Skip to main content
Log in

Clinical care update: The chronically mentally ill

Case management-more than a response to a dysfunctional system

  • Published:
Community Mental Health Journal Aims and scope Submit manuscript

Abstract

The service systems which assist the long-term mentally ill to function in the community have been routinely described as fragmented and uncoordinated. The development and implementation of case management has been seen as one response to this dysfunctional system. This article examines case management from the perspective that case management is a needed function no matter how coordinated and integrated the system.

From this perspective, case management is driven by the clients' goals and not the systems' goals. Case management is viewed as a process by which the person with severe psychiatric disability is supported in negotiating for the various services that they want and need. Four unique activities are identified as performed by the case manager: Connecting with Clients, Planning for Services, Linking Clients with Services, and Advocating for Service Improvements.

Case management must be seen as a uniquely human response to the client's specific service needs and overall goals. For persons with long-term psychiatric disabilities, case management brings to life the human dimension of the human service system.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Similar content being viewed by others

References

  • Anthony, W.A., Cannon, J., Cohen, B.F., Cohen, M.R., Pierce, R.M., Spaniol, L., & Vitalo, R. (1980).Psychiatric rehabilitation practice series: Books 1–6. Baltimore, MD: University Park Press.

    Google Scholar 

  • Anthony, W.A., & Nemec, P. (1984). Psychiatric rehabilitation. In A.S. Bellack (Ed.),Schizophrenia: Treatment management and rehabilitation (pp. 375–413). New York: Grune & Stratton.

    Google Scholar 

  • Bachrach, L.L. (1976).Deinstitutionalization: An analytical review and sociological perspective. (National Institute of Mental Health, DHEW Publication No. ADM 76-351). Washington DC: U.S. Government Printing Office.

    Google Scholar 

  • Bachrach, L.L. (1983). New directions in deinstitutionalization planning.New directions for mental health services: Deinstitutionalization, 17, 93–106.

    Google Scholar 

  • Bagarozzi, D., & Kurtz, L. (1983). Administrators' perspectives on case management.Arete, 8, 13–21.

    Google Scholar 

  • Bigelow, D.A., & Young, D.J. (1983).Effectiveness of a case management program. Unpublished manuscript, University of Washington, Graduate School of Nursing.

  • Caragonne, P. (1981).An analysis of the function of the case manager in four mental health social service settings (Ph.D. dissertation). Ann Arbor: Dissertation Abstracts International, 41, (7), 3262-A.

  • Caragonne, P. (1983). A comparison of case management work activity and current models of work activity within the Texas Department of Mental Health and Mental Retardation. Report for the Texas Department of Mental Health and Mental Retardation, Austin, Texas.

  • Cohen, M.R., Farkas, M., Cohen, B.F., & Unger, K. (in press).Psychiatric Rehabilitation Trainer Package: Setting An Overall Rehabilitation Goal. Boston: Boston University, Center for Psychiatric Rehabilitation.

  • Cohen, M.R., Nemec, P.B., Cohen, B.F., & Farkas, M. (1988).Psychiatric Rehabilitation Trainer Package: Case management. Boston: Boston University, Center for Psychiatric Rehabilitation.

    Google Scholar 

  • Curry, J. (1981). A study in case management.Community Support Service Journal, 2, 15–17.

    Google Scholar 

  • Cutler, D., Tatum, E., & Shore, J. (1987). A comparison of schizophrenic patients in different community support treatment approaches.Community Mental Health Journal, 23, 103–113.

    Google Scholar 

  • Farkas, M., Cohen, M.R., & Nemec, P. (in press). Psychiatric rehabilitation programs. Putting concepts into practice.Community Mental Health Journal.

  • Field, G., & Yegge, L. (1982). A client outcome study of a community support demonstration project.Psychosocial Rehabilitation Journal, 6(2), 15–22.

    Google Scholar 

  • Franklin, J., Solovitz, B., Mason, M., Clemons, J., & Miller, G. (1987). An evaluation of case management.American Journal of Public Health, 77, 674–678.

    Google Scholar 

  • Goering, P., Wasylenki, D., Farkas, M., Lancee, W. (in press). What difference does case management make?Hospital and Community Psychiatry.

