Case management is the coordination of community-based services by a professional or team to provide quality

mental health Mental health encompasses emotional, psychological, and social well-being, influencing cognition, perception, and behavior. It likewise determines how an individual handles stress, interpersonal relationships, and decision-making. Mental health ...

care customized accordingly to individual patients' setbacks or persistent challenges and aid them to their recovery. Case management seeks to reduce

hospitalization A hospital is a health care institution providing patient treatment with specialized health science and auxiliary healthcare staff and medical equipment. The best-known type of hospital is the general hospital, which typically has an emergency ...

s and support individuals' recovery through an approach that considers each person's overall biopsychosocial needs without making disadvantageous economic costs. As a result, care coordination includes traditional mental health services but may also encompass primary healthcare, housing, transportation, employment, social relationships, and community participation. It is the link between the client and care delivery system.

Development

The case management model developed in the US was a response to the closure of large psychiatric hospitals (known as

deinstitutionalisation Deinstitutionalisation (or deinstitutionalization) is the process of replacing long-stay psychiatric hospitals with less isolated community mental health services for those diagnosed with a mental disorder or developmental disability. In the late ...

) and initially for provision of services which enhances the

quality of life Quality of life (QOL) is defined by the World Health Organization as "an individual's perception of their position in life in the context of the culture and value systems in which they live and in relation to their goals, expectations, standards ...

without the need for direct

patient care Health care or healthcare is the improvement of health via the prevention, diagnosis, treatment, amelioration or cure of disease, illness, injury, and other physical and mental impairments in people. Health care is delivered by health profess ...

or contact. Clinical or therapeutic case management then developed as the need for the mental health professional to establish a therapeutic relationship and be actively involved in clinical care, often in this only the personal and interpersonal resources are utilized. The process involved can be cyclical because of its client-centered nature. According to the

American Association on Mental Retardation The American Association on Intellectual and Developmental Disabilities (AAIDD) is an American non-profit organization focusing on intellectual disability and related developmental disabilities. AAIDD has members in the United States and more th ...

(1994) "Case Management (service coordination) is an ongoing process that consists of the assessment of wants and needs, planning, locating and securing supports and services, monitoring and follow-along. The individual or family is the defining force of this service coordination process." A more active form of case management is present in

assertive community treatment Assertive community treatment (ACT) is an intensive and highly integrated approach for community mental health service delivery. ACT teams serve individuals that have been diagnosed with serious and persistent forms of mental illness, predominantly ...

(or intensive case management, if the services go beyond the scope of time), this provides an approach in psychiatric case management with coordinated services that promote increased wellness for the management's (homes or agencies) population. This form of management is often a part of managed care systems and falls in legal trouble for coerced care, others include health maintenance organizations, point-of-service plans, and preferred provider arrangements. These managed care services utilise case management as a system to allocate lower-cost service options instead of higher-cost ones, such as outpatient therapy as an alternative to hospitalisation, this limits clients access to services and boxes the overall care to its limits.

Functions

Case management is about engaging the clients in a process, not processing clients, and the point of service is accountability. Hence, Rose and Moore in 1995 defined the following as case management functions: # Outreach or identification of clients # Assessment of individual needs # Service or Care planning # Plan implementation # Progress monitoring # Regular review and Termination In cases when re-assessment might identify more than one needs and they are required to be delivered, a new case management cycle is initiated. Cause of the new cycles initiated it is often critiqued that case management leads to dependence rather than independence. The case manager becomes an effective facilitator or enabler by use of self, understanding the social systems, the

etiology Etiology (pronounced ; alternatively: aetiology or ætiology) is the study of causation or origination. The word is derived from the Greek (''aitiología'') "giving a reason for" (, ''aitía'', "cause"); and ('' -logía''). More completely, e ...

of needs, and functioning of the clients. Moore in 1990s said that a case manager should possess the clinical skills of a

psychotherapist Psychotherapy (also psychological therapy, talk therapy, or talking therapy) is the use of psychological methods, particularly when based on regular personal interaction, to help a person change behavior, increase happiness, and overcome pro ...

and the advocacy skills of a community organizer. A client record is maintained by the case manager for effective delivery of services per agency policy. Newer forms of record keeping involve using checklist and scan sheets for decentralized and statistical outcome management. Others who have explained the functions and tasks of a case manager are Grube & Chernesky, 2001; Mather & Hull, 2002; and Vourlekis & Green, 1962.

Models

Several models of case management emerged to coordinate care for individuals with different assessment and re-assessments involved. These models differ in their approach to care, frequency of contact, the number of professionals and referrals involved. In addition, outcome evaluation is typically used to assess the effectiveness of treatment interventions. Researchers have developed fidelity measures to assess the implementation of a particular case management model. A 2010 review shows the following similarities and differences in different models of case management with regards to the way they operate:

Effectiveness of managed care models

systematic review A systematic review is a Literature review, scholarly synthesis of the evidence on a clearly presented topic using critical methods to identify, define and assess research on the topic. A systematic review extracts and interprets data from publ ...

investigated the effects of intensive case management for patients with severe mental illness:

Development

Functions

Models

Effectiveness of managed care models

See also

References

Further reading