachs, JD (2008). Common Wealth Economics for a
    Crowded Planet. New York Penguin

References cont.
  • Sherer, R. (2002). Mental Health Care in
    Developing World. Psychiatric Times 19(1), 1-5
  • Beinecke, R.H., Daniels, A., Peters, J.,
    Pitts-Brown, S., Chehil, S., Van Zwanenberg Z.
    (2008). Attributes of a Successful Professional
    Exchange The 2007 International Initiative for
    Mental Health Leadership (IIMHL) Cincinnati
    Group. International Journal of Leadership in
    Public Services 4(1), 59-66
  • Beinecke, R.H. and Spencer, J. (2007).
    International Leadership Competencies and Issues.
    International Journal of Leadership in Public
    Services 3(3), 3-14

References continued
  • Sherer, R. (2002). Mental Health Care in
    Developing World. Psychiatric Times 19(1), 1-5
  • Beinecke, R.H., Daniels, A., Peters, J.,
    Pitts-Brown, S., Chehil, S., Van Zwanenberg Z.
    (2008). Attributes of a Successful Professional
    Exchange The 2007 International Initiative for
    Mental Health Leadership (IIMHL) Cincinnati
    Group. International Journal of Leadership in
    Public Services 4(1), 59-66
  • Beinecke, R.H. and Spencer, J. (2007).
    International Leadership Competencies and Issues.
    International Journal of Leadership in Public
    Services 3(3), 3-14

References continued
  • Beinecke, R.H. and Spencer, J. Examination of
    Mental Health Leadership Competencies across
    IIMHL Countries in Raffel, J.A., Leisink, P.,
    Middlebrooks, A.E., (Eds), Public Sector
    Leadership International Challenges and
    Perspectives, Cheltenham, UK Edward Elgar. To be
    published in May 2009.  
  • Beinecke, R.H. (Ed.). Special issue of The
    Innovation Journal The Public Sector Innovation
    Journal (www.innovation.cc) on Leadership
    including articles by Beinecke and

References continued
  • Beinecke, R.H., Daniels, A.S., Peters, J.,
    Silvestri, F. (2009). Introduction to the Special
    Issue The International Initiative for Mental
    Health Leadership A Model for Global Knowledge
    Exchange. International Journal of Mental Health
    38(1), 3-13. We edited this issue. 
  • Daniels, A.S., Adams, N., Carroll, C., Beinecke,
    R.H. (2009). A conceptual model for behavioral
    health and primary care integration emerging
    challenges and strategies for improving
    international mental health services.
    International Journal of Mental Health 38(1),

References continued
  • Shah, A.A. and Beinecke, R.H. (2009). Global
    mental health needs, services, barriers, and
    challenges. International Journal of Mental
    Health 38(1), 14-29
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