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 Kinicki

management
Scott-Ladd
Perry
Williams

a p r a c t i c a l i n t r o d u c t i o n 2e
Your stairway to success in management
Management: a practical introduction 2e is the exciting new
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ISBN 9781743769843
management
9 781743 769843
a practical introduction 2e
www.mhhe.com/au/kinicki2e

Kinicki_cover_Final TO PRINT_16/8 .indd 1 16/08/2017 9:06 AM

 CONTENTS vii

Chapter 2 Management theory 43

2.1 Evolving viewpoints: how we got 2.5 Systems viewpoint 58
to today’s management outlook 45 The systems viewpoint 59
Evidence-based management: facing hard facts, The four parts of a system 59
rejecting nonsense 46
Two overarching perspectives about management: 2.6 Contingency viewpoint 61
historical and modern 46 Three main contingencies 61
Five practical reasons for studying this chapter 46
2.7 Quality-management viewpoint 63
2.2 Classical viewpoint: scientific and Total quality control and total quality management 64
administrative management 47 Total quality management: creating an organisation
Scientific management: pioneered by Taylor dedicated to continuous improvement 64
and the Gilbreths 48 Quality management today 65
Administrative management: pioneered by Fayol
and Weber 50 2.8 The learning organisation in an era
The problem with the classical viewpoint: too of accelerated change 65
mechanistic 51 The learning organisation: handling knowledge
and modifying behaviour 66
2.3 Behavioural viewpoint: behaviourism, Characteristics of a learning organisation 66
human relations and behavioural science 52 How to build a learning organisation: three roles
Early behaviourism: pioneered by Munsterberg, managers play 67
Follett and Mayo 52 Gary Hamel: management ideas are not fixed,
The human relations movement: pioneered by they’re a process 67
Maslow and McGregor 54
The behavioural science approach 54 Key terms 69
Study notes 69
2.4 Quantitative viewpoints: management Management in action 70
science and operations management 55 Self-assessment 72
Management science: using mathematics to solve Legal/ethical challenge 73
management problems 57 Critical thinking 73
Operations management: being more effective 57 References 74

PART 2 The environment of management

Chapter 3 The manager’s changing work environment and ethical
responsibilities 79
3.1 The community of stakeholders inside Three domains of human action
Four approaches to deciding ethical dilemmas
94
94
the organisation 81
White-collar crime, SarbOx and ethical training 96
To whom should a company be responsible? 82
How organisations can promote ethics 98
Internal and external stakeholders 82
Internal stakeholders 82 3.4 The social responsibilities required
of you as a manager 99
3.2 The community of stakeholders Is social responsibility worthwhile? Opposing
outside the organisation 84
and supporting viewpoints 100
The task environment 85
Corporate social responsibility: the top
The general environment 89
of the pyramid 100
3.3 The ethical responsibilities required One type of social responsibility: sustainability,
‘going green’ 102
of you as a manager 93
Defining ethics and values 93

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 viii CONTENTS

Another type of social responsibility: philanthropy, Key terms 107

‘not dying rich’ 102 Study notes 107
How does being good pay off? 103 Management in action 108
Self-assessment 110
3.5 Corporate governance 104 Legal/ethical challenge 110
Agency theory 105 Further reading and questions for critical analysis 111
The need for independent directors 105 References 112
The need for trust 106

Chapter 4 Global management 117

4.1 Globalisation: the collapse of time Major trading blocs: NAFTA, EU, APEC, ASEAN
and Mercosur 141
and distance 119
Australia and New Zealand’s free trade agreements 143
The rise of the global village and e-commerce 120
Most favoured nation trading status 144
One big world market: the global economy 122
Cross-border business: the rise of megamergers and 4.5 The importance of understanding
minifirms worldwide 123 cultural differences 144
4.2 You and international management 125 The importance of national culture
Cultural dimensions: the GLOBE Project
145
145
Why learn about international management? 126
Other cultural variations: language, interpersonal
The successful international manager: geocentric,
space, communication, time orientation
not ethnocentric or polycentric 128
and religion 148
4.3 Why and how companies expand Managers on foreign assignments 150
internationally 129
Why companies expand internationally 129 Key terms 152
Study notes 152
How companies expand internationally 133
Management in action 154
The eclectic theory of multinational companies 136
Self-assessment 155
4.4 The world of free trade: regional Legal/ethical challenge
Further reading and questions for critical analysis
156
156
economic cooperation 137
References 157
Barriers to international trade 138
Organisations promoting international trade 140

PART 3 Planning
Chapter 5 Planning 163
5.1 Planning and uncertainty 165 Types of plans: standing plans and single-use
plans 174
Planning and strategic management 165
Why not plan? 165 5.3 Promoting goal setting: SMART goals
How planning helps you: four benefits 166 and management by objectives 175
How organisations respond to uncertainty 167 SMART goals 175
What is MBO? The four-step process for motivating
5.2 Fundamentals of planning 169 employees 176
Mission and vision statements 169 Cascading objectives: MBO from the top down 177
Three types of planning for three levels of The importance of deadlines 177
management: strategic, tactical and operational 171
Goals, action plans and operating plans 173 5.4 The planning–control cycle 179

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 CONTENTS ix

Key terms 182 Legal/ethical challenge 185

Study notes 182 Further reading and questions for critical analysis 186
Management in action 183 References 187
Self-assessment 184

Chapter 6 Strategic management 189

6.1 The dynamics of strategic planning 192 Porter’s four competitive strategies
Single-product strategy versus diversification
210
Strategy, strategic management and strategic
strategy 211
planning 192
The BCG matrix 212
Why strategic management and strategic planning
are important 193 6.5 Implementing and controlling strategy:
What is an effective strategy? Three principles 195 execution 213
Does strategic management work for small as well Execution: getting things done 213
as large firms? 196
The three core processes of business: people,
6.2 The strategic-management process 198 strategy and operations
Building a foundation of execution
213
214
The five steps of the strategic-management process 198
How execution helps implement and control
6.3 Establishing the grand strategy 203 strategy 215
Key terms 217
Competitive intelligence 203
Study notes 217
PESTEL analysis 204
Management in action 218
SWOT analysis 204 Self-assessment 220
Forecasting: predicting the future 207 Legal/ethical challenge 221
Further reading and questions for
6.4 Formulating strategy 208
critical analysis 221
Porter’s five competitive forces 209 References 222

Chapter 7 Individual and group decision making 225

7.1 Two kinds of decision making: The uses of ‘big data’ 240
rational and non-rational 227
7.3 Four general decision-making styles 243
Decision making in the real world 227
Value orientation and tolerance for ambiguity 243
Rational decision making: managers should make
1. The directive style: action-oriented decision
logical and optimal decisions 229
makers who focus on facts 244
Stage 1: Identify the problem or opportunity—
2. The analytical style: careful decision makers who
determining the actual versus the desirable 229
like lots of information and alternative choices 244
Stage 2: Think up alternative solutions—both the
3. The conceptual style: decision makers who rely
obvious and the creative 230
on intuition and have a long-term perspective 244
Stage 3: Evaluate alternatives and select a solution—
4. The behavioural style: the most people-oriented
ethics, feasibility and effectiveness 230
decision makers 244
Stage 4: Implement and evaluate the solution
Which style do you have? 245
chosen 230
What’s wrong with the rational model? 233 7.4 Making ethical decisions 245
Non-rational decision making: managers find it The dismal record of business ethics 245
difficult to make optimal decisions 233
Road map to ethical decision making: a decision
tree 246
7.2 Evidence-based decision making
and analytics 236 7.5 How to overcome barriers
Evidence-based decision making 237 to decision making 248
In praise of analytics 239 Decision making and expectations about happiness 249

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 x CONTENTS

How do individuals respond to a decision situation? Group problem-solving techniques: reaching for
Ineffective and effective responses 249 consensus 256
Nine common decision-making biases: rules More group problem-solving techniques 257
of thumb, or ‘heuristics’ 250
Key terms 260
7.6 Group decision making: how to work Study notes 260
with others 254 Management in action 262
Advantages and disadvantages of group decision Self-assessment 263
making 254 Legal/ethical challenge 264
What managers need to know about groups and Further reading and questions for critical analysis 265
decision making 255 References 266
Participative management: involving employees in
decision making 256

PART 4 Organising
Chapter 8 Organisational culture, structure and design 273
8.1 What kind of organisational culture 1. Traditional designs: simple, functional, divisional
and matrix structures 291
will you be operating in? 275
2. The horizontal design: eliminating functional
How an organisation’s culture and structure
barriers to solve problems 294
are used to implement strategy 275
3. Designs that open boundaries between
Four types of organisational culture: clan,
organisations: hollow, modular and virtual
adhocracy, market and hierarchy 276
structures 295
The three levels of organisational culture 279
How employees learn culture: symbols, stories, 8.6 Contingency design: factors
heroes, and rites and rituals 280 in creating the best structure 298
The importance of culture 281 Four factors to be considered in designing an
organisation’s structure 299
8.2 Developing high-performance cultures 282
1. The environment: mechanistic versus organic
Cultures for enhancing economic performance: organisations—the Burns and Stalker model 299
three perspectives 282 2. The environment: differentiation versus
The process of culture change 284 integration—the Lawrence and Lorsch model 300
3. Life cycle: four stages in the life of an
8.3 Organisational structure 285
organisation 300
The organisation: three types 286 4. The link between strategy and structure 301
The organisation chart 286 Getting the right fit: what form of organisational
8.4 The major elements that influence structure works best? 301
an organisation’s structure 288
Key terms 302
Common elements of organisations: four
Study notes 302
proposed by Edgar Schein 288
Management in action 304
Common elements of organisations: three more
Self-assessment 305
that most authorities agree on 289
Legal/ethical challenge 306
8.5 Basic types of organisational design 291 Further reading and questions for critical analysis
References
307
308

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 CONTENTS xi

Chapter 9 Strategic human resource management 311

9.1 
Strategic human resource Incentives
Benefits
335
336
management 313
Human resource management: managing an
organisation’s most important resource 314
9.7 Managing promotions, transfers,
disciplining and dismissals 336
Planning the human resources needed 315
Promotion: moving upward 337
9.2 The legal requirements of Transfer: moving sideways 337
human resource management 318 Disciplining and demotion: the threat of moving
downward 337
9.3 Attracting and selecting talent: putting Dismissal: moving out of the organisation 337
the right people into the right jobs 321
Recruitment: how to attract qualified applicants 321
9.8 Labour-management issues 339
Selection: how to choose the best person for the job 322 The development of industrial relations 339
How workers organise and negotiate agreements 339
9.4 Orientation (onboarding), training Collective bargaining 340
and development 327 The role of government: prescribed standards of
Orientation: helping newcomers learn the ropes 328 employment 340
Training and development: helping people perform Labour-management disputes 341
better 328
Key terms 342
9.5 
Performance management Study notes 343
and appraisal 330 Management in action 345
Two kinds of performance appraisal: objective and Self-assessment 346
subjective 331 Legal/ethical challenge 347
Who should make performance appraisals? 332 Further reading and questions for critical analysis 348
Effective performance feedback 333 References 349

9.6 Managing an effective workforce:

compensation and benefits 334
Wages or salaries 335

PART 5 Leading
Chapter 10 Managing individual differences and behaviour 355
10.1 Personality and individual behaviour 357 10.3 Perception and individual behaviour 366
The Big Five personality dimensions 358 The four steps in the perceptual process 366
Five traits important in organisations 359 Four distortions in perception 367
The self-fulfilling prophecy or Pygmalion effect 371
10.2 Values, attitudes and behaviour 362
Organisational behaviour: trying to explain and 10.4 
Work-related attitudes and behaviours
predict workplace behaviour 362 managers need to deal with 371
Values: what are your consistent beliefs and Important workplace behaviours 372
feelings about all things? 363
Attitudes: what are your consistent beliefs and 10.5 The new diversified workforce 374
feelings about specific things? 363 How to think about diversity: which differences are
When attitudes and reality collide: consistency and important? 375
cognitive dissonance 363 Trends in workforce diversity 376
Behaviour: how values and attitudes affect people’s Barriers to diversity 379
actions and judgements 364

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 xii CONTENTS

10.6 
Understanding stress and individual Key terms
Study notes
384
385
behaviour 380
Management in action 386
The toll of workplace stress 380 Self-assessment 388
How does stress work? 381 Legal/ethical challenge 389
The sources of job-related stress 381 Further reading and questions for critical
The consequences of stress 383 analysis 390
Reducing stressors in the organisation 383 References 391

Chapter 11 Motivating employees 398

11.1 Motivating for performance 400 11.4 Job design perspectives on
Motivation: what it is, why it’s important 400 motivation 414
The four major perspectives on motivation: Fitting jobs to people 415
overview 402 The job characteristics model: five job attributes for
better work outcomes 415
11.2 
Content perspectives on employee
motivation 402 11.5 
Reinforcement perspectives on
Maslow’s hierarchy of needs theory: five motivation 417
levels or more? 403 The four types of reinforcement: positive, negative,
Alderfer’s ERG theory: existence, relatedness and extinction and punishment 418
growth 405 Using reinforcement to motivate employees 419
McClelland’s acquired needs theory: achievement,
affiliation and power 405 11.6 
Using compensation and other
Herzberg’s two-factor theory: from dissatisfying rewards to motivate 421
factors to satisfying factors 407 Is money the best motivator? 422
Motivation and compensation 422
11.3 
Process perspectives on employee Non-monetary ways of motivating employees 423
motivation 409
Equity theory: how fairly do you think you’re being Key terms 427
treated in relation to others? 409 Study notes 427
Expectancy theory: how much do you want and Management in action 429
how likely are you to get it? 411 Self-assessment 430
Goal-setting theory: objectives should be specific Legal/ethical challenge 431
and challenging but achievable 413 Further reading and questions for critical analysis 432
References 433

Chapter 12 Groups and teams 437

12.1 Groups versus teams 439 Stage 3: Norming—‘Can we agree on roles
and work as a team?’ 444
Groups and teams: how do they differ? 439
Stage 4: Performing—‘Can we do the job properly?’ 445
Formal versus informal groups 440
Stage 5: Adjourning—‘Can we help members
Work teams for four purposes: advice, production, transition out?’ 445
project and action 440
The punctuated equilibrium model 445
Self-managed teams: workers with own
administrative oversight 442 12.3 Building effective and
efficient teams 445
12.2 Stages of group and team
1. Cooperation: ‘We need to systematically
development 443
integrate our efforts’ 446
Stage 1: Forming—‘Why are we here?’ 444
2. Trust: ‘We need to have reciprocal faith in
Stage 2: Storming—‘Why are we fighting over who each other’ 446
does what and who’s in charge?’ 444

