What is a Mental Health Case Manager and What Do They Do?

According to the National Alliance on Mental Illness, approximately 51.5 million Americans experience mental illness. A more staggering figure follows this: 13.1 million Americans experience it so intensely that it makes daily life a challenge and a burden to them. Mental health case managers set their sights on those most vulnerable in our society—people with psychiatric illnesses, substance abuse problems, or other personal challenges—advocating for those who may be unable to do so for themselves.

Mental health case managers can be thought of as a safety net that helps to catch people who are in trouble. The purpose of the mental health case manager is to assist clients in connecting to resources that can considerably improve the quality of their lives.

These psychiatric professionals utilize cutting-edge psychological research and inquiry to best aid their patients in reintegrating into society comfortably and with an increasing emphasis on healthy self-reliance. Mental health case managers prioritize the biopsychosocial needs of the patient at all times, typically with a focus on minimizing the monetary cost to the patient.

Mental health case managers work intimately with their patients to develop treatment plans that are properly targeted at the patient’s needs. This involves a thorough assessment of the patient’s psychosocial triggers, strengths, and personal needs. They typically coordinate their databases of resources and other public or free-of-charge care providers to better help respective clients realize their own complicated and evolving personal goals.

Routine activities and responsibilities in the job of a mental health case manager include:

• Assessing patients’ needs and support systems
• Planning for crises and helping clients develop coping mechanisms
• Explaining these scenarios and their attendant concerns with compassion
• Coordinating and monitoring of the patient’s use of these services

This often entails referrals to the necessary medical professionals, hotlines, and other resources such as vocational training and low-cost housing.

In the initial assessment, a case manager follows procedures to build a diagnostic image of a client’s condition and the factors that might be contributing to it. In addition to a person’s mental health conditions, this might include their housing situation, language and composition ability, financial status, substance abuse history, traumatic history, and any and all other relevant details. For most of those in need of psychiatric care, the road to this point has been long and confusing. It’s the job of the mental health case manager to look closely into a patient’s life and use their expertise to help that person implement long-term solutions.

In the next phase, a strengths evaluation, mental health case managers utilize a model that aims to resolve and remove certain barriers to unassisted living and adult responsibility. The approach takes into consideration the positive aspects of a patient’s personality and how they can be used to support a more positive attitude. This sometimes means that the mental health case manager acts in a counseling capacity, helping the patient to identify healthy personal relationships and understand how those relationships can help the patient to chart a course with actionable steps.

This phase also typically includes introducing the client to a network of resources that the client themselves can access. The point of this is to move ever closer toward a more significant level of self-sufficiency for the patient—to empower them and show them a clear path to self-reliance. This might include forwarding information about a food pantry, helping them draft and print their resume, or assisting them in booking and attending a doctor’s appointment.

The final phase sees the frequency of follow-up visits diminish, hopefully with a view toward eventual discharge from whatever program the patient might be enrolled in. The main purpose of the follow-up phase is to determine whether the patient has taken the actionable steps outlined in meetings with their mental health case manager.

These outpatient assessments include looking for increased levels of adult functionality, fewer instances of hospitalization, increased quality of life, growing interpersonal relationships, healed (or healing) relationships with family members, and eventually, little-to-no reliance on community programs.

While a bachelor’s degree is the baseline standard for this field, many employers prefer that applicants have a master’s degree in a relevant field such as psychology, human resources, sociology, or social work.

Because the component factors of a client’s life underpin the causes and ongoing challenges they face, mental health case managers must be observant, intelligent, and flexible—ready to build solutions for people in crisis. In addition to a deep comprehension and history of study in mental health and psychiatric assessment, mental health case managers benefit from being fully rooted in their local communities. This helps them to know where best to direct patients in dire need, as well as build lasting relationships with other professionals in the community who offer guidance services to those in crisis.

A sense of honor and compassion should inform all that a mental health case manager does. Because many clients simply require accountability partners to keep them on track, positions often call on professionals to employ a robust array of current theories and methodologies.

Those mental health case managers who wish to go further than a BS in mental health services can attain board certification as a case manager. In fact, in recent years, an increasing number of employers are requiring this additional step as a sign of commitment to the continuing education required in this field.

For example, mental health case managers and psychiatric professionals can attain a professional credential from the Commission for Case Manager Certification (CCM). They must meet both educational and experience-related eligibility requirements. Those professionals holding the CCM designation must recertify every five years and provide proof of 80 units of completed continuing education modules or retake the certification exam.

Please note that there are varied state credentials (e.g., Florida Certified Behavioral Case Manager) related to this profession as well.

Mental health case managers can often be found in a wide range of settings, including home care situations, mental health clinics, hospitals, detention centers, substance abuse clinics, churches, and centers for the homeless. Mental health case managers and case psychiatric staff tend to go wherever their patients need them, including offering services out of their own offices, practices, and even personal residences, in certain special cases.

A mental health case manager can be an advocate, counselor, or teacher, depending on the patient’s unique need. In this capacity as a sort of jack-of-all-trades, mental health case managers can enact plans of outreach and follow-up, schedule doctor’s appointments (or assignation of a legal representative), and engage interagency collaborations to best utilize available resources for a patient.

The concept of the case management model was developed in the United States in the middle of the 20th century when major psychiatric hospitals and asylums all across the country began to lose funding and close. In the beginning, these models existed only to augment and enhance the quality of life for patients who had no choice but to be thrust back into daily life; this is, of course, before the human safety net of mental health case managers came into play.

The various models employed include:

• Brokerage: For very brief approaches to case management mental health managers will use this model to quickly broker services for clients in only one or two visits.
• Clinical Case Management: Utilizing environmental interventions, clinical skills, and personal relationships, mental health managers use the clinical case management model to provide ongoing and effective care.
• Assertive Community Treatment: The clients with the highest needs will often be assigned to an assertive community treatment model where they will have a team of providers who work with them 24/7 to ensure their safety. This care model is reserved for the worst cases such as schizophrenia and bipolar disorder.
• Intensive Case Management: Clients who need intensive ongoing care because of chronic mental illness may receive intensive case management. Care is constant and through but is designed for clients who are not a risk to themselves or others.
• Personal Empowerment or Strengths: By focusing on fortitude and places where the client can take charge, the personal empowerment or strengths model helps clients regain control of their lives.
• Rehabilitation: Patients work to recover from their mental illness under the rehabilitation model. This can be a long process and is often seen as a journey rather than an outcome. Often, this is an ongoing kind of mental health case management and is centered on the client’s goals.

These approaches help connect clients to resources, involve case managers in treatment, reduce hospitalizations of the patient, reduce emergency service use, supplement and encourage patient’s abilities and interests, enact a client disability engagement plan, and offer mutual aid and support for patients. Such paths often call for multidisciplinary teams of professionals who often utilize the patient’s family and friends to build a reliable and safe support structure.