What Is a Mental Health Case Manager?

Case managers often form the front line of treatment for people with mental illness. They coordinate care and track the progress of patients who suffer from severe and debilitating mental health disorders such as bipolar disorder and schizophrenia. Above all, their role is to help patients navigate the complex network of clinics, doctors and community resources that can be daunting to patients and their families.

Function

• A case manager's chief function is to arrange continuous, integrated care for people with mental illness, according to the U.S. Surgeon General's Office. Duties can range from simply helping patients access treatment resources to actively participating in the patient's care. Case managers see themselves as advocates for patients, according to the Case Management Society of America. Their expertise in the mental health care system helps them guide patients to the right resources in a community treatment setting.

History

• Case management gained popularity in the 1980s, as mental institutions fell out of favor and more people with major mental illness were reintroduced to the community. There they faced a fragmented system of care and inadequate community resources that often made it difficult to live with mental illness. Case managers were conceived as the liaison between patients and a treatment regimen previously administered in a hospital setting. They aim to offer a cost-effective and more humane approach to treating mental illness than institutionalization.

Benefits

• A 1989 study by Andrew Borland, published in the journal, Psychiatric Services, found that intensive case management helped stabilize psychiatric patients, reduced the time they spent in hospitals and cut down on their use of emergency services. However, a 1991 study by Ronna Chamberlain, published in the Community Mental Health Journal, found that, in practice, case management could refer to a broad range of services, each yielding different outcomes.

Considerations

• Some critics of the case management model argue that case managers are not as effective at treating major mental illness as are doctors in a clinical setting, where medication can be supervised and stress can be regulated in a controlled environment. Case managers are not psychiatrists or psychologists, but are typically social workers trained to connect patients to resources, not to ensure that they use those resources. They are, critics point out, only as effective as the cooperation they get from the patient.

Alternatives

• Many community mental health programs have begun using peer advisors, who also cope with mental illness, along with case managers as a support network for patients. A 1995 study by C.J. Felton, published in Psychiatric Services, found that patients with a support network that included peer specialists showed greater gains--including better self-image, outlook and social support structures--than those with case managers alone.