There has been little research to substantiate the nature and degree of self-esteem among persons with mental illness. The results reported here are from a study involving 92 clients with severe mental illness. The study explored the relation between work status and quality of life, drug attitudes, and self-esteem. In this analysis, positive self-esteem was found among all subjects and was significantly higher in workers than in nonworkers. In stepwise multiple regression analysis, feelings regarding functioning, valuing of work, social relationships, and activities with family explained 50% of the variance in self-esteem. Mental health professionals should not assume that clients with mental illness experience low self-esteem.
The majority of outcome studies on case management seem to have been studied on the chronically mentally ill patients. Little is known regarding the use of a case management approach with general psychiatric populations, which include non-chronically mentally ill patients in an outpatient setting. This study examined the effect of a registered nurse case management (RNCM) model on the delivery and cost of mental health services during an 18-month period for clients in an outpatient psychiatric setting. Sixty clients met the criteria for sample selection. The data indicated that the use of the RNCM model resulted in more nursing than psychiatric care. Despite more frequent visits to the RNCM and longer RNCM visits, RNCM services appeared cost effective and were related to decreased length of hospital stay. A subgroup of high-risk clients was identified, and a significantly greater use of services by this group was substantiated.
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