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 CONTENTS xiii

3. Cohesiveness: the importance of togetherness 446 Three kinds of conflict: personality, intergroup
4. Performance goals and feedback 446 and cross-cultural 455
5. Motivation through mutual accountability 447 How to stimulate constructive conflict 459
6. Size: small teams or large teams? 447
7. Roles: how team members are expected to Key terms 460
behave 448 Study notes 461
8. Norms: unwritten rules for team members 449 Management in action 462
9. Groupthink and groupshift: when peer pressure Self-assessment 463
discourages ‘thinking outside the box’ 450 Legal/ethical challenge 464
Further reading and questions for critical analysis 465
12.4 Managing conflict 453 References 465
The nature of conflict: disagreement is normal 454
Can too little or too much conflict affect
performance? 454

Chapter 13 Power, leadership and effective communication 469

13.1 
The nature of leadership: wielding 13.5 
The full-range model: uses of
influence 471 transactional and transformational
Managers and leaders: not always the same 472 leadership 486
Managerial leadership: can you be both a Transactional versus transformational leaders 487
manager and a leader? 472 The best leaders are both transactional and
Coping with complexity versus coping with transformational 488
change: the thoughts of John Kotter 472 Four key behaviours of transformational leaders 488
Five sources of power 473 Implications of transformational leadership for
Leadership and influence: using persuasion to managers 489
get your way at work 475
Five approaches to leadership 476 13.6 Four additional perspectives 490
Leader–member exchange (LMX) leadership: having
13.2 
Trait approaches: do leaders have different relationships with different subordinates 491
distinctive personality Servant leadership: meeting the goals of followers
characteristics? 477 and the organisation, not of oneself 491
Is trait theory useful? 477 E-leadership: managing for global networks 491
Kouzes and Posner’s research: is honesty the top Followers: what do they want, how can they help? 493
leadership trait? 478
Gender studies: do women have traits that make 13.7 
Understanding the communication
process to remove barriers and
them better leaders? 478
improve communication 494
Leadership lessons from the GLOBE project 479
Communication differences between men and
13.3 
Behavioural approaches: do women 497
leaders show distinctive patterns of Managers need to learn ‘soft skills’ 498
behaviour? 480 Formal communication channels: up, down,
The University of Michigan leadership model 480 sideways and outward 498
The Ohio State leadership model 480 Informal communication channels 498

13.4 
Contingency approaches: does 13.8 Improving communication
leadership vary with the effectiveness 499
situation? 481 Being an effective listener 499
1. The contingency leadership model: Fiedler’s Being an effective reader 500
approach 482 Being an effective writer 501
2. The path–goal leadership model: House’s Being an effective speaker 502
approach 484
Applying situational theories: five steps 486

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 xiv CONTENTS

Key terms 503 Legal/ethical challenge 508

Study notes 503 Further reading and questions for critical analysis 509
Management in action 505 References 510
Self-assessment 507

PART 6 Controlling
Chapter 14 Control systems and quality management 517
14.1 Managing for productivity 519 Financial statements: summarising the
organisation’s financial status 534
What is productivity? 519
Ratio analysis: indicators of an organisation’s
Why increasing productivity is important 520 financial health 534
14.2 
Control: when managers monitor Audits: external versus internal 535
performance 522
14.6 Total quality management 535
Why is control needed? 522
Deming management: the contributions of
Steps in the control process 524 W. Edwards Deming to improved quality 536
14.3 Levels and areas of control 527 Applying TQM to services
Some TQM tools and techniques
538
539
Levels of control: strategic, tactical and operational 527
Six areas of control 527 14.7 Managing control effectively 543
14.4 
The balanced scorecard, strategy maps The keys to successful control systems
Barriers to successful control
543
544
and measurement management 529
The balanced scorecard: a dashboard-like view
of the organisation 529 Key terms 545
Study notes 545
Strategy map: visual representation of a balanced
Management in action 547
scorecard 530
Self-assessment 548
Measurement management: ‘forget magic’ 531
Legal/ethical challenge 549
14.5 Some financial tools for control 533 Further reading and questions for critical analysis
References
550
551
Budgets: formal financial projections 533

PART 7 Change management

Chapter 15 Organisational change and innovation 557
15.1 The nature of change in 15.2 
The threat of change: managing
organisations 559 employee fear and resistance 568
Fundamental change: what will you be called on The causes of resistance to change 568
to deal with? 560 The degree to which employees fear change:
Collins’s five stages of decline following failure to from least threatening to most threatening 569
respond to change 562 Lewin’s change model: unfreezing, changing and
Two types of change: reactive versus proactive 562 refreezing 571
The forces for change: outside and inside the Kotter’s eight steps for leading organisational
organisation 564 change 571
Areas where change is often needed: people,
technology, structure and strategy 566

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 CONTENTS xv

15.3 
Organisational development: Celebrating failure: cultural and other factors
encouraging innovation 581
what it is and why it is important 574
How you can foster innovation: four steps 583
What can OD be used for? 574
How OD works 574  pilogue: the keys to your managerial
E
The effectiveness of OD 577 success and business excellence 584

15.4 
Promoting innovation within the Key terms 586
organisation 578 Study notes 586
How does failure impede innovation? 578 Management in action 588
Two myths about innovation 578 Self-assessment 590
The seeds of innovation: starting point for Legal/ethical challenge 591
experimentation and inventiveness 579 Further reading and questions for critical analysis 591
Types of innovation: product or process, References 592
incremental or radical 580

Appendix 596
Glossary 603
Index 617

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 xvi

Preface to the first

Australasian edition

THE FIRST AUSTRALASIAN EDITION came about through an invitation from our publishers to produce a regional
and updated version of the established North American text, Management: A Practical Introduction, by Angelo Kinicki
and Brian Williams. We were thrilled to have this opportunity as it seems to us that the approach taken in the original book
was refreshing for its engaging writing style and its well-considered blend of academic and practical material. We wanted
to maintain the strengths and original spirit of the book while adding an Australasian and regional dimension. In addition,
we have taken note of any new developments in the field of management theory and practice. In doing this we have given
representation to some specifically Australian and New Zealand experiences and been mindful of the importance of the
relationship with Asia for both these economies. The aim of the book remains the same: to provide a clear, authoritative,
well-structured and easy-to-read guide to the task of managing people within organisations.
Inevitably, while trying to provide a broad introduction to a large area of scholarship and practice, selections are made.
As far as possible we have tried to ensure that each major area of management practice retains a presence and have been less
concerned with ensuring that the diversity of academic theories is summarised. As with the original book, the focus is on
providing a representative and contemporary approach to each area of management practice. Where some ideas are not dealt
with in the text, we have sometimes provided comments to references where additional material may be found.
This text covers the core roles and skills needed by managers, which is similar to other management texts. However, there
is a strong focus on helping students understand and confront the practical issues that modern organisations need to deal with;
for example, globalisation, diversity, ethics, entrepreneurship, innovation, customer focus, human resource management and
managing throughout change. To facilitate student learning, each chapter contains practical examples, vignettes, case studies,
practical exercises and ethical dilemmas. Each chapter concludes with some thought-provoking questions related to further
readings to encourage critical analysis and discussion.
Based on the belief that theory underpins practice and provides organisations and managers with informed choices, the
text is designed to be easy to read and visually attractive for students. Explanations are clear and concise so students can
grasp theoretical concepts and then test their knowledge against the exercises and case examples. The use of local practical
applications promotes engagement. Students can study such cases in real time by pursuing further research in the news or via
the internet. The many theories, models, exercises, questions and examples throughout the text are aimed at helping students
understand the complexity and veracity of the world of work they are entering, and equipping them with a good foundation
of what constitutes good management practice.

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 xvii

Preface to the second

Australasian edition

WE WANT TO THANK ALL OF YOU who have adopted this book as your course text! It has given us an
opportunity to further strengthen the regional specific content in the book, converting our original text developed for a
North American readership into a truly Australasian text. Based on the comments of the reviewers of the first edition, we
made other improvements.
∙ Each chapter has been updated to include the most recent research findings, new management ideas and to update case
experiences. We have also added new examples, giving particular attention to examples that come from the digital
economy, and updated our opening toolkit summaries to include new tools that seem to be gaining attention.
∙ Our extended end-of-chapter ‘management in action’ cases have been revised, in some cases involving the replacement
with an original case and in others updating events since the original case was developed. Several of the new cases have
been prepared by guest contributors, and we are delighted to have received their support.
∙ All chapter openings now contain an extended explanation of the scope of the chapter and why the topic matters for
management. We have also enhanced the signposting throughout the chapters to increase the ease of navigation through
the chapter material.
∙ Industry spotlights have been added to showcase the career path and choices of some former students who have graduated
and are now working. We wanted to showcase these students achievements and how the study of management has aided
them in their career choices and advancement. These spotlights help to show undergraduates that there is a diverse range
of potential opportunities for management students.
The aim of the book remains the same: to provide a clear, authoritative, well-structured and easy-to-read guide to the
task of managing people within organisations. In reality, theory underpins practice and gives managers and organisations a
wider repertoire of choices—this is demonstrated through the many practical examples drawn from both the international and
Australasian regions. The text is designed to be easy to read and visually attractive for students. Explanations are clear and
concise so students can grasp theoretical concepts and then test their knowledge against the exercises and case examples. The
use of local practical applications promotes engagement.
In writing a textbook, there is always a balance to be struck in giving representation to all possible theories and frameworks,
and keeping a focus on the essential ideas and those which have had most influence. While we have added some material
that did not appear in the first addition, such as the inclusion of PESTEL in connection with strategic management and
adding further decision-making theories, we have also been careful to maintain the readability of the book. A considerable
strength of the original Kinicki and Williams’ text is the accessibility of the writing, which gives an emphasis on illustrating
how theories are used in real examples, rather than overloading the book with dissections of theories and models. We hope
that this second edition keeps alive this lively presentation, and provides a text that will motivate students to get started in
management.

Brenda Scott-Ladd
Martin Perry

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 xviii

About the Australian authors

Brenda Scott-Ladd is an independent management consultant and researcher based in
Perth, Western Australia. She currently teaches on the Australian Institute of Management MBA
program and is a member of the editorial board of the International Journal of Management
Education. She commenced her academic career in 1997 and, until recently, was an Associate
Professor of Human Resource Management at Curtin University in Perth. She was a visiting
research scholar at the University of Surrey, UK, in 2011.
Brenda specialises in teaching and researching human resource practices in relation to
management, employee relations, organisational behaviour and international human resource
practices. She has taught on undergraduate and master’s programs in Singapore, Hong Kong,
China, Mauritius and Malaysia. Her long-standing career in industry spans sectors as diverse as
health, construction and manufacturing, and builds on her experiences in the occupational health
and rehabilitation fields and original qualifications as a triple certificated registered nurse. She has consulted to a significant
number of federal and state government agencies and private companies, and continues to practise as a human resources
consultant.

Martin Perry is an independent research consultant based in Wellington, New Zealand.

He was previously an Associate Professor in the School of Management, Massey University
(Wellington), where he taught a range of management courses to undergraduate and postgraduate
students including contemporary management, organisation and management, managing
services, business and sustainability, and enterprise development.
Originally from the UK, Martin joined the Department of Geography, University of Auckland,
New Zealand as a university grants committee postdoctoral research fellow. At the end of the
fellowship, he was first a teaching fellow and then later an Associate Professor in the Department
of Geography, National University of Singapore, as well a fellow of the public policy program.
Returning to New Zealand, he worked with the Labour Market Policy Group, Department of
Labour, Wellington, before joining Massey University, initially teaching in what was then the
Department of Enterprise Development and Management. He ’retired’ from Massey University following the university’s
decision to close its management teaching programs in Wellington.
Working as an independent research consultant, Martin has completed studies for a consortium of Hawke’s Bay local
authorities, the Data Futures Partnership and the Open Polytechnic. Martin has authored or co-authored 10 books: his most
recent books are Controversies in Local Economic Development (voted best book 2011 by the UK-based Regional Studies
Association) and Environmental Policy for Business, which was written as a contribution to PRME (Principles for Responsible
Business Education) book series.

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 xix

About the US authors

Angelo Kinicki is an emeritus professor of management and held the Weatherup/Overby
Chair in Leadership from 2005 to 2015 at the W.P. Carey School of Business at ­Arizona
State University. He joined the faculty in 1982, the year he received his doctorate in business
administration from Kent State University. He was inducted into the W.P. Carey Faculty Hall
of Fame in 2016.
Angelo is the recipient of six teaching awards from Arizona State University, where he
taught in its nationally ranked MBA and PhD programs. He also received several research
awards and was selected to serve on the editorial review boards for four scholarly journals.
His current research interests focus on the d­ynamic relationships among leadership,
organisational culture, organisational change, and individual, group and organisational
performance. Angelo has published over 95 articles in a variety of academic journals and
proceedings, and is co-author of eight textbooks (31 including revisions) that are used by hundreds of universities around
the world. Several of his books have been translated into multiple languages, and two of his books were awarded revisions
of the year by The McGraw-Hill Companies.
Angelo is a busy international consultant and is a principal at Kinicki and Associates, Inc., a management consulting
firm that works with top management teams to create organisational change aimed at increasing organisational effectiveness
and profitability. He has worked with many Fortune 500 firms as well as numerous entrepreneurial organisations in diverse
industries. His expertise includes facilitating strategic/operational planning sessions, diagnosing the causes of organisational
and work-unit problems, conducting organisational culture interventions, implementing performance management systems,
designing and implementing performance appraisal systems, developing and administering surveys to assess employee
attitudes and leading management/executive education programs. He developed a 360° leadership feedback instrument called
the Performance Management Leadership Survey (PMLS), which is used by companies throughout the world.
Angelo and his wife of 35 years, Joyce, have enjoyed living in the beautiful Arizona desert for 34 years. They are both
natives of Cleveland, Ohio. They enjoy travelling, hiking and spending time in the White Mountains with Gracie, their
adorable golden retriever. Angelo also has a passion for golfing.

