TDMHMRTexas Department of Mental Health and Mental Retardation
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The decision to assign someone to a residential program is a clinical decision made by local mental health professionals (TDMHMR, 1996).
By developing consistent systems of care, reporting, and managing, the hope is that more authority as well as accountability can be delegated to the centers and less ad hoc management will be required of TDMHMR. The HB 2377 pilots in Texas are a first step in this direction.
TDMHMR is a configuration of 13 state schools providing services to people with mental retardation, 8 state psychiatric hospitals, 35 community mental health and mental retardation centers, 5 state community centers, 1 residential treatment center for emotionally disturbed youth, and a central office which is headquarters for the system.
When we stepped back to reflect on the effort required by TDMHMR to achieve our vision, we recognized the necessity of the empowerment hierarchy described above.
The immediate goal was to have all senior managers possess the same understanding of TDMHMR's mission.
In TDMHMR, if you asked two years ago who owns the mission and vision, the answer would be the commissioner (agency CEO).
The TDMHMR vision looks at the agency from a ten-year perspective.
I conclude this case study with a brief overview of the lessons that TDMHMR learned as we pursued the transformation of our organizational culture.