April 23, 2015

Mental Health Case Management vs. Intellectual Disabilities Case Management




Case management services cover a wide range of services from foster care to hospice care. However, the two most widely recognized areas of case management are mental health (MH) and intellectual disability (ID) case management. Both MH and ID case management provide the basic functions of linking clients to community resources, coordinating services, and monitoring services. Both require a minimum of an undergraduate degree in psychology, counseling, or a human service related discipline as well as some experience in the field. However, there are some subtle and not so subtle differences in the way the case management services are provided.

Mental Health Case Management
1. Mental health case managers work with children with emotional and behavioral problems that are not diagnosed with intellectual disability. They also work with adults diagnosed with mental illness. They often work with clientele that are also dually diagnosed with mental illness as well as substance abuse.

2. Mental health case managers tend to be more active in the therapy and medication management services due to the tendency to be non-compliant. Mental health case managers provide an additional counseling component by encouraging clients to take participate in counseling and take medication as prescribed.

3. Mental health case management services tend to be short term and clients are usually discharged when they are considered stable and not in need of active case management.   


Intellectual Disabilities Case Management
1. ID case managers work with children who have been diagnosed with an intellectual disability. Intellectual disability is defined as having an IQ of 70 or below. Intellectual disability is categorized under four levels: Mild (IQ 50-70, Moderate (IQ 35-49), Severe (20-34), and Profound (IQ less than 20).

2. Unlike mental health case management, ID case managers usually provide services to clients who have both mental health an intellectual disabilities. Even in situations when the mental health disability is dominant, any diagnosis of intellectual disability is usually handled by an ID case manager.


ID case managers also work with people who also on the Autism Spectrum and have an intellectual disability. People who are on the autism spectrum are diagnosed with Autism, Asperger's Syndrome, or Pervasive Developmental Disorder.


3. Intellectual disability is a permanent disability requiring long-term support. ID case managers maintain cases for years (even decades) and rarely discharge clients unless they move out of the area or pass away.


4. Intellectual disability is more likely to be accompanied by significant medical issues such as seizure disorder, cerebral palsy, and Down syndrome.  ID case managers also tend to have clients who are non-verbal or have difficulty communicating their needs. In some cases of severe and profound intellectual disability, complete total care is needed to complete all daily living activities such as feeding, bathing, and getting dressed.  This requires more emphasis on monitoring for health and safety.