Case Management for Individuals with Severe Mental Illness: Outcomes of a 24-Month Practice.

Abstract

OBJECTIVE The aim of this study is to conduct a case management model on a group of individuals with severe mental illness (SMI) and to evaluate the outcomes during a 24-month follow up. METHOD A total of 34 patients diagnosed with schizophrenia or schizoaffective disorder with at least one exacerbation over the last year, poor treatment compliance, who were unemployed and unable to live independently and who gave consent to participate were included to the study. Case management was conducted by a medical professional in the house, schizophrenia association, hospital, and workplace of the patients by interviewing the patients, family members, and the employers of the patients, at intervals arranged according to the need of each patient. Patients were assessed at baseline stage, the sixth, 12th and the 24th month regarding functionality, clinical condition, treatment compliance and family burden. RESULTS The study was completed in 24 months with 30 patients with a mean age was 36, mean education level of 11 years, and a mean illness duration of 13 years. The majority consisted of unmarried males living with their parents. During the follow up, every patient participated in the recommended rehabilitation programs with, improvement in treatment adherence and functionality. A significant decrement was detected in the number of hospitalizations when compared to the history before the start of the study. Family burden decreased. Ten patients got employed and 3 patients left work. CONCLUSION It can be concluded that case management hypothesized to be beneficial for people with SMI with positive outcomes on clinical recovery, improved social and vocational functionality and reduced incidences of hospital stay should be included as a routine psychosocial rehabilitation service.