Behavioral health case management is a complex task that must incorporate strategies from multiple fields—social work, psychology, and medicine—to be successful. Despite its complicated nature, best practices for behavioral health case management can be summarized by three guiding principles: individualized care, professional responsibility, and a holistic approach to treatment. Each of these is an umbrella under which many aspects of effective case management fall.
It’s important to recognize that there is no one-size-fits-all approach to behavioral health case management. Effective case management must take each client’s unique combination of situations and needs into account. Case managers must listen to their clients, doing their best to avoid biases that may inappropriately influence decisions related to care.
The initial assessment is often the most crucial point where client-focused, individualized care must be exercised. The case manager should use this opportunity to establish any factors that may affect outcomes and quality of care, including:
Finances — A lack of funds may make recovery difficult and impede access to necessary medical care. Case managers can help low-income patients access available resources.
Current housing situation— The case manager should address whether or not the patient lives in a safe environment. In the event that a client is homeless, living with domestic violence, or is in another situation that negatively affects recovery, the case manager should help locate safer housing options.
Cultural competency — To best interact with clients from different socioeconomic backgrounds, case managers should understand where their patients come from.
Linguistic competency — When a case manager encounters a significant language barrier, he or she has a responsibility to refer the client to a colleague better able to manage care through fluent communication.
Substance abuse and dependency— Many clients who have been referred for other mental health issues have comorbid substance dependencies. An effective case manager should identify whether this is a factor and possibly refer the client to another case manager, as substance abuse case management has its own unique challenges.
Other health issues — A wide variety of physical illnesses are more prevalent among people with severe mental illness. Referral to medical doctors will likely be needed.
Each of these issues should also be reevaluated at regular points over the course of the patient’s care.
A case manager should also employ a strength-based approach that focuses on resolving problems through the cultivation of the positive aspects of a client’s life that promote mental well-being rather than on specific pathology. Points of focus should include:
- The client’s personal strengths and talents
- Positive interpersonal relationships in the client’s life
- Identifying realistic goals and discussing possible ways of achieving them
While it may seem obvious that effective case management requires professional rigor – case managers and social workers need a special kind of discipline. The following are indispensable for effective case management.
Case managers and their support staff must be sure to keep accurate, up-to-date records of their clients that are easily accessible when necessary. While in the past that meant detailed, hand-written notes kept in a physical folder, the transition to digital patient records has facilitated more diligent documentation along with more streamlined coordination of care.
Like other health services in the United States, behavioral health case management must comply with privacy standards outlined by the Health Insurance Portability and Accountability Act (HIPAA). This means that patient health information, including behavioral health information, may only be shared under certain circumstances, usually with the patient’s express permission. Additionally, case managers must also recognize when some patients with severe mental illness may not have the capacity to make decisions regarding the sharing of their information, as in the case of intoxication or temporary psychosis.
Social work isn’t easy. However, case managers have the responsibility to remain compassionate and to maintain a professional demeanor even when faced with the most difficult patients. At the same time, behavioral health case managers must also keep healthy professional boundaries. An overinvolved case manager is counterproductive to the client’s recovery.
Case management is a service with an ultimate goal that, at some point, the client will no longer need the help of his or her case manager. Care continued beyond this point often wastes valuable time—both the patient’s and the case manager’s—and limited community resources. Instead, the client should be counseled on his or her possible “graduation” from behavioral health case management.
It’s also important to recognize when the case manager–client relationship isn’t working out due to the lack of a “right fit.” When that happens, it’s necessary to give a referral to another competent colleague who may be a better match for a particular client.
Because of the interconnected nature of the mind and body, physical health influences mental health and vice versa. Thus, behavioral health case management and general health management should be integrated. An effective case manager should work to promote efficient coordination of care with both mental health and bodily health care providers.
Additionally, successful behavioral health case management should focus on all aspects of a patient’s life. A case manager should network with local community resource providers so as to better refer clients to available medical, social, educational, and vocational services.
Behavioral health case management should be outcome-based. A patient’s progress notes should highlight measurable indicators of success, which include:
- Increased quality of life.
- Higher level of functioning.
- Fewer days spent hospitalized (when applicable).
- Less dependency on community programs (when applicable).
Did you find yourself or your organization lagging behind while you were reading through the best practices above? There is always room for improvement! Some aspects of these best practices, such as maintaining proper levels of privacy and accurate documentation, may depend on choosing the right software for your organization.
If you have questions about how you can implement these best practices or evaluate your organization, Social Solutions is happy to help answer any questions you may have. Make sure you stay up-to-date with the latest news in the Health and Human Services space by heading over to our News page. See what is going on in your industry today!