Although case management is crucial to the delivery of mental health services to the seriously mentally ill, there is little understanding of what case managers actually do. The conventional view of the case manager role as an organizational linchpin is narrow and neglects the reciprocal and processual nature of the case manager role. In an effort to go beyond these limitations, a role-contingency approach is offered that assumes case managers perform a variety of therapeutic, interventive, and integrative functions for their clients along with the organizational-linchpin function. The frequency that each function is performed is dependent on service system, organizational, and client contingencies. Data from a study of 49 case managers in eight, countywide care systems in a northwestern state system based on the Community Support Program model provide support for the role-contingency approach. Additionally, the data show that the role most frequently performed by case managers is that of therapist/crisi...