Brian Williams has been managing editor for college textbook publisher Harper & Row/
Canfield Press in San Francisco; editor-in-chief for non-fiction trade-book publisher J. P. Tarcher
in Los Angeles; publications and communications manager for the University of California,
Systemwide Administration, in Berkeley; and an independent writer and book producer based in
the San Francisco and Lake Tahoe areas. He has a BA in English and an MA in communication
from Stanford University. Repeatedly praised for his ability to write directly and interestingly
to students, he has co-authored 22 books (66 counting revisions). This includes the 2015 Using
Information Technology: A Practical Introduction, 11th ed., with his wife, Stacey C. Sawyer, for
McGraw-Hill Education. In addition, he has written a number of other information technology
books, college success books and health and social science texts. Brian is a native of Palo Alto,
California, and San Francisco, but since 1989 he and Stacey, a native of New York City and
Bergen County, New Jersey, have lived at or near Lake Tahoe, currently in Genoa (Nevada’s oldest town), with views of the
Sierra Nevada. In their spare time, they enjoy foreign travel, different cuisine, visiting museums, music, hiking, contributing
to the community (Brian is past chair of his town board) and warm visits with friends and family.
Management: A Practical Introduction has twice been the recipient of McGraw-Hill/Irwin’s Revision of the Year Award,
for the third and fifth editions.

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 xx

About the contributing authors

Melissa Edwards is a senior lecturer and researcher at the University of Technology, Sydney (UTS) Business School. She
teaches sustainable business, organisation studies, social entrepreneurship, management and business design at undergraduate
and postgraduate level in Sydney and Shanghai. She was awarded a UTS Future Learning fellowship for her innovative teaching
practice. Her PhD, awarded by UTS, examined the human interaction dynamics that enable networks to self-organise to address
complex sustainability issues. Her work has been published in leading academic journals and she has presented at the Academy of
Management conference.
Trish Bradbury holds a Doctorate from Massey University, where she is a senior lecturer in the School of Management. She has
served as Chef de Mission at four World University Games, Assistant Chef de Mission at the 2000 Paralympic Games and board
member for national and regional sporting bodies. Trish’s major research interests concern sport management relating to events,
performance management, people management, governance and facilities.
Bernard Mees is a senior lecturer in the School of Management at RMIT University. He holds a PhD from the University of
Melbourne and has published in business and management history, corporate governance and industrial relations. His papers include
a study of labour heroes in the People’s Republic of China and the entry on Frank and Lillian Gilbreth in the Oxford Handbook of
Management Theorists.
Bonnie Becker is a Master of Human Resources student at Curtin University, Western Australia. Bonnie has worked in human
resources for the past seven years. She has extensive recruitment experience in the mining and resources sector. Her current area of
focus is employment and industrial relations, specialising in performance management, grievances and dispute resolution.
Julia Celinski graduated from the University of Western Australia with a Bachelor of Arts, Honours in Psychology and later
obtained a Graduate Diploma in Human Resource Management from Curtin University. Julia has worked in the recruitment and
human resource consulting industry for several years.
Melinda Anderson holds a Master of Human Resources from Curtin University and works as a human resources manager
within the not-for-profit sector. She has more than 10 years of generalist human resources’ experience within professional services
and construction industries.
Mark Wickham is a senior lecturer at the University of Tasmania, teaching Introduction to Management and Business Ethics. His
research interests include sustainability management and the role of ethics in strategy, and he has a particular interest in qualitative
methods.
Ace Volkmann Simpson is Senior Lecturer in Organisational Behaviour in the UTS Business School, University of
Technology Sydney. Ace’s research brings a critical-social perspective to organisational practices, including positive practices such
as compassion, love and humility. Ace’s research has been published in journals such as the Journal of Management, Journal of
Business Ethics and the Journal of Management Inquiry.
Lynn Gribble is adjunct faculty at UNSW Business School. Along with extensive career experience, she is a recognised leader
in teaching and learning, receiving the UNSW Vice Chancellor’s Teaching Excellence Award (2011) and the Facilitation Award for
Teaching Excellence. In 2014 she received the Outstanding Technology-Enabled Teaching Innovation Award. Lynn’s interests in
human and organisational behaviour guide all her teaching endeavours.
Duncan Murray is a Senior Lecturer at the University of South Australia Business School. He holds a Doctor of Philosophy,
Bachelor of Applied Science and a Bachelor of Arts (Psychology). His research interests are in the areas of consumer behaviour,
leadership (particularly toxic or harmful leadership), gender and physical attractiveness in organisations. His research has been
published in a range of international journals, including Leadership and Organization Behavior, Sport Management Review,
Managing Leisure, Sport, Business, Management: An International Journal and European Sport Marketing Quarterly.
Nimeesha Odedra is completing her PhD at Massey Business School, Massey University, New Zealand. Her research topic is
on migrant women’s careers in New Zealand and how they unfold over time. Her passion is women’s studies, concerning especially
how their careers develop, and she plans to pursue this field further in the future.
Natalia d’Souza is completing her PhD with the Healthy Work Group at Massey University, Auckland. Her research is centred
on workplace cyberbullying, with a focus on nurses. She is also currently involved in projects exploring workplace violence in New
Zealand, as well as on entrepreneurship in the healthcare industry.

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 xxi

Acknowledgments
THIS WORK WOULD NOT HAVE BEEN POSSIBLE without the tremendous support of so many people and we are
very proud of all who have contributed to the second Australia and New Zealand edition. Firstly, we would like to thank and
acknowledge the work of the American team behind Management, A Practical Introduction, from which this book is adapted.
To Angelo Kinicki and Brian Williams: you gave us a wonderful foundation to work with. We have endeavoured to add a
Pacific Rim flavour to the book without disrupting the quality and richness of content.
A special thank you to our content developer, Martina Edwards, for her great support and coordination. Her professionalism
in dealing with two authors in different countries and coordinating contributions from other academics was excellent and her
quick responses to emails made our lives so much easier. We also wish to thank other members of the team at McGraw-Hill
Education for their encouragement for and support of a second edition of the text: Jillian Gibbs, Product Manager; Claire
Linsdell, senior content producer; and Nicole Meehan, publishing director. There is so much more that goes into production
of a text than the writing: also included are the design, marketing, instructional support, art direction, etc. The team at
McGraw-Hill Education have put in an exceptional effort to produce a book that will truly enhance student learning. For all
your efforts, we thank you.
Martin thanks the students of Organisation and Management, a postgraduate course he taught from 2010 to 2013. These
students played an integral part in helping to challenge his thinking on management ideas. As well, he recognises a big
obligation to Alan Thomas, whose book Controversies in Management shed considerable light on ideas about management.
Martin would also like to thank the many company managers in New Zealand he interviewed as part of his work for the
New Zealand Centre of SME Research, Massey University, which facilitated his search for interesting examples of business
experiences. In this regard, Martin acknowledges the former director, David Deakins, and former co-director, Martina Battisti,
for inviting him to join many of the centre’s projects.
We would also like to join McGraw-Hill Education in thanking our academic colleagues who took the time to give
feedback and review the manuscript, and whose contribution has greatly improved this text in numerous aspects:

Allison James, University of Tasmania

Jalleh Sharafizad, Edith Cowan University
Jeremy Seward, La Trobe University
Katrina Radford, Griffith University
Roslyn Larkin, Newcastle University

Along with reviewers, contributors and editorial team, Brenda would like to extend her gratitude to Martin Perry for his care
and attention to detail. I’m not a ‘completer finisher’ and it was good to know that Martin had my back!

Brenda Scott-Ladd
Martin Perry

kin69849_fm_i-xxxii.indd xxi 09/13/17 04:14 PM

 goal accomplished provides you not only with
personal satisfaction but also with the satisfaction
of all those employees you directed who helped
you accomplish it.
∙ You can stretch your abilities and magnify
your range. Every promotion up the hierarchy of
an organisation stretches your abilities, challenges
your talents and skills and magnifies the range of
xxii your accomplishments.
∙ You can build a catalogue of successful
products or services. Every product or service
you provide—the personal Eiffel Tower or
Empire State Building you build, as it were—

Text
PART 1 –at a glance
becomes a monument to your accomplishments.
Mentoring. Being a manager is an opportunity ‘to counsel,
Indeed, studying management may well help you
Introduction motivate, advise, guide, empower and influence’ other
people. Does this sense of accomplishment appeal to you? in running your own business.
Finally, productivity-improvement expert Odette
© Rob Daly/age fotostock
Pollar of Oakland, California, concludes that, ‘This
is an opportunity to counsel, motivate, advise, guide,
The rewards of practising management However empower and influence large groups of people.
INDUSTRY SPOTLIGHT you become a management practitioner, there are many These important skills can be used in business
Advice from people just like you
rewards—apart from those of money and status—to as well as in personal and volunteer activities. If
NAME Matthew Bruggy being a manager: Each Part of the
you truly bookand
like people opens
enjoy with an and
mentoring
DEGREE STUDIED Bachelor of Business Management ∙ You and your employees can experience a helping
Industry others to grow and
spotlight—a thrive, Q&A
quick management
with is a
sense of accomplishment. Every successful great job.’25
UNIVERSITY The University of Queensland management graduates to find out
CURRENT ROLE Store Operations Director for Brendale, Queensland
where they have taken their careers
CURRENT EMPLOYER ALDI Australia
and what advice they would give to
1. What interested you about the workings of business that inspired you to study it? new students in the field.
1.2 Seven challenges to being
From an early age, I was drawn to the corporate world because of its limitless potential and the countless options
business offers for career development. I’ve also always wanted to work for a large organisation, as I’m fascinated by
an exceptional manager
how global businesses can connect the world and make it feel smaller. Furthermore, business and management skills
are transferable and open doors so I knew my degree wouldn’t pigeonhole me into a specific role or industry.

2. What did you learn from your degree and how has it prepared you for a career in business and management?
THE BIG PICTURE
From knowing how to research effectively to being able to write a solid business proposal, the skills I learned at
Each section begins with a recap
university have been incredibly useful from the start. During my studies, I explored business theories and learned
ofabout
themany
major question
related models andand
trends.includes MAJOR
It wasn’t just one approach that QUESTION
best prepared me for my career, but the idea
that any of those methods could be successful. To me it’s about finding the
canright approach toalive.
suit the scenario and challenges I could look forward to as a manager?
The big picture, which
then implementing it successfully.
presents Challenges make one feel What are seven
students with an overview of how Seven challenges face any manager: you need to manage for competitive advantage—to stay ahead of rivals. You need to
3. Could you give us a run-down of your career path? How did youforget to where you are now? gender and so on because the future won’t resemble the past. You need to manage
the section they are about to read manage diversity in race, ethnicity,
I joined ALDI as a Graduate Area Manager almost five for the effects
years of globalisation.
ago. During the two-yearYougraduate
need to manage information
program, you technology. You always need to manage to maintain ethical
answers the major questions.
work within every department of the regional office, fromstandards. You needtotologistics
store operations manageandfor sustainability—to
warehousing, to practise
really sound environmental policies. Finally, you need to manage for
the achievement
understand the workings of a retail business from the ground of Iyour
up. From there owninto
moved happiness
an Area and life goals.
Manager position
and in February 2016, I started in my current role as Store Operations Director. I’m now in charge of 50 ALDI stores
CHAPTER 1 The exceptional manager 7
in Queensland.
THE IDEAL STATE that many people seek is an is less than the challenge you are asked to complete,
CHAPTER 1emotional
The exceptional
zone manager
somewhere between boredom 7 such as (for many people) suddenly being called upon
4. What does your current role involve?
echelons of business clearly remain male dominated and
Management, said one pioneer of management anxiety, in the view of psychologist Mihaly to give a rousing speech to strangers.
The most important part of my role as Store Operations Director is managing teams, which tends 26 to keep me busy. I
Organisation CHAPTER 1 The exceptional manager 7
and, of spend
course,a lot both men visiting
and women have to deal ideas, is ‘theoperations,
art of getting Csikzentmihalyi.
things doneto through Boredom, A to he
group says,
of people may arise As a manager, could you achieve a balance
of time Area Managers in stores to discuss from recruitment finding ways improve
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job with aKeyaction terms are highlighted to have
help
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and, of course, both men and women have to deal developing strategies to maximise sales
ideas, is ‘the art of getting minimise
things donecosts within
through stores, sales
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up new embrace
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to answer the phones. But it’s not effective if it leaves us,
business. ‘Just give me a person to speak with, please’, answered not by people but by automated answering
class discussion at the end of each
the customers, fuming and less 10 inclined to continue doing
pleads a Nevada resident. Even most online shoppers, systems. Certainly this arrangement is efficient for the
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obviously favour efficiency over effectiveness in their © Monkey Business–LBR/age fotostock
kin69849_fm_i-xxxii.indd xxii customer service. ‘The approximate cost of offering a live, 09/13/17 04:14 PM
kin69849_ch01_001-042.indd 7 07/27/17 10:33 AM continued
 Challenge 6: Managing for Our economic system has brought prosperity, but
sustainability—the business it has also led to unsustainable business practices
because it has assumed that natural resources are
Sustainability of green limitless, which they are not. Sustainability is defined
Economic Sustainability has been described as a megatrend— as economic development that meets the needs of the
development that something that forces fundamental and persistent shifts present without compromising the ability of future
meets the needs of
in how companies compete.52 With environmental generations to meet their own needs.54 It is an idea that
the present without
compromising the impacts now recognised as an increasing threat to business is responding to because it does not have to
ability of future the ability of businesses to continue to create value compromise the ability to make a profit. Rather,
generations to meet for customers without damaging their standing in the sustainability is being viewed as a driver of new xxiii
their own needs. larger community, sustainability has gained the status product ideas and as encouraging a shift to more
of being a business megatrend. It is partly a product of efficient forms of technology. A good example of this
the growth of newly industrialising economies which, is Interface, a US company with operations in Australia
while enabling Western economies to source many and New Zealand—perhaps best known for its
products and services more cheaply than in the past, is sustainable carpet tiles—which has a goal of becoming
putting increased pressure on environmental resources
CHAPTERthe
1 The exceptional
world’s first trulymanager 37
sustainable industrial company.

