The goal of this article is to describe the role of the psychiatrist as a member of an organisation. In Holland 80% of the practising psychiatrists is working in institutions. The role of the psychiatrist in hospitals as well as in out-patient departments has changed a lot. He is no longer working on his own. He leads a team or is a member of it. He belongs to the medical staff and sometimes is its chief: he also can be the director of a hospital. Outside the hospital he is held responsible for the cooperation between residential and out-patient activities. In all these different situations the psychiatrist has a professional role as a medical specialist but at the same time as a member of an organisation. As member of a team he is responsible as well for the vision on treatment as for the control of the treatment process itself and of the treatment outcome. If he is the leader of the team his role is that of a coordinator, evaluator, informer, conflictsolver, bargainer, planner, decisionmaker and guiding spirit. Cooperation between different teams can be his concern; for example the intake policy. In the medical staff psycjiiatrists help each other to maintain professional credibility. There they develop a medical policy for the hospital and from there they advise the board of directors. In the daily practice of hospital-care these roles are very underdeveloped. The same is true in out-patient care. The psychiatrist there is most of all a teamcoordinator, but he doesn't coordinate very much. He also has a role in developing cooperation between residential and out-patient care. His responsibilities are:
- regional interests of mental health care (prevention, epidemiology, etc. etc.);
- maintainance of quality;
- continuity of care between residential and out-patient departments.
To be able to perform all this the psychiatrist needs knowledge and abilities to bargain , to solve conflicts, to select priorities, to make decisions and to implement on a regional level. It is also important for him to know how to handle the political situation. A more appropriate training seems necessary to fill the gaps which frequently exist at present in the knowledge required for this rather complicated task: An important point to concern for the dutch psychiatrie association.