Front-Line Organization of the State Mental Hospital

The power of attendants at state mental hospitals to influence policy has often been noted. This paper suggests that the distribution of power in the state mental hospital fails to conform to Michels's iron law of oligarchy. From an analysis of the ward system, three main characteristics are derived. These are then stated as the formal characteristics of a front-line type of organization in which power tends to be distributed to peripheral units rather than to centralized positions of leadership. It is suggested finally that a front-line type of organization presents special problems of control and hence will tend to develop characteristic structures and processes of control as solutions. Dorothy E. Smith is lecturer, Department of Sociology, and assistant research sociologist, Institute of Human Development, University of California at Berkeley.