Exploring and managing paradoxical tensions within social non-profit organisations in the health care industry

Abstract

Purpose – Health care is complex and expensive; the industry is struggling in varying degrees to maintain financial sustainability in an uncertain and changing environment. Mental health disorders have increased significantly, yet even more by the impact of the covid-19 pandemic. Around the globe about one billion individuals are affected by mental disorders, nonetheless mental health is one of the most neglected areas of public health care. Non-profit organisations aim to bridge the gap in public health care service, while facing paradoxical tensions. The purpose of this study is to examine paradoxical tensions and management approaches within non-profit organisations in the field of mental health focusing on eating disorders, in order to deepen the understanding of these organisations and to improve their ability of managing paradoxes in a more efficient way. Methodology – This in-depth, descriptive case study consists of an inductive approach aimed at exploring paradoxical tensions and their relations with another. The author collected data primarily via interviews, in order to perform a qualitative content analysis. Findings – Health care non-profit organisations in the field of mental health are rife with paradoxes, most of them already have been discovered in paradox literature and can be easily allocated to the four types of paradox: learning, organizing, performing, belonging. Whereas others, are absolutely unique and sector specific. The umbrella paradox (financial sustainability – social responsibility) and further sub paradoxes are interlinked with one another and build a complex system. For managing paradoxical tensions, non-profit organisations highlight the importance of communication, transparency and the value in both/and thinking, in order to balance between opposing poles of paradox. Value – This study will contribute to the organizational literature on paradoxes by empirically examining the essential but under-researched theoretical link between paradox and non-profit organisations in the health care sector. Moreover, to provide management-assistance for non-profit organisations by introducing a tool to assess and maintain a complex and dynamic system of interwoven paradoxes.