Neglected Voices: Consumers with Serious Mental Illness Speak About Intensive Case Management

Abstract

This study explores early alliance formation between adult consumers with schizophrenic-spectrum disorders and their case managers from the consumers' perspectives using a prospective, cohort design. While quantitative studies have demonstrated positive links between the alliance and some client outcomes, such methods cannot reveal in concrete and authentic ways what consumers want in the case management relationship. This study finds that consumers can provide tangible and insightful information about the specifics of their case management relationships, confirming previous findings about the desire for connection with others, while extending it to include the desire for connection to the social world through the case manager relationship.

The Art of Helpful Relationships with Professionals: A Meta-ethnography of the Perspective of Persons with Severe Mental Illness

“…Furthermore, for professionals to be physically available, to be accessible and acknowledge requests when they occur [23, 24, 27, 29, 31-34, 37, 38, 41] and be able to help when challenges arise [22,23,27,30,31,36,39,41] is described as helpful. In addition, what can be called affective availability is described in the studies.…”

“…In addition, what can be called affective availability is described in the studies. This pertains to the fact that a professional is available for the individual because s/he cares about them, being there as a person for them [23,26,27,30,31,41]. ''She was there for me, not for her job or the system, but because she wanted to be'' [23, p. 476].…”

“…Participants in the included studies express appreciation for the concrete support that professionals have provided in terms of help with medication [36], practical, everyday life support [21-23, 30-33, 35, 36, 39, 41], support directed at the individuals' social life [23,31,32,35,36,38,41], and particularly support that is experienced as related to their life as a whole and not narrowly focused on mental illness [30,31,38,41].…”

“…The company of professionals is something that is described as positive by participants-'company of professionals' meaning having someone to be with [21,22,33] or doing social things with [23,28,32,38,41].…”

Understanding the Role of Individual Consumer–Provider Relationships Within Assertive Community Treatment

“…Qualitative studies have provided insight into what consumers find valuable in their relationships with providers; looking for common ground, feeling known, the importance of talk, and feeling like ''somebody'' (Ware et al 2004). Buck and Alexander (2005) applied this ''model of connectedness'' to case management relationships and found that consumers saw their case managers as an important conduit into the social world. In fact, the extent to which consumers articulated a desire for friendship with providers often challenges professional practice norms of maintaining clinical boundaries.…”