could be as simple as the inherent need, both by organisations 2017); Zack Guzman, Zappos CEO Tony Hsieh on getting rid of
and people, for the role of a manager. If we look at Chapter 1 of managers: What I wish I’d done differently, 13 September 2016, http://
PRACTICAL ACTION
the text, we see the role a manager plays, the critical function www.cnbc.com/2016/09/13/zappos-ceo-tony-hsieh-the-thing-i-regret-
that it has of balancing efficiency and effectiveness to meet about-getting-rid-of-managers.html, (accessed 4 February 2017);
Practical action boxes, appearing organisational goals. Zappos’ experience (at least at the time of Steve Denning Is Holocracy succeeding at Zappos? Forbes.com,
one or more times in each chapter, Lying and cheating required to succeed?
writing) seems to suggest that people in organisations do crave May 23 2015, http://www.forbes.com/sites/stevedenning/2015/05/23/
TODAY’S TEENAGERS AND young adults are butmuch more likely than their parents ‘to believe they’re great people,
offer practical and interesting advice self-expression and some degree of autonomy, autonomy is-holacracy-succeeding-at-zappos/#1686a16540bb (accessed
with destined
a structure. for maximum
Too muchsuccess autonomy as workers,
may actually spousescreateand as parents’, says 2016);
16 December an article summarising a study spanning
https://en.wikipedia.org/wiki/Zappos; Andy the
on issues students will face in the
36 PART 1 Introduction many years 1975astodoes
issues 2006. 55
In part,prescriptive
too much this may be because Zappos
restriction. their parents Doyle,were much more
Management likely to praise
and organization them.4 March 2016;
at Medium,
workplace. seems to have undertaken a corporate experiment that has https://blog.medium.com/management-and-organization-at-medium-
Young cynics There’s nothing wrong with self-confidence. But another study suggests a more troubling trend: Teenagers
highlighted that an organisation still needs a line of authority and 2228cc9d93e9#.t7fshk1kk (accessed 11 January 2017).
and young adults are more cynical than people over 40 and ‘are more likely to believe it is necessary to lie or cheat
some degree of56linear structure to function effectively.
tothe
succeed’. The study, by thetoLos Angeles an based Josephson a Institute
as FOR of Ethics, found that younger generations are
DISCUSSION
1.7 The skills exceptional managers need ability to think analytically, visualise organisation
more likely
It should be notedto engage that Zapposin dishonest is not conduct,the only including company cheating on exams
to 1. Looking in high1.1,school,
identify which
two of meant they were ‘at
The three skills that exceptional managers cultivate are (1) whole and to understand how the parts work together; and (3) at Table the managerial roles
attempt
least twice a form of self-management
as likely to become unethical for its staff.
adults’. Medium, with that may be difficult to fulfil in a holacracy, and two that
technical, consisting of job-specific knowledge needed to human, consisting of the ability to work well in 57 cooperation
an online Somepublication
of the findings company,includebriefly trialled the concept
the following:
perform well in a specialised field; (2) conceptual, consisting of other people in order to get things done. you think could be fulfilled with no ‘set’ managers. Explain
before reverting back to a more traditional management and your answer.
• Of teenagers 17 years and younger in 2008, 64 per cent cheated on an exam, 42 per cent lied to save money and
organisational structure. Andy Doyle, from Medium, stated that
30 per cent stole something from a store. 2. Read the section in Chapter 1 on entrepreneurship. Do
while holacracy had a lot of positive components to it, there
MANAGEMENT IN ACTION were • concerns
Teens 17 that years or under
it was are five times
too cumbersome and moredivisivelikely
Managementyou think thatin action
Hsieh’s cases
decision to move to holacracy
whenthan adults over 50 to believe that lying and cheating are
it came necessary to succeed strategy
to whole-of-company (51% versus and 10%) decisions.and four timesdepict
Ultimately, more likelyhow
is reflectivecompanies
of thetheir
to deceive bossthat
characteristics of an entrepreneur?
(31% versus 8%).
Discuss why or why not.
‘. . . every time the size of a city doubles, innovationstudents
as likely to lie to theirare
or 3. Choose onefamiliar with respond
he•said, Youngit wasadults
‘getting(18–24) in the way areofmore work’.than Medium twice ‘s experience boyfriend, girlfriend, spouse or partner about
Has Zappos created a company of seemed to reflect
something the modern
significant (48% company’s
productivity per resident increases by 15 per cent. to
versus 18%).reality—we love But situations
of the seven challenges to being an
exceptionalor issues
manager. featured
Explain how and in why Hsieh’s move
confusion? empowerment and want ideas and innovation from all parts, but
when companies get bigger, innovation or productivity per
ultimately we need managers to seek consensus, and to make
employee generally goes down. So we’re trying to figure the text. to takeDiscussion
Zappos to holacracy questions
may fit intoarethe challenge you
by Duncan Murray, University of South Australia decisions if consensus is not forthcoming. It seems that the role identify.
38 out how to structure Zappos
PART 1 Introduction more like a city, and less
of the manager, while adjusting to a contemporary context, is 4. How would an organisation moving to a ‘zero boss’
included
like a for ease of use in class, as
ZAPPOS HAS ALWAYS been a company that has taken risks bureaucratic corporation. In a city, people and businesses
and done things in a pretty non-conventional manner. Founded
not going the way of the dinosaur just yet.
are self-organising. We’re trying to do the same thing by
reflectionstructure,assignments or
such as that implemented over atonline
Zappos, potentially
by Nick Swinmurn, with the backing of investors Tony Hsieh Sources: switching
Adapted from fromA.a Zimmerman,
normal hierarchical Showdownstructure to a system
over ‘showrooms’, discussionmotivateboards.
staff (you should refer to Chapter 11)?
and Alfred Lin, they uncovered a blue ocean market in 1999, The Wallcalled
Street Holacracy,
kin69849_ch01_001-042.inddJournal, 16 23 which
January enables
2012: B1, employees
B5; Jennifer to
Reingoldact more 5. Identify what you think are the two most important
2. Based on your results, where do you have the biggest 4. Do these results encourage or discourage you07/27/17 from 10:33 AM
likewith entrepreneurs
left Zapposand takeaways for you for the future from this case? Explain
seeing the potential to sell shoes over the internet. With Hsieh Howgaps a radical shift
entrepreneurs in self-direct
reeling. termsFortune.com,
of the their work 2016,
4 March
individual instead of thinking about starting your own business? Explain.
coming on as co-CEO, their annual revenue increased from reporting to a manager
http://fortune.com/zappos-tony-hsieh-holacracy/ who tells them what to11do.’
(accessed January your rationale.
motives, aptitudes and attitudes?
$1.6 million in 2000, to $184 million in 2004. They cracked the
3. What do these gaps suggest about your entrepreneurial
billion dollar mark in 2008 after also expanding their online Many advocates of flatter organisational structures (you can
spirit? Discuss.
offerings to include a more diverse range of items such as read more about this in Chapter 8) would say that such a
Self-assessment
handbags, clothing and children’s exercises products. enable SELF-ASSESSMENT
In 2009 they were move is consistent with the benefits of flatter, more agile and
students
bought out by toAmazon
personally in a dealapplyworth $1.2 billion. Hsieh still organic structures. However, while we are not saying that self-
chapter
LEGAL/ETHICAL
To what extent do CHALLENGE
remained as CEO after the sale, and only agreed to the sale organisation and self-management is not without its benefits,
you possess an to take a self-assessment that allows you to compare your
content.
with the conditionThese that exercises
Zappos remained include
an independent entity there have been some major concerns raised about Zappos’ motivations, aptitudes and attitudes to those found in a sample
objectives
distinct
38 from Amazon.for ease PARTin assigning,
1 Introduction
entrepreneurial spirit?
implementation of holacracy (and its more recent iterationof entrepreneurs from a variety of industries.
To delay or not to delay?
known as ‘Teal’) that relate back to the roles of a manager, and Ten minutes before the presentation is set to begin, however, the
instructions
So what makes for Zappos use, guidelines
different from any for other successful Objectives
the very purpose of a manager. vice-president takes you out of the meeting room and says she
Instructions
online startup? The last point outlined previously gives us some YOU HAVE BEEN hired by a vice-president of a national Take wants an to talk with you. The two of you go to another office and she
interpreting results and questions
idea. Hsieh was not solely looking at Zappos as a ‘get rich quick’
for 1. To When assess whether
Hsieh first or not you have
proposed in 2013 motivations,
that the aptitudes
company
company to create an employee attitude survey, to administer advice_centre/benchmarking_tools/Pages/entrepreneurial_ would
entrepreneurial self-assessment at www.bdc.ca/EN/
closes the door. She then tells you that her boss’s boss decided
further
2. Based
enterprise. reflection.
on was
He yourfocused
results,on where do you
the nature ofhave the biggest
the company culture
and attitudes
it to soon have
4. employees
all Do these
possessed
zero results
and managers by entrepreneurs.
to encourage
interpret there theorwere some
discourage
results. Youraisedyou from
have eyebrows,
known to come to the presentation unannounced. She thinks that he is
self_assessment.aspx.
gaps with
and deeply entrepreneurs
interested in terms
in the human of the individual
component of work. To him 2.
thisTobut consider
not
thinking
vice-president whether
a huge aboutfor or
reaction. notthan
starting
more you
Afteryourwould
10all,own
years like
Zappos to start
business?
and was
have your
renowned
Explain. own for
worked coming to the presentation to look solely for negative information
motives,
this was aptitudesplatform
an essential and attitudes?
of the organisation, enshrined for company.
forging
her its ownoccasions.
on several path, and She of doing truststhings and likes in a youunique andway. you The in your
The quizreport.
enables Heyoudoes not like the
to compare yourvice-president and wants
motivation, aptitudes andto
in3.one of the
What docompany’s
these gapscore values
suggest ‘. . . toyour
about create fun and a little
entrepreneurial trustcompany
and likewas her.ranked You have in thecompleted
Top 10 Fortune your work companies and now to work replace her
attitudes to awith one
group of of his friends. If you present your results
entrepreneurs.
Introduction
weirdness’.
spirit? Discuss. are forready in to 2012, and the findings
present fundamentals and your of the company seemed
interpretations to as planned, it will provide this individual with the information he
Earlier in the chapter, we yearsnotedsince that the small businesses are and
the strong. However,
vice-president’s amanagement
few team. The move to holacracy
vice-president needs to createFOR
QUESTIONS serious problems for the vice-president. Knowing
DISCUSSION
With this value in mind, Hsieh was influenced by Brian creating the majority of new jobs. We also discussed a variety
has thetoldcracksyou that have she started
wantstoyour show.honest For theinterpretation
first time in eight of the years,
this, the vice-president asks you to find some way to postpone
Robertson, who developed the concept of ‘holacracy’. In of personal
Zappos characteristics
did she
not make that
the list differentiate managers from 1. To what extent are your motives, aptitudes and attitudes
results because is planning to ofmake Fortune’s
changes BestbasedCompanies
on the To your presentation. You have 10 minutes to decide what to do.
LEGAL/ETHICAL CHALLENGE
holacracy the notion of the traditional manager is removed. entrepreneurs.
Work
results. BasedFor. on The overall
When thisthe
goal of
results
discussion,
of the thisindividual
your report
is for youfrom similar to entrepreneurs? Explain.
exercise questions
clearly identifies Legal/ethical challenges present
Managers and direct line of supervision are replaced by ‘lead the Fortune survey were broken down, staff were particularly
several strengths and weaknesses that need to be addressed.
links’ and ‘circles’, which work on top of or in conjunction with negative about whether management had a clear view of where
For example, employees feelpresentation
that they areisworking too hard
cases—often
and the
SOLVING THEbased CHALLENGE on real events—
To delay or not to delay?
each other, and where even the most junior staff member can the Ten minutes
organisation
that management
vice-president
before the
does is going
takes notyou and
care out how
about
of theitproviding
was
set to begin,
meeting going good to get
room
however,
and there.
customer that
says TheWhat would you do?
she require students to think through
have the opportunity for impact. The foundation of holacracy seismic shift in thinking to a self-management system, combined 1. Deliver the presentation as planned.
service.wants At tothetalkmeeting
with you. you The willtwo beofpresenting
you go to another the results officeand how
and she they would handle the situation,
isYOU HAVEa BEEN
ultimately move to hired by a vice-president
self-management. This is of theaessence
national
yourwithcloses a changed
interpretations
the door.to business thenstrategy,
a group
She of
tells15 you has
that left
managers. herYoustaff confused
have
boss’s known
boss and,
decided2. Give the presentation but skip over the negative results.
ofcompany to create
the attraction Hsieh ansaw employee attitude survey,
in holacracy—a chancetotoadminister
go back as helping prepare them for decision
it to most to of perceived
these to
come thebypresentation
managers manyfor atofleast them, fivedirectionless.
unannounced. years. She thinks Hsieh that offered
he3. is Go back to the meeting room and announce that your
to, asallheemployees
perceivedand to interpret
it, the the results.
agile origins of theYou have As
startup. known
an employees tomaking
this vice-president for more than 10
organisation grows, it becomes slower, less adaptable and years and have worked coming to a redundancy
the presentation package
to
You arrive for the presentation armed with slides, handouts and look if they
solely for didn’t
negative want work spouse
information in their
has hadcareers.
an accident at home and you must leave
under
in your thereport.
new system: He does almost
not 20 the
like per cent took it up.and
vice-president Turnoverwantsofto immediately. You tell the group that you just received this
for her on several
increasingly occasions.
bureaucratic. HsiehShe says,trusts andthink
‘I don’t likesanyyoumanager
and you specific recommendations.
kin69849_ch01_001-042.indd 37 Your slides are loaded on the computer 07/27/17 10:33 AM
staff
replace is now up to 29 per cent across a single year.
istrust and like
purposely her. You
thinking, “How have
cancompleted
I become more your bureaucratic?”’
work and now and most of her
the with one of his
participants have friends.
arrived. If youThey present your results message and that you will contact the vice-president to
are drinking
are ready to present the findings and
Holacracy is meant to address this deficiency, which Hsieh your interpretations to
coffee as
Why? planned,
andHow telling it
could will
you provide
how enthused
a successful this individual
company, theythat with
areclearlythe information
about understands
hearing he schedule a new meeting.
the vice-president’s
believes ultimately leads management
to the deathteam. of anyThe vice-president
business. This is yourand needs cares to create
presentation. about You serious
thealsohuman problems
are excited
side of forwork
tothesharevice-president.
and your insights.
organisation, Knowing4. Invent other options. Discuss.
get
has told you that she
highlighted by Hsieh when he states: wants your honest interpretation of the this, the vice-president asks
it so wrong that almost a third of its staff wishes to you to find some way to leave?
postpone It
results because she is planning to make changes based on the your presentation. You have 10 minutes to decide what to do.
results. Based on this discussion, your report clearly identifies
Further reading and questions for
several strengths and weaknesses that need to be addressed. FURTHER READING AND QUESTIONS FOR CRITICAL ANALYSIS
critical
For example, analysis
employees atfeel
the thatend
they are each too hard and SOLVING THE CHALLENGE
ofworking
What would you do?
chapter ask students to think more
that management does not care about providing good customer
TO ANSWER THESE questions you will need to do further to other people). In this context, the earlier contribution of Fayol
service. At the meeting you will be presenting the results and 1. Deliver the presentation as planned.
deeply and critically
your interpretations to a group about specific
of 15 managers.
research beyond reading the chapter. Useful references are in outlining the main purposes of management is considered to
You have known 2. Give the presentation but skip over the negative results.
given below each section of the questions to guide your still be of relevance, although it provides limited understanding
issues thatmanagers
most of these affect
kin69849_ch01_001-042.indd 36 management
for at least five years. 3. Go
literature back to the meeting room and announce that
research. your10:33 AM
07/27/17
of how managerial jobs are affected by the environment in
practice.
You arrive for These questions
the presentation armed identify that and
with slides, handouts spouse has had an accident at home and you must leave which managers work.
specific recommendations. Your slides are loaded on the computer This immediately.
chapter has You
introduced tell the yougroup to that
how you Henryjust received
Mintzberg this
practical dilemmas can sometimes be
and most of the participants have arrived. They are drinking changedmessage the perceptionand that you of awillmanager’s
contact therole vice-president
by studying to 1. To understand what managers do, explain how it is necessary
to study both the activities performed by managers and the
ambiguous:
coffee and telling thereyou how is no rightthey
enthused answer.
are about hearing how theyschedule spent their a new meeting.
working day and classifying managerial
purposes of their activities.
activities
your presentation. You also are excited to share your insights. into decisional,
4. Invent interpersonal
other options. Discuss. and informational roles.
This gave a new insight into the activities involved in being a 2. As well as variation across the levels of management (first-
manager but did not distinguish between the things that people tier, middle and top), how would you expect the manager’s
called ‘manager’ do that contribute to the management of the role to vary with the extent to which the organisational
FURTHER READING AND QUESTIONS FOR CRITICAL ANALYSIS organisation (such as coordination and control) from the things environment is changing, such as through new technology,
they do that everyone in an organisation does (such as talking changes in market demand or new forms of competition?
TO ANSWER THESE questions you will need to do further to other people). In this context, the earlier contribution of Fayol
research beyond reading the chapter. Useful references are in outlining the main purposes of management is considered to
given below each section of the questions to guide your still be of relevance, although it provides limited understanding
literature research. of how managerial jobs are affected by the environment in
which managers work.
This chapter has introduced you to how Henry Mintzberg
kin69849_fm_i-xxxii.indd xxiii 1. To understand what managers do, explain how it is necessary 09/13/17 04:14 PM
changed the perception of a manager’s role by studying
kin69849_ch01_001-042.indd 38 07/27/17 10:33 AM
to study both the activities performed by managers and the
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kin69849_fm_i-xxxii.indd xxiv 09/13/17 04:14 PM

