EVOLUTION OF COMMUNITY MENTAL-HEALTH CASE-MANAGEMENT - CONSIDERATIONSFOR CLINICAL-PRACTICE

Case management has been the preferred method of helping persons with mental illness live in the community, This report examines the histori cal development of case management practice over the past 30 years, Th e analysis revealed that evolutionary growth in case management develo ped in response to expansion of community mental health services rathe r than consumer interests to improve their quality of life, Consequent ly, this reveals itself in the lack of outcome criteria needed to meas ure case management effectiveness, Currently, the concept of case mana gement is undergoing a revolutionary paradigm shift that is ''consumer -driven'' and responds to consumer concerns, However, as menial health care costs rise within a rapidly growing community mental health care system, managed care is being implemented as a method to contain thes e rising costs, Because of major differences in philosophical underpin nings, developments in support of public mental health managed care ma y jeopardize the genesis of consumer-driven case management by support ing case management models that reflect managed care ideology. Copyrig ht (C) 1997 by W.B. Saunders Company.