Case Management for the Chronic Mentally III: Models and Dimensions

Community-based care of the chronic mentally ill requires the integrative efforts that generally fall under the rubric of case management. The authors describe models of case management according to three dimensions: the manager's degree of involvement in direct service, the type of caseload, and the source and extent of the manager's control over services and resources. The last dimension can be affected by such factors as contracts with private service providers and the case manager's rapport with clinical service providers. Various systemic problems, such as insufflcient funds and duplication of services, may impede case management. Effective case management depends on adequate resources and clear communication among the components of the system.