  • Intagliata, J. (1982). Improving the quality of care for the chronically mentally disabled: the role of case management.Schizophrenia Bulletin, 8, 655–674.

    Google Scholar 

  • Intagliata, J., & Baker, F. (1983). Factors affecting case management services for the chronically mentally ill.Administration in Mental Health, 11, 75–91.

    Google Scholar 

  • Joint Commission on Accreditation of Hospitals (1976).Accreditation of Community Mental Health Service Programs. Chicago.

  • Jordan, J. & Riffer, N.W. (1980).Taking constructive action: A guide to fieldwork. Albany, NY: Training Unit, New York State Office of Mental Health.

    Google Scholar 

  • Kurtz, L., Bagarozzi, D., & Pollane, L. (1984). Case management in mental health.Health and Social Work, 9, 201–211.

    Google Scholar 

  • Levine, M. (1979). Case Management: Lessons from earlier efforts.Evaluational Program Planning, 2, 235–243.

    Google Scholar 

  • Long, L. & Jacobs, E.L. (1986).A curriculum for working with the homeless mentally ill. Long Island City, NY: Human Services Program, La Guardia Community College.

    Google Scholar 

  • Marlowe, H.A., Marlowe, J.L., & Willets, R. (1983). The mental health counselor as case manager: Implications for working with the chronically mentally ill.American Mental Health Counselors Association Journal, 5, 184–191.

    Google Scholar 

  • Modrcin, M., Rapp, C.A., & Chamberlain, R. (1985).Case management with psychiatrically disabled individuals: Curriculum and training program. Lawrence, KS: University of Kansas School of Social Work.

    Google Scholar 

  • Muller, J.B. (1981). Alabama community support project evaluation of the implementation and initial outcome of a model case manager system.Community support services Journal, 6, 1–4.

    Google Scholar 

  • Murphy, J. (1985). Consumer perspectives on case management.Community Support Network News, 2(4), 9.

    Google Scholar 

  • Ohio Department of Mental Health (in press).Case management curriculum. Columbus, OH: Office of Education and Training, Ohio Department of Mental Health.

  • Rapp, C.A. (1983).Community mental health case management project: Final report. (Available from University of Kansas, School of Social Welfare, Twente Hall, Lawrence, KS 66045).

    Google Scholar 

  • Rapp, C.A., & Wintersteen, R. (1983).Case management with the chronically mentally ill: Results of seven replications. University of Kansas, School of Social Welfare, Trente Hall, Lawrence, KS 66045.

    Google Scholar 

  • Riffer, N.W. & Freedman, J.A. (1980).Case management in community based services. Albany, NY: Training Unit, New York State Office of Mental Health.

    Google Scholar 

  • Rogers, E.S., Cohen, B.C., Danley, K.S., Hutchinson, D., & Anthony, W.A. (1987). Training mental health workers in psychiatric rehabilitation.Schizophrenia Bulletin, 12, 709–719.

    Google Scholar 

  • Schwartz, S., Goldman, H., & Churgin, S. (1982). Case management for the chronically mentally ill: Models and dimensions.Hospital and Community Psychiatry, 33, 1006–1009.

    Google Scholar 

  • Texas Department of Mental Health and Mental Retardation (1986).Case management training curriculum. Austin, TX: Texas Department of Mental Health and Mental Retardation.

    Google Scholar 

  • Turner, J.E., & Tenhoor, W.J. (1978). The NIMH community support program: Pilot approach to a needed social reform.Schizophrenia Bulletin, 4, 319–348.

    Google Scholar 

  • Wasylenki, D.A., Goering, P.N., Lancee, W.J., Ballantyne, R., & Farkas, M. (1985). Impact of a case manager program on psychiatric aftercare.Journal of Nervous & Mental Disease, 173, 303–308.

    Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Rights and permissions

Reprints and permissions

About this article

Cite this article

Anthony, W.A., Cohen, M., Farkas, M. et al. Clinical care update: The chronically mentally ill. Community Ment Health J 24, 219–228 (1988). https://doi.org/10.1007/BF00757139

Download citation

  • Issue Date:

  • DOI: https://doi.org/10.1007/BF00757139

Keywords

Navigation