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After commissioner, what?

Published Online:https://doi.org/10.1176/ajp.142.6.752

One hundred nine psychiatrists who had been commissioners of state departments of mental health answered a questionnaire about their experiences after being commissioners. Most of these former commissioners got jobs they wanted after leaving the post. Those who experienced "decompression" adjustment difficulties tended to be less satisfied with subsequent jobs and were willing to serve again as commissioner. An important factor in decompression was a sense of loss and depression over having to abandon important unfinished work. The authors speculate that the large-scale opportunities for challenge and mastery characteristic of the job of commissioner are rarely matched in subsequent jobs.

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