Psychiatrists who become administrators often find themselves in an unfamiliar world of planning, budget and cost control, labor relations, and mental health law. They discover that the physical and mental demands of leadership are great, their role makes them highly visible, and their future is uncertain. Psychiatric administrators in general hospitals are in a unique position of competing for resources with medicine and surgery. In addition, the need for linkages to the community challenges the psychiatric administrator to deliver services to defined catchment areas, identify cases at risk, and establish halfway houses and similar facilities. While the author discusses primarily the stresses and problems of being a psychiatric administrator, he also says there are special satisfactions of the executive role.