CONVERTING THE NATIVES: Planning as a Missionary Process

by Joseph A. Walsh

Through the metaphor o f a missionary journey, a five year planning program for a county mental health agency is discussed. Special attention is given to the involvement o f staff in the planning process.

I oO..* . . . . ° o

Anchoring in the Harbor

In agencies that are run by reacting to the problem-of-the-moment rather than by planning ahead, the idea of five year plan may sound like heresy. Nonetheless, external pressures such as the demands of state funding agencies occasionally force even the most complacent among us to get religion and start planning.

Joseph Walsh is Director, Mental Health Services, DuPage County Health Department in Addison, Illinois.

The rationale for planning is clear and well reviewed in the management literature. Schaffer (1967) indicates that the essential purpose of planning should be to enable managers to act today with increasing skill, speed, and confidence in order to produce the desired results tomorrow. Two key principles emerge in the developmental approach to planning: (1) planning should be focused on goals that are urgent but achievable so that success can be realized in a relatively short pe- riod of time; and (2) initial projects should be designed in ways that help managers develop

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new competence and confidence in using planning tools.

Others say that we can best understand planning by examining the basic stages in making a specific decision: diagnosing the problem, finding good alternative solutions, projecting the results of each alternative, and selecting the one course of action to be followed (Newman et al 1967). Mary Richmond (1917) has probably captured the social welfare nature of planning in her commitment to assessment, diagnosis, and treatment as the problem solving process.

In the social welfare field, Kruse (1970)

We can best unders tand planning by

examining the basic stages in making a decision.

defines planning as determining what is to be done and how to do it. Commitment by an agency to internal research and development is important in making these decisions. There must also be an awareness of the important external forces that affect change, i.e., knowledge development, relationships with other public and voluntary agencies, and changing community conditions and needs.

Developing a five year plan for the DuPage County mental health agency had the dual purpose of complying with the required procedures for outside funding and blending agency goals and objectives with community needs into a long range work program. Clearly, clients would profit from this since an agency commit ted to c o m m u n i t y service can maximize efficiency if it knows what service the community wants and has an action plan to deliver the goods.

There is no assurance, of course, that planning equals happiness! Kelly (1966) hypothesizes that even as community mental health services to an area become more efficient and productive, the area may become less comfortable. Change produces the possibility of new and unsettling relationships.

It is wise, accordingly, to distinguish political objectives from program objectives prior to program planning.

Convincing the staff to join in planning when there is no assurance that plans can be implemented or even approved is no small task. This can be achieved in part by a proselytizing missionary approach - giving beads, holy pictures and even fire-water to the natives (missionaries must sometimes sacrifice principles to win souls!) Special hearings on pet concerns and allowing all supervisors to participate in the planning effort so that their turf is not violated is an important early step. Being able to set foo t on the turf is the first objective o f a missionary after anchoring in the harbor.

Clearing the Jungle

As is the lot o f most missionaries, getting from the ship in the harbor to the nearest village requires chopping through a multitude o f overgrown brush and bramble. In this effort, the jungle was found in deciding how to plan, i.e., should there be one plan for the division of mental health; a series of small plans prepared by service units; development of plans along budget lines or commonality of services; should goals be general or specific. Most participants favored specific goals. Yet if these goals were couched in behavioral terms many staff members would resist since they disliked behaviorist practice. Compromise at each bend in the road appears to be a major trade-tool o f any missionary-planner.

Business p lanners encoun te r similar r e s i s t a n c e s . W h e n a d a p t a t i o n to environmental forces becomes necessary, planners will either attempt to modify the organizational objective or they may try to push through a particular objective by modifying the forces standing in the way (Albers 1969). Our agency decided to plan along budgetary lines and forego the convenience of grouping all similar activities (e.g. consultation services from all units) into a

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single plan. In this way some common terms and sense of direction were achieved. We also agreed to begin each planning narrative with a statement describing the current operation of that area. In this way one of the major elements in a planning effort - portraying the current state of affairs was acknowledged and achieved (McFarland 1970; Albers 1969).

I t was sobering to discover that accurate

planning beyond one year is difficult at

best. i

Agreeing on the actual data to be included in each plan was the next task. We decided to begin with a statement of purpose for each program discussed and then to present the current status, the three year and five year plans each with the following elements: target popu~tion; goals; activities to achieve these goals; costs and staff time; and evaluation.

The specific programs around which plans were formed included: general services (including direct treatment, community c o n s u l t a t i o n and d e v e l o p m e n t , case consultation and staff training); alcohol treatment; community day treatment; and half-way house. While overlap existed between the types of services offered under these different headings, the State funds programs according to most of these major headings. Astute missionaries always keep track o f the road to the golden mountain/

Each program was then assigned to at least one of the supervisory (management) level staff to prepare an initial draft plan. Participation of the entire staff in the planning process was yet to come. We felt it would be easier for the staff to react to a proposal than to

have to generate one entirely on its own. Full staff participation in the planning process is desirable for several reasons. First, all persons should have some say in the work they perform. This is particularily true of professionals and other experienced people who can make a substantial contribution to the planning activities. Further, people in an organization are invested in its future and this investment is enhanced when they help s t r u c t u r e t h a t f u t u r e . F ina l l y , s t a f f participation in planning helps build the necessary skills for future planning efforts.