Another Random Scribd Document
with Unrelated Content
 General paralysis of the
5,248 648
insane
Other forms of mental
1,651 3,895
alienation
——— ———
Total 15,080 12,987

The contributory causes definitely showing mental diseases

constitute only 3.4 per cent of the whole number, and the death rate
for 1917, including both primary and contributory causes suggestive
of probable psychoses, was 37.2 per 100,000. This would indicate
that the number of deaths from mental diseases shown in the
primary causes represents only about fifty-three per cent of all
mental cases which are actual factors in determining the death rate
of the community. A comparison of these figures with the number of
cases dying in hospitals shows that they cannot be looked upon as
determining the percentage of the general population showing
psychoses. Of the 1,952 persons dying in the institutions for mental
diseases in Massachusetts in 1919, approximately nineteen per cent
showed the psychoses in the primary causes of death. This
percentage would probably be fairly constant throughout the
country. It is, of course, a well recognized fact that the death
certificate at best is not beyond suspicion and does not furnish
information regarding the cause of death which can be accepted
without question.
Dr. Richard C. Cabot[1] has made an elaborate study of errors in
diagnosis as shown by autopsies. His work shows the following
percentage of diagnostic accuracy:
 Per cent.
Diabetes mellitus 95
Typhoid fever 92
Aortic regurgitation 84
Lobar pneumonia 74
Cerebral tumor 72.8
Tubercular meningitis 72
 Gastric cancer 72
Mitral stenosis 69
Brain hemorrhage 67
Aortic stenosis 61
Phthisis, active 59
Miliary tuberculosis 52
Chronic interstitial nephritis 50
Hepatic cirrhosis 39
Acute endocarditis 39
Bronchopneumonia 33
Acute nephritis 16

It must be admitted that Cabot's findings are discouraging. They

are not so bad as they would seem, however, at first thought. Death
certificates, unfortunately, do not have the significance which they
should have. Physicians are well known to be entirely too careless in
their preparation and inclined to look upon them merely as legal
formalities which cannot readily be avoided. It is furthermore
difficult, as every doctor knows, to point to one immediate primary
cause of death in every instance. Very often there is a combination
of factors concerned and it is possible at practically every autopsy to
find lesions not represented in any way whatever in the death
certificate. It is unquestionably true that statistics of any kind must
be based on information some of which we know to be inaccurate.
This should not be used as an argument for discontinuing,
absolutely, our search for knowledge. It is merely a reason why our
clinical standards should be improved.
An exceedingly important contribution to our rather limited fund
of accurate information regarding the general health of the country
was the publication recently issued by the Metropolitan Life
Insurance Company[2] on the mortality statistics of wage earners
and their families. This covers a period of six years (1911 to 1916)
and represents a study of 635,449 deaths. The cases reported came
from every state in the union with the following exceptions:
Mississippi, North Dakota, South Dakota, Wyoming, Colorado, Texas,
Nevada, Arizona and New Mexico. Canada and many other localities
outside of the "Registration Area" of the United States Census
Bureau were included. The facts presented in this report are unique
in that they render available for the first time a careful and detailed
consideration of the diseases which may be looked upon as
representative of the industrial population of the country. The
various occupations shown in the order of their numerical
importance were as follows:—Laborers, teamsters, drivers and
chauffeurs, machinists, textile mill operatives, clerks, office
assistants, etc. It covers a study of ten million policy holders and
nearly fifty-four million years of life in the aggregate. The age
groups studied range from one year to seventy-five in ratios not very
different from those exhibited in the general population. The death
rate for all persons exposed was 11.81 per 1,000 as compared with
a rate of over thirteen per 1,000 (white) of the general population of
the registration area during the same period of time. The death rate
per 100,000 from 1911 to 1916 of some of the more important
general diseases was as follows:

Typhoid fever 16.8

Diphtheria and croup 24.3
Scarlet fever 8.6
Acute articular rheumatism 6.3
Diabetes 14.4
Cancer and other malignant tumors 70.0
Bronchopneumonia 30.2
Diarrhea and enteritis (over two years old) 13.9
Cirrhosis of the liver 15.0
Puerperal septicemia 8.1
Accidents of all forms 75.1
Ill-defined diseases 10.1
Measles 8.9
Influenza 15.0
Tuberculosis (all forms) 205.1
Tuberculosis (pulmonary) 173.9
Alcoholism 4.7
 Diseases of the arteries, including atheroma,
17.0
aneurysm, etc.
Pneumonia (lobar and undefined) 77.5
Intestinal obstruction 5.9
Bright's disease 96.8
Suicide 12.2
Homicide 7.0

The death rate for syphilis, locomotor ataxia and general

paralysis of the insane, combined, was 14.3 per 100,000. The
percentage of deaths due to diseases of the nervous system, many
of which must be looked upon as probably having been associated
with mental disturbances, is somewhat surprising, as shown by the
following table:

Encephalitis 1.0
Meningitis 7.8
Locomotor ataxia 1.5
Acute anterior poliomyelitis 3.5
Other diseases of the spinal cord 4.0
Cerebral hemorrhage (apoplexy) 68.1
Softening of the brain .9
Paralysis without specified cause 5.2
General paralysis of the insane 4.1
Other forms of mental alienation 1.4
Epilepsy 3.5
Convulsions (non-puerperal) .2
Chorea .2
Neuralgia and neuritis .6
Other diseases of the nervous system 2.5

This shows a total rate of 104.5 per 100,000 due to diseases of

the nervous system. If to this we add those dying of senility and the
suicides as probably representing psychoses it would bring the total
up to 123.2 per 100,000. It must be confessed, however, that such
speculations mean comparatively little.
 Practically the only other source of information at our disposal
relative to the incidence of general diseases in the community is the
tabulation of communicable diseases by Boards of Heath. The
annual report of the United States Public Health Service for 1919
shows a case rate for diphtheria of 137 per 100,000 of the
population based on the reports of thirty-seven states. The case rate
for measles in thirty-seven states was 170. Poliomyelitis in thirty
states showed a rate of 2.5 and scarlet fever a rate of 110 in thirty-
seven states. The smallpox rate was sixty-eight and represented
thirty-six states. The typhoid fever rate for thirty-seven states was
only forty. The case rate for tuberculosis, all forms, was 346.7 in
1918. It was 274.2 in New York, 271.6 in the District of Columbia
and 271.3 in New Jersey. These were the highest reported in the
United States during that year. Unfortunately these statistics relate
to communicable diseases only. This difficulty is due largely to the
fact that comparatively few states have made attempts to keep
elaborate records. The reports of Massachusetts are probably as
comprehensive as any. The case rate per 100,000 of the population
of all reportable diseases during the year 1920 was as follows:

Influenza 938.5
Measles 830.7
Pneumonia, lobar 143.6
German measles 12.5
Pulmonary tuberculosis 173.1
Tuberculosis, other forms 20.7
Diphtheria 194.2
Gonorrhea 186.7
Whooping cough 258.3
Scarlet fever 265.2
Chicken pox 138.4
Mumps 154.1
Syphilis 77.2
Ophthalmia 42.3
Typhoid fever 24.2
Dysentery 1.0
Epidemic cerebrospinal meningitis 4.7
 Malaria 1.6
Pellagra .4
Smallpox .7
Trachoma 2.2

The case rates for influenza and pneumonia cannot be looked

upon as representative, owing to the epidemic of 1919 and 1920.
During 1917 the death rate from influenza was 12.9 per 100,000 and
from pneumonia 163.8. The death rate from heart diseases (organic
diseases of the heart and endocarditis) in Massachusetts in 1920
was 178 per 100,000 of the population, from apoplexy 108.4, cancer
and other malignant diseases 116.7, Bright's disease and nephritis
92.4, diarrhea and enteritis 52.9, violence 76.3, automobile
accidents and injuries 11.9 and suicides 10.1.
It must be admitted that it is exceedingly difficult to establish a
definite basis for a comparison of our statistics relating to mental
disorders and those dealing with the frequency of other diseases in
the community. As has been shown, our information on the latter
subject, such as it is, has to do only with communicable diseases
and the reported death rates. In making an analysis of the reports of
mental diseases we are limited almost entirely to the institution
population. It is true that these statistics are much more reliable
than the others, as we are dealing with a stable population entirely
under control. The cases, furthermore, are almost invariably subject
to a prolonged observation and careful study. The diagnosis in
almost every instance is based on elaborate mental examinations
and exhaustive personal and family histories. It is, of course, true
that there are innumerable cases of mental diseases outside of
institutions. There were 18,268 patients at home on visit from the
state hospitals alone on January 1, 1920. Those not requiring
hospital treatment or custody in an institution can, however, be
eliminated for the purpose of comparative studies. The fact that an
analysis of death rates alone does not throw any light whatever on
the frequence of psychoses for reasons already given will, I think, be
conceded. For statistical purposes, at least, it may be assumed that
the frequence of mental diseases as shown by a study of the
hospital population is fairly representative of conditions existing in
the community.
For purposes of comparison we may contrast the admission rate
of mental diseases per 100,000 of the population in Massachusetts
in 1920 with the case rate of communicable diseases as follows:

Mental diseases 101.7

Chicken pox 138.4
Diphtheria 194.2
German measles 12.5
Gonorrhea 186.7
Measles 830.7
Mumps 154.1
Scarlet fever 265.2
Syphilis 77.2
Tuberculosis, pulmonary 173.1
Tuberculosis, other forms 20.7
Typhoid fever 24.2
Whooping cough 258.3

