Am J Psychiatry 1995; 152:1259-1265
Copyright © 1995 by American Psychiatric Association
Case management in psychiatry: an analysis of tasks
WH Sledge, B Astrachan, K Thompson, J Rakfeldt and P Leaf
Department of Psychiatry, Yale University School of Medicine, New Haven, CT 06519, USA.
OBJECTIVE: The authors analyze the concept of case management from the
perspective of the task areas of psychiatry and demonstrate the importance
of case management in the organization of psychiatric services. METHOD: The
relevant literature was reviewed, and a functional analysis of current
practices is provided. RESULTS: Case management is an ambiguous concept
without a clear base in a professional discipline, and thus there is
ongoing uncertainty about its mission, practice, and training, as well as
authority and accountability issues. The activities of the case manager in
both the private and the public sectors entail work in the task areas of
medical care, rehabilitation, social control, growth and development, and
social welfare. In all of these areas, the case manager may function in
boundary management and in system enhancement and development as well as
provide clinical services. CONCLUSIONS: Case management has considerable
potential as a means of organizing and delivering mental health services in
a cost-effective manner as long as its purpose, practice, and
organizational structures are consistent. Psychiatrists should be involved
in the organization of case management services.
