Improving the Quality of Community Care for the Chronically Mentally Disabled: The Role of Case Management

Abstract

This article draws upon an extensive case management literature in order to integrate a number of key concepts and findings that must be considered by those responsible for the planning, administration, and provision of effective community care to the chronically mentally disabled. A discussion of the reasons for the current popularity of the case management concept within human services is followed by a detailed presentation of the objectives, ideology, functions, and structural elements that characterize case management systems. A series of practical problems and issues that must be addressed to effectively implement a case management system are then identified and analyzed. Finally, a set of recommendations for those developing case management systems is offered, and a number of important unanswered research questions about the delivery and impact of case management services are identified.

Towards Structural Quality Indicators for Intensive Community-Based Care Programmes for Substance Abusers

“…First, they add several domains to the study of intensive community-based care: e.g., the forms and consequences of cooperation, means and preconditions, registration and evaluation, and the personal characteristics of staff. Second, this is the first attempt since Intagliata (1982) to organize the critical components of intensive community-based care in a theoretical manner rather than in a practical one (for example, presenting a model programme).…”

“…Although the programmes had a number of similar components, they differed on others. Intagliata (1982) noted that the programmes differed in comprehensiveness, in that some simply link a client to appropriate services (primarily providing outreach, assessment, planning, and referral) whereas others provide a more complete care package (including direct casework, advocacy, and monitoring). According to Mueser et al (1998), programmes not only differ in comprehensiveness, but also whether their goal is rehabilitation (providing practical services for this purpose).…”

“…Already in the 1980s, Intagliata (1982) recognised the importance of the broader services network and stated that intensive community-based care programmes needed to be built on existing system components; he also concluded that some new structures and mechanisms were needed. However, subsequent studies of intensive community-based care paid little attention to organisational structure.…”

La coordination des plans de services

“…Cette forme de support doit être disponible en tout temps et selon les besoins du client. (Intagliata, 1982;De Weaver, 1983). Quelle que soit la clientèle visée, l'objectif le plus fondamental consiste à assurer la continuité des services.…”

L’utilisation du plan de services individualisé en protection de la jeunesse

“…Un de ces facteurs est la charge de travail. Une charge trop lourde réduit la qualité et l'efficacité de la coordination en diminuant la fréquence des contacts entre le coordonnateur et les clients et en confinant les interventions à des réponses aux situations de crise (Cohn et De Graaf, 1982 ;Intagliata, 1982). Un autre facteur tient à la supervision offerte.…”