How Do Case Mangers Determine the Types of Services Provided to Users in the Intensive Case Management? A Longitudinal Study

Abstract

Introduction Intensive case management is an essential component of community mental health care system for people with severe mental illness. We examined the association of service types with previous and future functioning and hospital admissions using a longitudinal data, to clarify the case managers’ activity. Methods The study included baseline assessment, recording and analysis of services, and follow-up assessment. At the baseline and follow-up assessments, we examined functioning (ie, Personal and Social Performance Scale: PSP) and hospital admission of users for past periods. For recording and analysis of services, we recorded services provided by case managers over 2 months, and five core services were used for the analyses: regular face-to-face contact, outreach services, hospital-based (outpatient) services, and easy contacts and coordination. Results Outreach services were significantly associated with hospital admissions at baseline and follow-up assessments. Hospital-based services were significantly associated with lower PSP scores and hospital admission at follow-up assessment. Easy contacts and coordination were associated with lower PSP scores at follow-up assessment. Conclusion In Japan, most services are provided in the outpatient department of hospital, and outreach services are relatively time consuming for case managers; thus, the indications for providing outreach services need to be carefully considered. Therefore, we suggest that case managers provide flexible services to users according to the circumstances in Japan.