The total institution population (mental cases) at the end of the

year 1920 represented a rate of 395.49 per 100,000 of the
population. It should be borne in mind that, with the exception of
tuberculosis and syphilis, the communicable diseases reported above
represent, as a rule, the total number of cases in the state during
the year. Comparative studies should, therefore, be based not on the
number of mental cases in the hospitals at any one given time, but
on the total number under treatment during the year. This would
indicate an incidence of mental diseases of 566.98 per 100,000 of
the population.
On January 1, 1916, there were 147 state and federal institutions
for the care and treatment of mental diseases in the United States,
as shown by the Census Bureau reports. There were at this same
time twenty-seven institutions for the feebleminded, nine for
epileptics, three for inebriates, forty-five for tuberculosis, twenty-
eight for the blind, thirty-three for the deaf, twelve for the blind and
deaf and eighty-four for the dependent classes. [3]
The appropriations for the maintenance of these institutions for
1915 amounted to $33,557,058.29. This constituted 7.6 per cent of
the appropriations made by those states for all purposes. In
Massachusetts it represented 14.8 per cent, in New Hampshire 10.1,
in New York 12.7, in Ohio 12, in Indiana 10.7, in Illinois 13.4, and in
a number of other states over ten per cent of the appropriations for
all purposes. It was equivalent to an average of $431.16 per million
of the total assessed valuation of these states. In Massachusetts it
was as high as $653.62 and in New York $567.37. This means thirty-
three cents per capita for all states, eighty-four cents for
Massachusetts and sixty-eight cents for New York.
The actual expenditure for the maintenance of these institutions
was $36,312,662.20. For purposes of comparison, attention should
be called to the fact that the maintenance of the tuberculosis
hospitals of the United States for the same year cost $3,539,454.95,
institutions for criminals $21,244,892.00, for the feebleminded
$3,341,442.85, for epileptics $1,345,821.57, for the blind
$1,066,973.14, for the deaf $1,893,490.09 and for the dependent
classes $9,675,932.37.
The value of the property invested in the state and federal
hospitals for mental diseases in 1916 was estimated at
$187,028,728.00. The valuation of these institutions per 100,000 of
the population was $184,795.81. This does not include
establishments for mental defectives. The average value per patient
was $938.43. In Massachusetts it was $1,097.85 and in New York
$1,039.85. In Arkansas it was as high as $2,264.00. The total
acreage of land was 109,503.2, an average of 744.9 acres per
hospital. There were 33,124 persons employed, an average of 226.9
for each institution. This represented one employee for every six
patients.
The census taken by the National Committee for Mental Hygiene
[4] in 1920 shows 156 state hospitals for mental diseases, two
federal institutions, 125 county or city hospitals and twenty-one
institutions of a temporary care type. In the public and private
hospitals for mental diseases on January 1, 1920, there were
232,680 patients under treatment. Of these, 200,109 were in public
and 9,238 in private hospitals. This represented an increase of 8,723
in two years. It is interesting to note that city and county institutions
cared for 21,584 persons.
The first authoritative information relative to the institution care
of mental diseases was obtained from the federal census reports of
1880. In that year there were 40,942 patients in the public hospitals.
In 1890 there were 74,028; in 1904, 150,151; in 1910, 187,791; in
1917, 232,873 and in 1918, 239,820. The rate per 100,000 of the
population increased from 81.6 in 1880 to 229.6 in 1918. From 1910
to 1918 the general population increased 13.6 per cent and the
hospital population 27.7 per cent. The rate per 100,000 of the
population in institutions in Massachusetts[5] on January 1, 1920,
was 373.8, in New York 374.6, in Connecticut 317.8, in Iowa 248.1,
in Wisconsin 300.6, in California 297.2, in Pennsylvania 215.2, in
Ohio 212.1, in Illinois 229.5 and in Michigan 210.8. The admission
rate per 100,000 of the population in 1917 was 151.6 in
Massachusetts, 109.2 in Illinois, 124.8 in Montana, 97.3 in New York,
80.9 in Connecticut and 85.7 in California.
The cost of maintenance in the state hospitals increased to
$43,926,888.88 in 1917 with an average per capita cost of $207.28.
The number of cases cared for in some of the more populous states
is of interest. On January 1, 1920, the institution population of New
York was 38,903, Pennsylvania 18,764, Ohio 12,217, Illinois 14,884,
Massachusetts 14,399 and California 10,184.
Based on the estimated population of Massachusetts on July 1,
1920 (3,869,098), the 1,475 deaths in institutions for mental
diseases would represent a death rate of 38.12 per 100,000 of the
population. The death rate for other diseases for that year was:
diphtheria 15.4, measles 9.0, pulmonary tuberculosis 96.7, typhoid
fever 2.5, whooping cough 14.0, scarlet fever 5.5, syphilis 5.8, lobar
pneumonia 71.9 and influenza 43.9. The importance to be attached,
however, to such comparisons is very uncertain at best. From the
standpoint of social and economic importance to the community
there is another factor under consideration which should not be
overlooked. The duration of other diseases, as a general rule, is
comparatively short. A study of over ten thousand deaths in New
York state hospitals for mental diseases shows the average hospital
residence of these cases to have been over six years. At the rate of
admission to public institutions for 1917 (62,898) and the average
per capita cost for that year ($207.28) the care of persons admitted
annually, during their years of hospital life, would mean an
expenditure of over seventy-eight millions of dollars.
If we figured the earning capacity of the 62,000 persons
admitted to institutions for mental diseases in the United States as
averaging only one thousand dollars per year, it would represent an
economic loss to the country of sixty-two millions of dollars annually.
Estimated in the same way, the total population of the hospitals
would represent the staggering sum of nearly two hundred and forty
million dollars. This, of course, does not take into consideration at all
the cost of maintenance or the property investment represented by
hospitals.
To avoid any possibility of confusion, no reference has been
made heretofore to statistical studies of mental deficiency or
epilepsy. From a public health point of view, however, and as social
and economic problems, they are questions which cannot be
disregarded in a consideration of mental diseases. As a matter of
fact, they are very closely correlated in many ways. A survey made
by the National Committee for Mental Hygiene shows that on
January 1, 1920, there were in this country thirty-two state
institutions for mental defectives, eleven admitting both
feebleminded and epileptics and twenty exclusively for the latter
class. [6] In addition to this, one city institution was reported. Of the
private hospitals twenty-seven care for the feebleminded only, and
six for epileptics, while nineteen admit either of these classes. The
total number of mental defectives in institutions on January 1, 1920,
was 40,519. At that time 34,836 were in state, 2,732 in other public
institutions and 2,951 in private hospitals. In the following states
they are cared for in hospitals for mental diseases, no other
provisions having been made for their treatment:—Alabama, Arizona,
Arkansas, Florida, Louisiana, Mississippi, Nevada, South Carolina,
Tennessee, Utah and West Virgina. The states reporting the largest
number are New York 5,762, Pennsylvania 4,281, Massachusetts
3,192, Illinois 3,147, Ohio 2,435, Michigan 1,849, Iowa 1,704, New
Jersey 1,762, Wisconsin 1,624, Minnesota 1,502, Indiana 1,264 and
Missouri 1,047. At the same time there were 14,937 epileptics under
treatment, 13,223 in state, 859 in other public institutions and 855
in private hospitals. Colorado, Delaware, Georgia, Nebraska, New
Mexico and Washington take care of the epileptics in their hospitals
for mental diseases. The intimate relation between mental diseases
and epilepsy is shown by the fact that as nearly as can be
determined at this time approximately thirty per cent of all of the
epileptics in our state institutions have been committed as insane.
This, however, nowhere nearly includes all of the cases which
actually show mental disorders of one kind or another. The states
showing the largest numbers of epileptics are New York with 1,683,
Ohio 1,680 and Massachusetts 1,227. No other states report over
one thousand, although Michigan and Pennsylvania have over eight
hundred and Illinois and Missouri over seven hundred.
Although the incidence of mental as compared with other
diseases prevalent in the community cannot be established with
absolute accuracy, sufficient evidence has been presented to warrant
the statement that from the standpoint of the public health we are
dealing with no other problem of equal importance today. The state
care of mental defects, epilepsy, tuberculosis and the deaf, dumb
and blind is, for various reasons, of much less consequence to the
community than the hospital treatment of mental diseases. The
defective, delinquent, criminal and dependent classes combined do
not equal in number the population housed in our state hospitals for
mental diseases. Nor does the number of cases cared for in the
general hospitals of the state, county or municipal type compare in
any way with the mental cases coming under state or federal
supervision. It can, I think, be said without any fear of contradiction
that no other disease or group of diseases is of equal importance
from a social or economic point of view. Perhaps nothing emphasizes
this fact more strongly than the report recently issued from the
Surgeon General's office relative to the second examination of the
first million recruits drafted in 1917. Twelve per cent of these were
rejected on account of nervous or mental diseases. The number
disqualified for service finally reached a total of over sixty-seven
thousand.
Mental integrity is now looked upon as a military necessity and is
insisted upon as one of the important requirements of the soldier. It
has been demonstrated conclusively that only men of the most
stable mental equilibrium can withstand the stress and strain of
modern methods of warfare. Nor are peacetime requirements any
less exacting. In commercial competition the law of the survival of
the fittest is practically absolute. The feebleminded often inherit
wealth, but they rarely acquire it. Vaccination for the prevention of
smallpox is compulsory and the isolation of communicable diseases
dangerous to the public welfare is rigidly enforced. At the same time
we allow many paranoics the freedom of the country and they
occasionally assassinate a President. Psychopaths are not
infrequently elected to public office and epileptics are not
disqualified from driving high-powered and dangerous motor
vehicles. The engineers of our fastest trains must not be color blind,
but they occasionally are victims of the most fatal of all mental
diseases,—general paresis. The navigating officer of a transatlantic
liner, responsible for the lives of hundreds of passengers, must pass
an examination for a license, but he may be dominated by delusions
which escape observation because they are not looked for. Important
trials, where human lives were at stake, have been presided over by
insane judges. Army officers in command of troops in time of war
have been influenced by imaginary voices. Insurance companies
issue large policies to individuals suffering from incipient mental
diseases which could be detected by even a superficial psychiatric
examination.
 Serious consideration should be given to the advisability of
subjecting to a careful mental examination such persons, at least, as
are to be charged with an entire responsibility for the lives of others.
It is a question as to whether this procedure is not indicated in the
case of other important public trusts where the interest of the
community should be safeguarded.
The correlation of psychiatry and psychology as scientific aids to
industrial efficiency promises to open up entirely new and important
sociological fields of research which have only recently attracted
attention. [7] This is a subject of far reaching importance. The extent
to which the industrial classes of the country are affected is shown
by the following analysis of the occupations represented by 104,013
admissions to New York state hospitals: 1. Professional—(clergy,
military and naval officers, physicians, lawyers, architects, artists,
authors, civil engineers, surveyors, etc.) 1,926 or 1.8 per cent; 2.
Commercial—(bankers, merchants, accountants, clerks, salesmen,
shopkeepers, shopmen, stenographers, typewriters, etc.) 7,572 or
7.2 per cent; 3. Agricultural—(farmers, gardeners, etc.) 5,942 or 5.7
per cent; 4. Mechanics—at Outdoor Vocations—(blacksmiths,
carpenters, enginefitters, sawyers, painters, etc.) 8,564 or 8.2 per
cent; 5. Mechanics at Sedentary Vocations—(bootmakers,
bookbinders, compositors, tailors, weavers, bakers, etc.) 7,501 or 7.2
per cent; 6. Domestic Service—(waiters, cooks, servants, etc.)
21,037 or 20.2 per cent; 7. Educational and Higher Domestic Duties
—(governesses, teachers, students, housekeepers, nurses, etc.)
21,861 or 21 per cent; 8. Commercial—(shopkeepers, saleswomen,
stenographers, typewriters, etc.) 1,140 or 1.09 per cent; 9.
Employed at Sedentary Occupations— (tailoresses, seamstresses,
bookbinders, factory workers, etc.) 4,310 or 4.1 per cent; 10.
Miners, Seamen, etc., 581 or .56 per cent; 11. Prostitutes, 81 or .08
per cent; 12. Laborers, 12,962 or 12.4 per cent; No occupation,
7,820 or 7.5 per cent; Unascertained, 2,715 or 2.6 per cent. [8] This
certainly indicates an enormous economic loss to the community.
The intimate relation between mental diseases, alcoholism,
ignorance, poverty, prostitution, criminality, mental defects, etc.,
suggests social and economic problems of far reaching importance,
each one meriting separate and special consideration. These
problems, while perhaps essentially sociological in origin, have at the
same time an important educational bearing, invade the realm of
psychology and depend largely, if not entirely, upon psychiatry for a
solution.
 CHAPTER II

