Most workers in a psychiatric hospital are directly engaged in cure and care of patients. They have their own professional responsibilities. Strategic hospital management is a primary task for directors and heads of the departments. It is important to clearly mark the different managerial tasks.

Strategic management contains three focusses of attention, datacollection to make decisions, strengthening of the position of the hospital to survive and enhancement of the motivation of the stakeholders to choose for the hospital. In correspondence we distinguish a rational, a political and a motivational approach towards managerial questions. The quality of strategic management relies upon a well balanced mixture of approaches, depending on the nature of the problem to be solved. The motivational approach seems to be the most powerful eventually.