Case Management

I appreciate the faithful and well-written summary of my invited lecture at the recent Institute on Psychiatric Services in Los Angeles that appeared in the November 20 issue. There is one area that may be confusing. Following the lead of Dr. Leonard Stein and Joel Kanter, I tried to make the point that the role of a solo case manager is a tenuous one, at best. The case managers usually are not paid enough to remain in their job indefinitely and, if they are engaged by the work, they may leave to return to school. When an important support is removed, the consumer is subject to relapse. Often, those professionals who are paid more or who have terminal degrees may end up being the true case managers. The ideal situation is a team, which provides cross coverage. The team approach provides sustaining support even if a member leaves or is out for vacation or illness. The more permanent the support, the more sustained are the relationships and the less subject patients are to relapse due to the removal of important supports.

Once again, we thank you for the opportunity to disseminate the vision that informs our program, Mental Health Connections.

Joel S. Feiner, M.D.
Dallas, Tex.