Behavioral health case management is a complex task that must incorporate strategies from multiple fields—social work, psychology, and medicine—to be successful. Despite its complicated nature, best practices for behavioral health case management can help practitioners properly assess patients, provide necessary therapy, and create effective treatment plans.
According to the Center for Behavioral Health Statistics and Quality, one of the most important steps in providing quality behavioral health care is establishing a strong therapeutic relationship between the patient and therapist. This relationship should be built on trust, understanding of patient intent, reality-based information about the patient’s needs, appropriate boundaries with the patient, acceptance of the patient’s values without judgment or demands for change, and compassion for all aspects of their care.
Care should be personalized and client-focused
There is no one-size-fits-all approach to behavioral health case management.
Case managers must listen and evaluate each client’s unique needs in an unbiased way.
Step One: The Initial Assessment
The case manager use this initial meeting to assess any factors that may affect outcomes and quality of care, including:
Financial security — The impact of a lack of funds in a person’s life can be significant and may impede one’s access to necessary medical and behavioral health care. Accessing available resources can be difficult for people with low income or no income at all, and financial assistance programs can be difficult to navigate alone. Case managers can take proactive steps to address financial strain by helping clients access resources.
Housing — Behavioral health clients need a safe, reliable shelter environment to help them recover. Case managers can help assess a client’s housing situation and locate safe housing options, if needed.
Demographics and background — Case managers should have knowledge of where the person they’re helping comes from and be able to address those unique circumstances. Cultural competency helps case managers improve interactions with clients from diverse backgrounds and develop trusting relationships. Similarly, case managers encountering language barriers are obligated to refer that individual to a colleague who can better communicate with them and establish trust.
Mental and physical health – Clients with severe mental illness may present with other physical comorbidities – such as cardiovascular disease, diabetes, and cancer – which means case managers can intervene to ensure proper medical care is arranged.
Substance use disorders — As a case manager, it’s important to address how substance abuse is affecting your clients. If you see signs of substance abuse, there are effective steps you can take to refer them to another case manager who has experience in substance use disorder and dependency case management.
These criteria are fluid and can change rapidly. Case managers should check in with clients on their financial status, housing, and health indicators at regular points over the course of care. This will help identify and address problems as they develop and allow for optimized treatment.
Pro-tip: Try using a Strengths-Based Approach
A strengths-based approach that focuses on the cultivation of positive aspects of a client’s life, such as personal strengths and talents, positive relationships, and realistic goals is recommended. These approaches may be centered around:
Talking about the client’s strengths and talents.
Considering the client’s interpersonal relationships.
Identifying possible ways to achieve realistic goals.
Discussing other areas for improvement and how they should be addressed.
Strike the balance between discipline and compassion
Behavioral health case managers straddle a fine line – they must be compassionate and able to feel empathy of their clients’, but also need to uphold healthy professional boundaries and avoid getting too involved.
Privacy Requirements
Like other health fields, behavioral health service providers must adhere to privacy guidelines outlined by HIPAA. Client health information and data can only legally be shared under certain circumstances, usually with the patient’s express permission. Clients utilizing behavioral health services are particularly vulnerable to privacy violations, and it’s critical for case managers to do what they can to protect their clients. Case managers may also need to make judgment calls if a client may not be able to make informed decisions about disclosing sensitive information. This is especially true if clients struggle with severe mental illnesses, or if a client comes from a background of substance abuse.
Documentation
Case managers should try to document as much of their client interactions as possible. By maintaining records and thorough case notes, case managers can easily evaluate how clients are doing and identify areas where they might need more assistance. Each client should have their own case file with background information, their full care plan, and success metrics.
Compassion
Working with clients who require behavioral health services is no easy task. The challenges these types of clients face must be handled with care and compassion. As a case manager, it’s vital to advocate for your clients in the ways you can without compromising on your own boundaries. Otherwise, you run the risk of burnout, which doesn’t help you or your clients.
Discontinuation of Services
At the end of the day, clients should feel empowered and well-equipped to walk their life paths with little assistance from organizations. As clients work through their care plan, they should gradually feel less dependent on their case managers. When developing a care plan, case managers should work closely with other providers and their clients to develop unique milestones for “graduation.” And when it’s time for a client to move forward, take that time to celebrate with them, knowing that your organization will be there if they need to reach out again for assistance.
Take a holistic approach
Physical health and mental health are often intertwined and influence one another. Often, if a client requires behavioral health services, then they will also benefit from additional health services, even if your organization is unable to provide them. Looking at the full picture of a client’s background, circumstances, and environment makes a huge difference in your client’s success across a continuum of care.
Success should be measured by client outcomes that extend beyond just mental wellness. While each client is different, in general, some key indicators a client is doing well with their case plan include:
Overall improvement in quality of life.
Less dependence on community programs/services.
Less time spent in residential treatment.
Fewer days in the hospital.
Higher level of independent functioning.
Incorporate and apply these behavioral health case management best practices with the right software
Case managers have a lot to juggle — especially in behavioral health fields. CaseWorthy makes it easier to complete administrative work and organize case data so you can spend more time focusing on your clients. With CaseWorthy, case managers can write notes or use speech-to-text, build custom care plans, request referrals, and monitor client progress.
