How Much Case Management Is Necessary?

Community mental health programs serving chronically and severely ill psychiatric patients have limited resources to optimize clinical effectiveness. These programs have developed varying intensities of community interventions and wraparound services to assist these patients and reduce their utilization of services. Investigators in Israel identified 370 patients with at least three hospitalizations in the prior 2 years. The researchers randomized 122 to clinical case management plus standard treatment and 95 to standard treatment alone; the remaining 153 patients, who could not be located or who refused treatment, were placed into a no-treatment comparison group.

Specially trained case managers carried caseloads of 30 patients and were expe…