Although case management is an important component of treatment for persons with major mental illnesses, little is known about who works in case management, what functions are performed and how much occupational stress case managers experience. Mental health care managers (CM's) throughout the state of Oregon (N = 216) completed an inventory of case management functions and the job dissatisfaction and occupational stress scales of the Medical Personnel Stress Survey-Revised. The average expected tenure for a CM was 11 years, although one fifth expect to be a CM for four years or less. CM's spend 36% of their time performing administrative tasks, 20% in therapy, 17% with skills training, and 18% in case coordination tasks. CM level of education was associated with a different distribution of effort across case management functions. Greater job dissatisfaction was associated with specialized training, larger case load size and greater intention to leave the position. Consumer CM's demonstrated equivalent levels of job satisfaction as their non-consumer colleagues. The relevance of the project's findings for human resource management are discussed.

The purpose of this study was to identify changes in case management within public sector mental health, following the implementation of managed care. Case managers in the State of Oregon completed surveys in 1992 and 2000 regarding aspects of case management. Results showed that current case managers are more experienced and expect longer tenure than previously. Caseload sizes have increased. Meanwhile, case managers' activities and functions have not changed across time periods. The results suggest that mental health personnel have changed in the past decade, though the practice of case management has remained largely the same.

A great deal of discussion and research has gone into defining and clarifying the role of "case manager" (CM) for persons with severe mental illness. This three state survey examines the philosophy and activities of practicing CMs in an attempt to identify current styles of case management. A cluster analysis based on CM rankings of five CM functions suggested four styles of case management: "supportive social workers", "individual therapist", "therapist broker", and "community advocate". Overall, CMs rated supportive interventions as most important and formal psychotherapy as relatively unimportant. CM style was related to CM activity (i.e., distribution of effort). Differences between states are noted and implications for future research are discussed.