This paper reports the preliminary results of a study on the implementation of case management in the community psychiatric nursing service (CPNS). The purpose of the study is to compare the outcome of case management service with the conventional practice of CPNS in the care of chronic schizophrenic clients. The impact of case management service on clients' clinical status, functional level and satisfaction was measured. A matched, pre-post, case-control group design was used to compare case management and conventional care groups. A specific case management model based on the practice at Carondelet Saint Mary's Hospital and Health Centre in Tucson has been developed to care for the schizophrenic clients in the community. Subjects in the experimental group were cared for by CPNs using this case management model. Subjects in the control group were cared for by CPNs based on current practices in the CPNS. Pre- and post-measures were taken upon recruitment and at 5 months later. Findings showed that the experimental group had better outcome in terms of their mental status and functional level when compared with the control group. They were generally more satisfied with the service. When comparing case managers' role with that of conventional CPNs, case managers performed more in areas such as assessment, liaison, case discussion and life skills training. This study demonstrates that this particular model of case management can be effective in caring for clients with long-term mental health problems in Hong Kong.

PURPOSE.To explore the roles, functions, and work practices of case managers and their perceptions on the implementation of case management in the Comrnu nity Psychiatric Nursing Services. METHODS.A qualitative descriptive approach was used. Data were collected from daily reports, field observations, reflective diaries, and small group interviews.FINDINGS. The study showed the work practices of case managers were more intensive compared to the conventional community psychiatric nursing practice, and there was more involvement of clients and their family in the treatment process.Case managers identified liaison, coordination, supportive and family counseling, and teaching practical living skills as their important roles.CONCLUSIONS. This study provides valuable information in understanding the process of case management and contributed to the development of case management as a care delivery model in Hong Kong.