Effective Management Essay (Master of Nursing)

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This essay will discuss current literature on clinical case management in mental health in the Australian context. The terms relating to case management will be defined and explained. The essay will discuss and describe case management models and social models in mental health. In this essay my own clinical experience in case management will be highlighted. The issues of efficacy and effectiveness in clinical case management will also be addressed. The essay will identify and outline the groups that benefit from mental health case management. Finally, the essay will critically evaluate current evidence, benefits and limitation pertaining to case management in mental health. Rosen, Mueser & Teesson (2007) described case management as a heterogeneous range of methods applied in mental health, as well as other health welfare and service sectors. In the mental health service context, case management is defined by the same authors as the role of combining into one coherent system all services required to meet the consumer's needs, usually while he or she is living in the community but also during temporary hospitalisation periods (Rosen, Mueser & Teesson (2007). It essentially serves a problem-solving function and is designed to ensure continuity of services and overcome system rigidity, fragmentation, inaccessibility and the lack of accountability of mental health services (Bond et al 2001). It is commonly described as a flexible, planned and individualised approach to service delivery that provides consumer choice and maximises the efficient use of formal and informal resources in service provision. Elder, Evans & Nizette (2007) highlighted that in case management; the term case does not refer to the client or consumer but refers to the service provision. However, Roberts (2002) argued that defining case management is dependent on the specific model of case management being implemented. The same author suggested that there is no uniform definition that encompasses all aspects of case management and that it depends on the particular country's organisational framework of the health and social system (Roberts 2002). Case management is now the predominant form of service delivery in the community. According to the National Survey of Mental Health and Wellbeing, 60% of Australians with psychotic disorders reported attending community mental health centres, and 56% had a case manager (National Survey of Mental Health and Wellbeing 2001). The majority of case management programs target vulnerable patients with prolonged psychiatric disorders who need interventions that will optimise their adjustment to community living and minimise their functional disabilities. Kelly et al (2006) suggested that it is more appropriate for clinicians working within Australian community mental health services to utilise a clinical case management framework where typical interventions include supportive counselling, skill development and the promotion of medication adherence (Kelly et al 2006). Harvey, Gursansky & Kennedy (2002) supported that case management in community care has a long established history in Australia and the practice approach is pervasive across the disability, mental health, ageing and child, adolescent and family support arenas. Harvey and colleagues reiterated that case management in this context is recognised as having the potential to lead to better outcomes for clients being supported to live in the community and the potential to reduce the cost of service provision by keeping people out of residential care (Harvey, Gursansky & Kennedy 2002). However, Smith & Newton (2007) claimed that despite the widespread implementation of case management there remains some debate fuelled by contradictory findings regarding the effectiveness of this treatment (Smith & Newton 2007).

In community, people with severe mental illness should receive an integrated package of assessment, planning, linking,...
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