Dysfunctions in public psychiatric bureaucracies

Am J Psychiatry. 1988 Mar;145(3):331-4. doi: 10.1176/ajp.145.3.331.


The author describes common dysfunctions in public psychiatric organizations according to the model of bureaucracy articulated by Max Weber. Dysfunctions are divided into the categories of goal displacement, outside interference, unclear authority structure and hierarchy, and informal relations in the work place. The author emphasizes the bureaucratic nature of public psychiatry and the need for mental health professionals to understand the dysfunctions of the organizations in which they work, including the impact of these dysfunctions on the provision of quality care.

MeSH terms

  • Cost-Benefit Analysis
  • Decision Making, Organizational
  • Delivery of Health Care / organization & administration*
  • Delivery of Health Care / standards
  • Humans
  • Mental Health Services / organization & administration
  • Mental Health Services / standards
  • Models, Theoretical
  • Organizational Objectives
  • Personnel Management
  • Psychiatry* / economics
  • Psychiatry* / standards
  • Public Policy
  • Quality of Health Care
  • United States