We explore persistent and malleable beliefs within the mental models of decision makers when responding to a shock-induced organizational crisis. The empirical research was conducted with individuals at multiple levels within a single health service organization over a four-year period. The contested nature of defining customers in terms of either clients/patients or fundholders in the hybrid organization linked to normative-utilitarian dimensions of identity was found to be important to both persistent and malleable beliefs. The findings highlight considerable persistence in beliefs over time linked to normative factors associated with organizational identity or helping clients/patients with health recovery. This dimension of identity is part of the core driving philosophy of this health service organization. However, the findings also report malleable beliefs linked to factors associated with utilitarian (financial) dimensions of identity, as well as changes to objectives based on strategic options considered to resolve the crisis. The findings contribute to resolving prior contradictory empirical findings, within the domain of managerial and organizational cognition, when responding to external change. The findings also highlight fluctuations in consensus within decision makers when resolving an organizational crisis over time. Thus, the findings provide a counter-intuitive contrast to prior longitudinal studies which report unidirectional moves to consensus.