THE EVOLUTION OF THE MODERN HOSPITAL

The medical treatment of mental diseases had its inception, in
this country, in the wards of the Philadelphia Hospital, established in
1732 and referred to officially for over a century as an almshouse. It
included an infirmary for the "sick and insane," although it
apparently had no distinct and separate hospital department for
many years. "In 1742," to use the words of Dr. D. Hayes Agnew, "it
was fulfilling a varied routine of beneficent functions in affording
shelter, support and employment for the poor and indigent, a
hospital for the sick, and an asylum for the idiotic, the insane and
the orphan. It was dispensing its acts of mercy and blessing when
Pennsylvania was yet a province and her inhabitants the loyal
subjects of Great Britain." In 1772 it housed as many as three
hundred and fifty persons. In 1769 the General Assembly passed an
act authorizing the "Managers of the Contributions for the Relief and
Employment of the Poor," who had charge of the almshouse, to issue
bills of credit for the purpose of relieving their indebtedness. This
paper currency was issued in three denominations—one shilling, two
shillings and a half crown. The law provided that counterfeiters or
persons altering the denomination of these bills should be
"sentenced to the pillory, have both his or her ears cut off and nailed
to the pillory and be publicly whipped on his or her back with thirty-
nine lashes, well laid on, and, moreover, every such offender shall
forfeit the sum of one hundred pounds, to be levied on his or her
land, tenements, goods and chattels." [9] This certainly must have
discouraged counterfeiting. It was not until after the institution was
removed to the Hamilton estate in Blockley (now a part of West
Philadelphia) in 1834 that it came to be known as the "Philadelphia
Hospital and Almshouse," although there was no change made in its
organization or functions. In 1902, after one hundred and seventy
years of continuous existence, it was finally divided officially for
administrative purposes into The Philadelphia Home or Hospital for
the Indigent, The Philadelphia General Hospital and The Philadelphia
Hospital for the Insane. At that time the hospital was, as it is today,
the largest on the American continent. The institution, which has
admitted mental cases uninterruptedly since 1732, had over
seventeen hundred patients in the department for the insane. In
1917 this number had increased to nearly three thousand.
One of the reasons set forth by sundry petitioners in 1751 for a
"small Provincial Hospital" in Philadelphia, which at that time had
made provision for the care of indigent cases only, was "THAT with
the Numbers of People, the Number of Lunaticks or Persons
distempered in Mind and deprived of their rational Faculties, hath
greatly increased in this Province. That some of them going at large
are a Terror to their Neighbours, who are daily apprehensive of the
Violences they may commit; And others are continually wasting their
Substance, to the great Injury of themselves and Families, ill
disposed Persons wickedly taking Advantage of their unhappy
Condition, and drawing them into unreasonable Bargains, etc. That
few or none of them are so sensible of their Condition, as to submit
voluntarily to the Treatment their respective Cases require, and
therefore continue in the same deplorable State during their Lives;
whereas it has been found, by the Experience of many Years, that
above two Thirds of the Mad People received into Bethlehem
Hospital, and there treated properly, have been perfectly cured." [10]
This resulted eventually in the opening of the Pennsylvania Hospital
in 1752. This institution is a general hospital supported by private
funds and has always received mental cases. A separate department
for mental diseases was established in West Philadelphia in 1841.
Before this was done considerable difficulty was experienced on
account of the annoyance of the patients by curious-minded citizens
of the neighborhood. This developed into such a nuisance in 1760
that it was suggested "That a suitable Pallisade Fence, either of Iron
or Wood, the Iron being preferred, shall be erected in Order to
prevent the Disturbance which is given to the Lunatics confined in
the Cells by the great Number of People who frequently resort and
converse with them." [11] It was also deemed advisable to employ
"Two Constables or other proper Persons, to attend at such times as
are necessary to prevent this Inconvenience until ye Fence is
erected." The public was notified later "that such persons who come
out of curiosity to visit the house should pay a sum of money, a
Groat at least, for admittance." [12] The Pennsylvania Hospital has
played a very important part in the history of the care and treatment
of mental diseases in this country. In 1919 it had over three hundred
patients.
The first institution designed and used exclusively for mental
diseases in this country was the Eastern State Hospital at
Williamsburg, Virginia. It was incorporated by the House of
Burgesses in 1768 and opened for patients on October 12, 1773. It
is interesting to note that the act of incorporation, except in the title,
makes no use of the word lunatic, refers frequently to the care and
treatment of the patients, authorizes the appointment of physicians
and nurses, and specifically designates the institution as a hospital
and not an asylum. The original building was one hundred feet long
by thirty-two feet two inches wide. During the first year thirty-six
patients were admitted. The first pay patient was received in 1774 at
a rate of fifteen pounds per annum. An allowance of twenty-five
pounds per year was made by the legislature for the maintenance
and support of each person admitted. Visiting physicians prescribed
for the patients, and the "keepers" for the first few years were not
graduates in medicine. The superintendents were, however,
physicians after 1841. Known for many years as the "Publick
Hospital," the legislature made the mistake of changing this
designation to The Eastern Lunatic Asylum in 1841 and it was not
until 1894 that it again officially became a hospital. Virginia opened
its second institution, The Western State Hospital for the Insane, at
Staunton on July 25, 1828. Its third hospital was opened at Weston
on September 9, 1859. Virginia is thus entitled to the credit of being
the first commonwealth to furnish state care for mental cases and
make adequate provision for them.
The next step in the evolution of hospital treatment of mental
diseases was taken by Maryland in incorporating a hospital for "The
Relief of Indigent Sick Persons and for the Reception and Care of
Lunatics" in 1797. The hospital was formally opened in 1798 under
the management of the city of Baltimore, which leased the
establishment in 1808 to two physicians, who conducted it as a
private institution until 1834. It then reverted to the state and was
operated as the Maryland Hospital. The institution was removed to
Catonsville in 1872 and is now known as the Spring Grove State
Hospital, the Johns Hopkins Hospital occupying the site of the
original building in Baltimore. Another interesting event in the history
of this institution was the founding of what subsequently became
the Mount Hope Retreat by the Sisters of Charity, who withdrew
from the Maryland Hospital in 1840.
The earliest hospital care of mental diseases in New York was in
the wards of the New York Hospital which was opened in 1791. A
separate building for mental cases was ready for the reception of
patients in 1808. The total number of cases treated up to July 1820
was 1,553. The Bloomingdale Asylum replaced this in 1821, on a
piece of property which now belongs in part to Columbia University.
Public patients were cared for at the expense of the state until the
opening of the New York City Asylum in 1839. Church services were
inaugurated in 1819. The hospital buildings furnished
accommodations for about three hundred patients. In 1894 the
property on Bloomingdale Road was abandoned and the hospital
removed to White Plains in Westchester County. It is still known as
the Bloomingdale Hospital and is supported entirely by public
contributions and the income derived from the care of patients. It
has about three hundred and fifty beds.
The activities of the "Religious Society of Friends," which were
indirectly responsible probably for the inception of the Pennsylvania
Hospital, ultimately led to the establishment of the Friends' Asylum
for the Insane at Frankford, Pennsylvania, in 1817. It was under
sectarian control until 1834, when its doors were thrown open to all,
without regard to religious belief. It claims to be the first institution
"erected on this side of the Atlantic in which a chain was never used
for the confinement of a patient." [13] The hospital is still in a
flourishing condition and has accommodations for over two hundred
patients.
Massachusetts at the beginning of the nineteenth century had no
hospitals of any kind. In 1764, on the death of Thomas Handcock, it
was found that provision had been made in his will for the
establishment of a hospital for mental diseases in Boston. An
expenditure of six hundred pounds was authorized for the purpose
of "erecting and furnishing a convenient House for the reception and
more comfortable keeping of such unhappy persons as it shall please
God, in His Providence, to deprive of their reason in any part of this
Province." [14] The Selectmen of Boston declined this legacy on the
grounds that there were not enough mental cases in the vicinity to
warrant the existence of such an establishment. This proved to be
an error of judgment on their part. In 1811 the Massachusetts
General Hospital was incorporated and a fund of over $93,000 was
subscribed for building purposes. As it was deemed more urgent, the
department for mental diseases in Charlestown was opened first. It
was ready for the reception of patients on October 6, 1818, when it
admitted a young man supposed to be possessed of a devil. This
department became the McLean Asylum in 1826 as the result of a
legacy of $25,000 left to the institution by a Boston merchant of that
name. The corporation finally received in all an amount
approximating $120,000 from the McLean estate. As early as 1822
the first published report of the hospital[15] called attention to the
fact that the various amusements offered the patients included
"draughts, chess, backgammon, ninepins, swinging, sawing wood,
gardening, reading, writing, music, etc." A carriage and pair of
horses for the use of patients was purchased in 1828. In 1835 the
first pianos and billiard tables were installed and a library of one
hundred and twenty volumes placed in the wards. Hot water heating
was introduced in 1848. It is interesting to note that in 1827 the
visiting committee reported that the rates for the maintenance of
patients should not be less than three dollars or more than twelve
dollars per week. In 1882 the McLean Hospital established the first
training school for nurses connected with any institution for mental
diseases in this country. The first class was graduated in 1886. In
1895 the hospital was removed to Waverley, Massachusetts. A
chemical laboratory was opened in 1900 and a psychological
laboratory in 1904. Hydrotherapy was first used in 1899, and a
gymnasium was built in 1904. In 1913 the hospital owned three
hundred and seventeen acres of land and had a capacity of two
hundred and twenty beds, with a plant valued at nearly two million
dollars.
The first provision for the care of mental diseases in Connecticut
was a direct result of the activities of the State Medical Society. It
was on their petition that the Hartford Retreat was chartered in
1822. Over two thousand persons subscribed to a fund for the
opening of the hospital. These subscriptions included "$30 payable
in medicine," "One gross New London bilious pills, price $30" and
two lottery tickets. [16] About fourteen thousand dollars was
subscribed in all, the citizens of Hartford contributing four thousand.
The hospital building, designed to accommodate forty patients, was
opened on April 1, 1824, and has always been conducted on an
unusually high plane. It now averages about one hundred and
seventy-five patients.
Mental cases were first provided with hospital care in Kentucky
when the Eastern State Hospital was opened in Lexington on May 1,
1824. Governor Adams, who suggested the establishment of this
institution, in a message written in 1821 expressed the opinion that
it would be of great benefit to the students of Transylvania
University, "which would in time repay the obligation by useful
discoveries in the treatment of mental maladies."
The State Hospital at Columbia, South Carolina, was opened in
December, 1828. A curious fact in connection with its history is that
in 1829 the management, having received no patients as yet,
advertised for them in the newspapers of South Carolina and
adjoining states.
In 1829 the necessity of making further provision for mental
diseases in Massachusetts became the subject of a legislative
investigation and a committee was appointed "to examine and
ascertain the practicability and expediency of erecting or procuring,
at the expense of the Commonwealth, an asylum for the safe
keeping of lunatics and persons furiously mad." [17] The report of
this committee, of which Horace Mann was Chairman, is exceedingly
interesting. The following is an illustration:—"To him whose mind is
alienated, a prison is a tomb, and within its walls he must suffer as
one who awakes to life in the solitude of the grave. Existence and
the capacity for pain alone are left him. From every former source of
pleasure or contentment he is violently sequestered. Every former
habit is abruptly broken off. No medical skill seconds the efforts of
nature for his recovery, or breaks the strength of pain when it seizes
him with convulsive grasp. No friends relieve each other in solacing
the weariness of protracted disease. No assiduous affection guards
the avenues of approaching disquietude. He is alike removed from
all the occupations of health, and from all the attentions everywhere
but within his homeless abode bestowed upon sickness. The solitary
cell, the noisome atmosphere, the unmitigated cold and the
untempered heat, are of themselves sufficient soon to derange every
vital function of the body, and this only aggravates the derangement
of his mind. On every side is raised up an insurmountable barrier
against his recovery. Cut off from all the charities of life, endued with
quickened sensibilities to pain, and perpetually stung by annoyances
which, though individually small, rise by constant accumulation to
agonies almost beyond the power of mortal sufferance; if his exiled
mind in its devious wanderings ever approach the light by which it
was once cheered and directed, it sees everything unwelcoming,
everything repulsive and hostile, and is driven away into returnless
banishment." [18] The investigation conducted by this committee led
to the establishment of the Worcester Lunatic Hospital, later the
Worcester State Hospital, opened on January 19, 1833. The original
building was designed to care for one hundred and twenty patients.
After many years of agitation on the part of the public, the hospital
was removed to a site overlooking Lake Quinsigamond in the
outskirts of Worcester in 1877. It was soon found that it was
impracticable to dispense with the use of the old building on
Summer Street and it became the Worcester Insane Asylum, later
the Worcester State Asylum, and finally the Grafton State Hospital.
In 1919 it again became a part of the Worcester State Hospital. The
original building is in excellent condition today and promises an
indefinite continuation of an unusual career of usefulness. Many men
destined to occupy positions of importance in the psychiatric world
were trained within its walls.
The death of a prominent politician in 1806 is said to have led
indirectly to the establishment of the first hospital for mental
diseases in Vermont. [19] His medical advisers treated him for some
form of mental alienation by submerging him in water until he
became unconscious. It was thought that this "would divert his mind
and, by breaking the chain of unhappy associations, thus remove the
cause of his disease." As this plan failed he was given opium as "the
proper agent for the stupefaction of the life forces." In spite of this
vigorous treatment he died. The immediate event which made
possible the incorporation of the Vermont Asylum for the Insane in
1835 was a legacy of ten thousand dollars rendered available for this
purpose by the will of Mrs. Anna Marsh of Hinsdale. The hospital was
opened in Brattleboro in 1836 and became the Brattleboro Retreat
after the establishment of the State Hospital at Waterbury. The state
care of mental diseases began in Ohio with the establishment of the
Columbus State Hospital, which was opened on November 30, 1838.
This was the first of a number of institutions now under the
supervision of the Ohio Board of Administration.
The study of the development of the state hospital system of
care now takes us back to Massachusetts. Notwithstanding the fact
that the state already had two institutions for mental cases, McLean
and the Worcester Lunatic Hospital, further accommodations were
urgently indicated. This was largely on account of the needs of the
metropolitan population centering in the city of Boston. To meet this
situation the city established a hospital of its own in South Boston in
1839,—the first municipal institution for this exclusive purpose in
America. Originally known as the Boston Lunatic Hospital and
afterwards as the Boston Insane Hospital, it finally became the
Boston State Hospital in December, 1908. Charles Dickens on the
occasion of his visit to America was very profoundly impressed by
the hospital and made the following references to it in 1842 [20]:—
"At South Boston, as it is called, in a situation excellently adapted for
the purpose, several charitable institutions are clustered together.
One of these is the hospital for the insane; admirably conducted on
those enlightened principles of conciliation and kindness which 20
years ago would have been worse than heretical, and which have
been acted upon with so much success in our own pauper asylum at
Hanwell...." "At every meal, moral influence alone restrains the more
violent among them from cutting the throats of the rest; but the
effect of that influence is reduced to an absolute certainty, and is
found, even as a measure of restraint, to say nothing of it as a
means of cure, a hundred times more efficacious than all the straight
waistcoats, fetters and handcuffs that ignorance, prejudice and
cruelty have manufactured since the creation of the world." ... "In
the labor department every patient is as freely trusted with the tools
of his trade as if he were a sane man. In the garden and on the farm
they work with spades, rakes and hoes. For amusement they walk,
run, fish, paint, read, and ride out to take the air in carriages
provided for the purpose. They have among themselves a sewing
society to make clothes for the poor, which holds meetings, passes
resolutions, never comes to fisticuffs or bowie-knives as sane
assemblies have been known to do elsewhere; and conducts all its
proceedings with the greatest decorum. The irritability which would
otherwise be expended on their own flesh, clothes and furniture is
dissipated in these pursuits. They are cheerful, tranquil and healthy."
... "It is obvious that one great feature of this system is the
inculcation and encouragement, even among such unhappy persons,
of a decent self-respect." The institution was removed to the
Dorchester district of Boston in 1895, where it now houses in the
neighborhood of two thousand patients. The Boston State Hospital
was the first institution of its kind in the United States to establish a
separate psychopathic department, which was opened in 1912.
 Influenced doubtless by the attention given to this subject in
other states, Maine opened its first state hospital at Augusta in 1840.
There were between two and three hundred mental cases in the
state at that time. A second hospital was opened at Bangor in 1889.
This humanitarian movement naturally extended to New Hampshire.
Governor Dinsmore in 1832 [21] called attention to the condition of
the insane, seventy-six of whom were in confinement. Of this
number seven were in cells or cages, six in chains and irons and four
in jail. Of those not in confinement at the time, some had been
handcuffed previously, while others had been in cells or chained.
After much unavoidable delay the New Hampshire State Hospital
was opened at Concord on October 29, 1842. The next hospital
development appeared in Georgia. After an active campaign
inaugurated by the physicians of the state and continued for several
years, the Georgia State Sanitarium was opened in Milledgeville in
December, 1842. It now houses over four thousand patients.
By this time it became evident that further procedures on behalf
of the persons requiring treatment for mental diseases in New York
were imperative. The Bloomingdale Hospital, although taxed to its
utmost capacity, was not able to meet the needs of the situation. In
1830 the population of the state had increased to nearly two million.
The report of a legislative committee showed that there were 2,695
insane persons in the state in 1830, with hospital accommodations
at Bloomingdale and one other private hospital at Hudson for only
two hundred and fifty of these cases. An extensive system of state
care was inaugurated by the opening of the Utica State Hospital on
January 16, 1843. In addition to numerous other industries and
occupations, a printing office was established in the hospital and the
publication of the "American Journal of Insanity" was undertaken in
1844. This was the first journal in the world to be devoted
exclusively to the subject of mental diseases. "The Opal," edited,
published and printed by the patients of the hospital, was started at
the same time. In the early days, strong rooms, padded cells and
mechanical restraint of all kinds were used extensively. The "Utica
Crib" has received a great deal of attention. This consisted of an
ordinary ward bed enclosed in wooden slats, making it impossible for
the patient to escape. These were eliminated for all time by Dr. G.
Alder Blumer in 1887. Attendants were first required to wear
uniforms in 1887. During the following year female nurses were
assigned for the first time to male wards. Annual field day exercises
for the benefit of the patients have been held since 1887. Baseball
games, steamboat excursions, Fourth of July celebrations and
Christmas entertainments have been in vogue since 1888. With the
development of a large department on the "Marcy" site, nine miles
from the city, the Utica State Hospital promises to add new
accomplishments to an already dignified history.
The early care of mental cases in Rhode Island, as shown by a
report to the legislature by Thomas R. Hazard in 1851, was perhaps
no worse than that of other states, although the conditions he
described so graphically have not been attributed to other New
England communities by historians. The following extract from a
codicil to the will of Nicholas Brown, who died in 1843, is proof of
the fact that this unfortunate state of affairs had not entirely
escaped notice [22]:—"And whereas it has long been deeply
impressed on my mind that an insane or lunatic hospital or retreat
for the insane should be established upon a firm and permanent
basis, under an act of the Legislature, where that unhappy portion of
our fellow beings who are, by the visitation of Providence, deprived
of their reason, may find a safe retreat and be provided with
whatever may be most conducive to their comfort and to their
restoration to a sound state of mind: Therefore, for the purpose of
aiding an object so desirable and in the hope that such an
establishment may soon be commenced, I do hereby set apart and
give and bequeath the sum of $30,000 towards the erection or
endowment of an insane or lunatic hospital or retreat for the insane,
or by whatever other name it may be called, to be located in
Providence or its vicinity." Supplemental contributions by Cyrus
Butler made it possible for the incorporators to found the Butler
Hospital in Providence. The first patients were received on December
1, 1847.
 More than any other one person, Miss Dorothea L. Dix of
Massachusetts was undoubtedly directly responsible for the
inauguration of the state care of mental diseases in this country. She
is credited with having memorialized twenty-two different state
legislatures on this subject. One of her first accomplishments
consisted in inducing the New Jersey legislature to make an
appropriation for the establishment of the state hospital at Trenton.
This institution was opened in 1848, after some of the hardest
campaigning that Miss Dix conducted. The last years of her life were
spent as an honored guest of the hospital and she died there in
1887 at the advanced age of eighty-five.
Indiana inaugurated a system of state care by the establishment
of the Central Hospital for the Insane in 1848. The East Louisiana
Hospital at Jackson was opened in the same year. Missouri made its
first provision for mental cases by opening a hospital at Fulton in
1852. Notwithstanding the fact that the first hospitals for mental
diseases in this country were located in Philadelphia, the
Commonwealth of Pennsylvania did not make any provision for a
state institution until the State Hospital at Harrisburg was opened in
1851. This was only undertaken after a vigorous campaign on the
part of Dorothea Dix had made some legislative action almost
imperative. This is probably the only hospital in the country which
has found it necessary to demolish all of the original buildings and
replace them by others. In 1847 Miss Dix visited Tennessee and
started a movement which resulted in the opening of The Central
Hospital for the Insane at Nashville, the first institution of the kind in
the state. California entered the state hospital field in 1853 with the
establishment of an institution at Stockton. The St. Elizabeths
Hospital in Washington, D.C., the first federal institution for mental
diseases, was opened for patients in 1855. It receives cases from the
United States Government Services and from the District of
Columbia. Dorothea Dix was largely instrumental in its origin. The St.
Elizabeths Hospital was an early invader of the field of scientific
research. A pathologist was appointed in 1883. It was one of the
first institutions to use hydrotherapy extensively. It now cares for
nearly four thousand patients. Mississippi established its first state
hospital for mental diseases in 1856, North Carolina in 1856, West
Virginia in 1859, Michigan in 1859, Wisconsin in 1860, Texas in 1861,
Kansas in 1866, Minnesota in 1866, Connecticut in 1868, Rhode
Island in 1870 and Vermont in 1891. The Sheppard and Enoch Pratt
Hospital, a well known private institution in Baltimore, was also
opened in 1891.
It is hardly worth while at this time to emphasize the fact that
the necessity of providing adequate facilities for the care and
treatment of mental diseases, a problem which received little
consideration of any kind for many years, gradually led to the
elaboration of an extensive system of state hospitals. These are to
be found now in every part of the country. They have long since
passed through the purely custodial stage and have developed into
highly specialized modern hospitals of most advanced type. Their
function is to provide proper treatment for persons who cannot for
financial or other reasons be cared for in the private hospitals which
are to be found in almost all localities. These institutions, originating
in Virginia in 1773, now represent one of the most important
activities conducted by any state government. The extent of the field
which they cover is illustrated by the fact that Kansas, Kentucky,
Nebraska, North Carolina, Oklahoma, Tennessee, Texas, Washington,
West Virginia and Wisconsin each maintain three state hospitals for
mental diseases; Iowa, Maryland, Missouri and Virginia each have
four institutions of this type, Minnesota five, California, Indiana and
Michigan six, Pennsylvania seven, Ohio and Illinois nine,
Massachusetts twelve and New York fifteen. In addition to this eight
other states have two hospitals each and seventeen find one such
institution sufficient for their needs. It is worthy of note that every
state without any exception has now recognized the necessity of
making provision for the care and treatment of mental diseases.
 CHAPTER III

