| The concept of case management as a way to coordinate services in a given community came from public health nursing and social work in the early 1900s (Sowell & Meadows, 1994). Over time, case management has become a more refined intervention to address the difficulties posed by the fragmentation and partial funding of services for persons who need long-term support and services (Baldwin & Woods, 1994). Traditionally, case management has been provided to persons who need extended, or even life-long care, such as people with serious mental illnesses or chronic medical conditions, abused and neglected children, the elderly, and those who are developmentally disabled (Rothman, 1992).
Case management has a different implementation history for each of these populations; yet commonalities exist for each group - namely, that case managers face clients with debilitating, long-term difficulties in a fragmented, ever-changing, and increasingly restrictive community service system (Rothman, 1992). For example, from the 1950s to 1970s, when many patients with severe mental illness were deinstitutionalized, case managers were enlisted to coordinate their extended care needs so that patients could be maintained in the community. However, resources that had maintained patients in the hospital were not transferred to community-based programs, leaving case managers with the difficult task of trying to coordinate the few existing services for these clients and extract services from fiscally strained community agencies (Rothman, 1992).
Go to section 2.1.1 Definitional Issues |