Corporate management and clinical autonomy: The ethical dilemma in mental health

Abstract

Funding constraints and management practices are increasing pressure on clinicalautonomy within Australian mental health services. The introduction of total qualitymanagement, output-based funding and changes to public mental health policy havepromoted business-like efficiency and increased control of resources. It is argued thatsuch moves significantly circumscribe the discretionary authority that mental healthprofessionals have previously enjoyed. This paper attempts to highlight the ethical andmoral tension inherent within a corporate management approach, and calls formental health services to acknowledge the value of intellectual capital, creativity andinnovation.