Building the Church

I f the missionaries leave nothing else behind, they at least like to know some symbolic monument exists to show they have given their best to convert the natives. It is also nice if this symbol is not a missionary scalp/ It was a sobering but swift discovery that accurate planning beyond one year is difficult at best and long range plans are very apt to be changed before completion. Nonetheless, written plans serve a definite purpose in setting up an orderly approach to the problems of long-range growth (Conference Board 1952).

The problems of building a church (or any other planned structure) are really found in the insidiously difficult areas of administrative process. How does one separate general purposes from goals? Should goals be philosophical (mental health services are here to improve the well-being of people) or concrete (to reduce f rom 100 to 75 the number of psychiatric hospitalizations per year from the county?) Which activity comes first: developing relationships with other agencies to

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smooth inter-agency referrals or developing staff diagnostic skills to differentiate a psychiatric responsibility from a social welfare responsibility? How useful are evaluation criteria? Does the length of time someone is in treatment say anything at all about the value of

There is no participant who can avoid rethinking long held beliefs.

treatment for that person's problems? Does the number of people directly served by the center mean anything positive or is it preferable to consult other community care-givers so that problems are handled at that level and need not be referred to the center? Can qualitative evaluations of service based on the responses of randomly chosen former clients really stand the scrutiny necessary for valid research on the effectiveness of our services?

If one adds to this the complexity of dividing a budget among programs and predicting how those programs will look in a few years, even more headaches arise. Everything then becomes an estimate and all calculations are based on those estimates. How much population increase will there be in the county

Dispersing the planning responsibility

among staff has obvious advantages but it

may also create friction. I I

in three years? In five years? What is a reasonable estimate of inflation over the years so that we can predict the costs of services over time? Should the staff grow in some way proportionate to the growth of the county population? No matter the arguments mustered for increasing staff and services, does

the tight budget situation allow for any practical increases? Is there any virtue in increasing our dependence on state funding if this also requires that we bow to state- determined priorities and regulations rather than determining these locally?

We have not thoroughly answered any of these questions. They are listed simply to illustrate how bartering and value clarification are so much a part of planning. There is no participant who can avoid re-thinking many long-held beliefs when faced with the reality that the growth of one program over time may literally eradicate another, even one that currently occupies the major part of staff time and resources. This reality again underscores the importance of having all staff members involved in the planning process - to appreciate its complexities and to protect their interests as well as those of their clients. Without this system of balancing, the plan would be as craftily constructed as a cathedral in a jungle but similarly lacking in worshippers.

Bapt ism - The Immers ion Phenomenon

Speaking of baptism implies a victory of sorts. It is probably more accurate to suggest that before baptizing, the missionary must survive some trials byfire. It is safe to say many plans would be better used as fuel for that fire than anything else~ In the process of planning staff develops new ideas about what they can do along with action priorities which link the plans together. Getting to this point generally requires that the group reach some consensus through some of the procedures outlined above. This overall consensus automatically dilutes the influence of individual biases.

While dispersing the planning responsibility

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among staff has obvious advantages, it also creates many moving parts that may become areas of friction. Friction becomes evident through differing perceptions of objectives, communication gaps, political and other short-run pressures, and the injection of personal preferences and aspirations in planning meetings (Newman et al 1967). The problems of the administrator in helping to resolve conflicts around values that are so much a part of planning is akin to that of the missionary: how do you dilute the influence of the witch doctor before the witch doctor dilutes you! Dwight Waldo (1955) suggests that as an area of study administration is a science; as an area of practice it is an art. The

stroke of an artist whose own values are clear is generally needed to guide a staff through the turmoil of planning. Once the initial plan is completed, annual revisions can be done somewhat more easily. The first steps, however, demand sensitive, patient, and committed top leadership.

Given all the virtues of planning in the name of religion, a final question remains: Is the new religion to be found in planning or in action? The pragmatist cannot help but wish for an ecumenism that would meld the diverse religions into a single one of planned-action. Without such a commitment, the missionaries would be better off staying at home.

R E F E R E N C E S

Albers, Henry. Principles of Organ&ation and Management. New York: John Wiley and Sons, 1969.

Industry Plans for the Future. The Conference Board Business Record, 9 (8): 324, August 1952.

Kelly, James. Ecological constraints on mental health services. American Psychologist, 21: 535- 39, 1966.

Kruse, Arthur H. The management function in planning human care systems. In: Schatz, Henry ed. Social Work Administration: A Resource Book. New York: Council on Social Work Education, 1970.

McFarland, E.E. Principles of Management: An Analysis of Managerial Function. New York: McGraw-Hill Book Company, 1968.

Newman, W.H., Summer, C.E. and Warren, E.K. The Process of Mdnagement. Englewood Cliffs, N.J.: Prentice-Hall, 1967.

Richmond, Mary. Social Diagnosis. New York: Russell Sage Foundation, 1917.

Schaffer, R.H. Putting action into planning. Harvard Business Review, 45(6): 158-64, Nov.- Dec., 1967.

Waldo, Dwight. The Study of Administration. Garden City, N.Y.: Doubleday, 1955.

ADMINISTRATION IN MENTAL HEALTH

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