Abstract
BackgroundIn Japan, the mental health system has been shifting from hospitalization-based to community-based care; some organizations have gradually begun providing intensive case management (ICM) services. We developed an Intensive Case Management Screening Sheet (ICMSS) to screen for the need for ICM in people with mental illness.MethodsThe aim of this study was to examine the psychometric properties and discriminative ability of ICMSS. Subjects consisted of 911 people with mental illness. The ICMSS score was rated by a professional such as a nurse, social worker, or occupational therapist.ResultsExploratory factor analysis showed a one-factor structure with 14 items. The factor structure was supported by confirmatory factor analysis (comparative fit index, 0.98; Tucker–Lewis index, 0.97; root mean square error test of close fit, 0.05). In the receiver operating characteristic analysis for discriminating between users and non-users of ICM services, the area under the curve (AUC) for ICMSS was significantly larger than for Global Assessment of Functioning and Personal and Social Performance Scale, indicating better discriminative ability. However, the AUC for ICMSS was moderate. Thus, we suggest that the need for ICM services is determined by quantitative assessment (i.e., ICMSS) and clinical judgment.ConclusionICMSS is a brief tool for mental health professionals that will be useful in routine clinical practice. We expect that ICMSS will be used as a measure that reflects the views of professionals from various disciplines in Japanese institutions.
Highlights
In the context of deinstitutionalization, it is widely accepted that most people with severe mental illness do not need to reside in the hospital if they receive support from community mental health services [1, 2]
For the Japanese mental health system, we considered it important to develop a scale that comprehensively includes factors associated with the need for intensive case management (ICM) and is easy for professionals from various disciplines to rate
Using data from two institutions that voluntarily provided ICM services to people with mental illness [29, 30], we aimed to examine the psychometric properties of Intensive Case Management Screening Sheet (ICMSS) and its discriminative ability for users and non-users of ICM services
Summary
In the context of deinstitutionalization, it is widely accepted that most people with severe mental illness do not need to reside in the hospital if they receive support from community mental health services [1, 2]. The case manager’s role is to connect people with mental illness to necessary services; but with a staff-to-client ratio of approximately 50, interventions by the case manager and outreach services are poor. A case management model, which includes a staff-to-client ratio of less than 20, services directly provided by the case manager, and outreach services is generally considered intensive case management (ICM). In Japan, the mental health system has been shifting from hospitalization-based to community-based care; some organizations have gradually begun providing intensive case management (ICM) services. We developed an Intensive Case Management Screening Sheet (ICMSS) to screen for the need for ICM in people with mental illness
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