LEGISLATION AND METHODS OF ADMINISTRATION

The administration of the earlier hospitals for mental diseases
was placed very wisely in the hands of local boards of directors,
managers or trustees. These were made up of persons prominent in
the community in which they lived, well known as having a keen
interest in humanitarian movements, and fully deserving of the
confidence reposed in them by the public. They received no
compensation other than the satisfaction of having served in a
worthy cause. The state hospital at Williamsburg, Virginia, the first
of its kind in America, was controlled by a court of directors which
was made up of some of the most prominent Virginians of colonial
days. It included Thomas Nelson, Jr., a signer of the Declaration of
Independence who served with distinction in the Revolutionary War,
Peyton Randolph, the President of the first Continental Congress,
and George Wythe, the preceptor in law of both Marshall and
Jefferson, as well as a signer of the Declaration of Independence
and professor of law at William and Mary College, together with
various other distinguished citizens, some perhaps of less
prominence, but all men of the highest standing in Virginia. The first
"court" consisted of fifteen members. The second state institution,
the Maryland Hospital, under the management of the city of
Baltimore for some years, was eventually placed under the control of
a board of visitors in 1828. Kentucky's first hospital was from the
beginning in the charge of a board of ten commissioners. When the
second Virginia institution was opened at Staunton, the form of
organization adopted at Williamsburg was duplicated and a court of
directors appointed. There were, however, thirteen instead of fifteen
members. The state hospital at Columbia, South Carolina, was
originally, and still is, under a board of regents. The Massachusetts
hospitals, dating from the opening of Worcester in 1833, have
always had trustees. The Vermont Asylum, later the Brattleboro
Retreat, was also managed by a board of trustees, as was the New
Hampshire State Hospital at Concord. The Georgia State Sanitarium,
opened in the same year, adopted a similar form of control. The
Utica State Hospital has been conducted from the first by a board of
managers, a term which is generally used by the New York
institutions. When the Trenton State Hospital was founded it was
placed under a board of ten managers, more or less along the lines
followed at Utica. The State Hospital at Raleigh, North Carolina, had
a board of directors. For many years the earlier institutions for
mental diseases were under no other form of control, the powers of
the trustees being absolute. This is still the case in a few states.
Usually, however, there is some additional form of supervision.
Boards of trustees, managers, directors, or some other local
governing body, exist in the following states but without exclusive
control:—Alabama, California, Connecticut, Delaware, Georgia,
Idaho, Indiana, Louisiana (administrators), Maine, Maryland,
Massachusetts, Mississippi, Missouri, New Jersey, New Mexico, New
York, Pennsylvania, South Carolina (regents), Texas and Virginia. [23]
In the following states the hospitals have no local boards of any
kind:—Arizona, Arkansas, Colorado, Florida, Illinois, Iowa, Kansas,
Kentucky, Michigan, Minnesota, Montana, Nebraska, Nevada, New
Hampshire, North Carolina, North Dakota, Ohio, Oklahoma, Oregon,
Rhode Island, South Dakota, Tennessee, Utah, Vermont,
Washington, West Virginia, Wisconsin and Wyoming.[24]
As the state hospitals increased in number and importance, steps
were taken to coordinate their activities and for various obvious
reasons they were soon grouped together in departments. In the
states having a sufficient number of hospitals to warrant such a
procedure, separate specialized administrative units were established
under lunacy commissions, etc. In less populous communities where
there were only a few hospitals there soon developed a tendency to
associate them with the charitable, correctional and, in some
instances, penal institutions. Seventeen states, as has been shown,
now have only one hospital for mental diseases, eight have two and
ten only three institutions. This led either to placing the hospitals
under boards of charities and corrections or to the organization of
new departments known as boards of control. The hospitals for
mental diseases are under the supervision of boards of charities and
corrections in the following states:—Colorado, Connecticut, Indiana,
Louisiana, Maine, Nebraska, North Carolina, South Carolina, South
Dakota and Virginia. [24]
Boards of control exist in Arkansas, California, Iowa, Kentucky,
Minnesota, North Dakota, Oregon, Vermont, West Virginia and
Wisconsin. California has, in addition to this, a board of charities and
corrections and a commission in lunacy. Vermont has a director of
state institutions. In New Hampshire the board of trustees of the
state hospital constitutes a commission in lunacy. A number of states
have special departments for the supervision of hospitals for mental
diseases and in some instances for the control of all institutions.
Delaware has a board of supervisors of state institutions. This is
essentially a board of control. This is true of the board of
commissioners of state institutions in Florida. Illinois has a
department of public welfare, which places the control of the
charitable, penal and corrective institutions, as well as the hospitals
for mental diseases, largely in the hands of one man, a layman.
Michigan and Pennsylvania also have departments of public welfare.
Kansas has placed its hospitals under the control of a board of
administration of state charitable institutions. Maryland has a lunacy
commission and Missouri a board of managers. Montana and Nevada
each have a board of commissioners for the insane. New Jersey has
a state board of control of institutions and agencies, the direction of
the state hospitals being delegated to a commissioner of charities
and corrections. New York has the largest department in the country
having exclusive state hospital functions. It is under the supervision
of a hospital commission. Ohio has a board of administration which
manages and governs all of the charitable, corrective and penal
institutions of the state. This is, of course, a board of control pure
and simple. Oklahoma has a commissioner of charities and
corrections who is an elective officer, and has, in addition, a lunacy
commission and a board of public affairs. Rhode Island has a penal
and charitable commission of nine members. Utah has a board of
insanity and Wyoming a board of charities and reform.
Massachusetts has a department of mental diseases under the
direction of a medical commissioner, with four unpaid associates. In
addition to the hospitals for mental diseases the department has
under its jurisdiction the institutions for the feebleminded and the
epileptics.
The necessity of some form of central supervision or control, of
state institutions in general and hospitals for mental diseases in
particular, has long been a subject of serious consideration and
discussion. The administration of hospitals, prisons, reformatories,
etc., by a central board of control may be indicated in states where
there are only a few institutions and the creation of highly
specialized and expensive departments obviously would not be
warranted. The question may very properly be raised as to the
necessity of any supervision other than that by local boards of
trustees in such communities. A study of methods of supervision
made some years ago by the medical director of the National
Committee for Mental Hygiene [25] shows that the board of control
system leaves much to be desired. He has expressed himself on this
subject in no uncertain terms, as is shown by the following:—"Under
Boards of Control, politics influence the care of the sick to a degree
unknown under different types of supervision and the scientific and
humane aspects of the work undertaken are generally subordinated
to doubtful administrative advantages. With hardly an exception,
these Boards of Control have not endeavored to secure better
commitment laws, to lead public sentiment so that higher standards
of treatment will be demanded or to deal with the great problems of
mental disease in any except their narrowest institutional aspects.
There has been striking absence of evidences of any feeling of
personal responsibility in these matters; indeed many members of
these boards would doubtless unhesitatingly state that their duties
do not involve such considerations. What the results would have
been if efficient and fearless local boards of managers had been
retained when these states created Boards of Control cannot be
stated. It is an essential part of the policy which places the care of
the insane under this form of administration that there shall be no
"division of responsibility" and, seemingly, there is no place in such a
scheme for bodies which are as much interested in the personal
welfare of the wards of the State as they are in governmental
"efficiency" and, which, moreover, are directly accountable to their
neighbors—the friends and relatives of patients. It is interesting to
compare some of the conditions mentioned with those existing in
States in which the care of the insane is entrusted to Boards created
for that special purpose. In these States,—California, Maryland,
Massachusetts and New York,—it can be said truly that the care of
the insane reaches its highest level."
The experience of the past has shown that the injection of
politics into the administration of state institutions is almost
invariably due to the over-centralization of power in state
departments, the local boards of trustees or managers either being
abolished or largely deprived of their authority. The greatest menace
to the future welfare of the hospitals for mental diseases is, in the
opinion of many, the unfortunate result of a popular and more or
less legitimate demand for the reorganization of state governments,
reducing their administrative activities to a few separate
departments, each one under the entire charge of a director
responsible only to the Governor. The argument for this procedure is
that it does away with innumerable commissions, boards and
departments working along independent lines without any reference
to the desirability of coordinating the activities of the state as a
whole and places the affairs of the commonwealth on an efficient,
systematic and economical basis. There is no question as to the
theoretical advisability of such methods. The difficulty is, that in
putting into practical operation this unquestionably commendable
undertaking, the humanitarian aspect of the charitable enterprises
conducted by state governments for more than a century, is likely to
be lost sight of. It is almost invariably urged that the directors of
these various departments should be experienced business men of
recognized ability and that in only such a way can the affairs of the
state be put on a "businesslike basis." It must be confessed that this
argument is one which appeals very strongly to the taxpayer, who
naturally has not given the matter very careful thought. There are
other important considerations, however, where the question of
administering hospitals is involved. As Commissioner Kline [26] has
said:—"If it be conceded that the care and treatment of the mentally
sick is a highly specialized medical problem, requiring the services of
medical experts, and that the institutions function primarily for the
welfare of the patient, then the supervision and control of
institutions should be in the hands of medical men especially trained
for the purpose."
In some instances where the state governments have been
reorganized and the proposed consolidation of departments effected,
the administration of the state hospitals has come under the
direction of a single individual without hospital or institution
experience of any kind and without any special knowledge of
medicine or psychiatry. There is no escaping the fact that the
administration of a hospital is a medical problem. Nor is there any
question as to the advisability of some central supervision and
financial control of institutions. The hospital departments in our
more populous states are, however, so extensive and so important
that they cannot be merged with other interests without sacrificing
to a considerable extent the welfare of the patients. It should be
remembered, moreover, that the administration of hospitals for
mental diseases is a specialty and a large one, not specifically
related to the problems arising in the management of charitable
institutions or prisons. The best results have been obtained where
there is a division of responsibility between local boards of trustees
or managers and a central body charged with the supervision, and a
limited or complete financial control, of institutions for mental
diseases only. The head of such a department should unquestionably
be a medical man with psychiatric hospital experience. This policy
has been responsible for the high standards maintained in the state
hospitals of Massachusetts and New York.
It is, unfortunately, true that the care of mental diseases is not
exclusively a function of the state or private hospitals. In thirteen